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Assessing the Bumb’INGOMSO HIV prevention programme

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Tafara Ngwaru

Alexandra Doyle Gabriella Elte Johanna Wallin Joy Banda Katharina Keck Sean O'Leary Stephanie Brockerhoff Tafara Ngwaru

Working in Buffalo City municipality, the programme includes four integrated interventions that aim to impact behavior change, strengthen health service systems, combat gender-based violence, and expand access to economic opportunities for young women.

Challenges

The probability of HIV infection in South Africa is highest in the decade after leaving school. Young women are particularly at risk, and have a much higher HIV incidence rate than the general population – 2.5% compared to 1.7% (Shisana, 2012). However, due to different behavioral and structural risk factors, prevention approaches have to be tailored to the characteristics of specific locations to be successful.

The Bumb’INGOMSO HIV prevention programme was designed as a combination of interventions that address the particular structural, behavioural, and biomedical HIV drivers of HIV epidemics in different settings. The mix of interventions differs by location and target group, to respond appropriately to variations in risk factors and service delivery gaps.

Our approach

We produced two baseline assessments to guide the targeting, delivery, and evaluation of the Bumb’INGOMSO HIV prevention programme. Through geospatial mapping of HIV prevalence and associated risk factors, ‘pockets’ of HIV risk were identified as potential target areas for the HIV prevention programme. Recommendations focused on aligning intervention strategies with varying patterns of HIV distribution and service availability.

The approach to the primary baseline assessment is responsive to the targeting and design of the intervention components of the HIV prevention programme. The baseline assessment follows a mixed methods approach, including a household survey, focus group discussions, in-depth interviews, and key informant interviews. The qualitative studies focus on exploring the underlying assumptions around each intervention component’s theory of change.

Outcomes

We provided practical recommendations to guide the targeting and delivery of the HIV prevention programme. Our findings and recommendations were shared with the service providers, who will implement the intervention components.

Our baseline assessment is expected to form the basis of a rigorous, theory-based impact evaluation that will establish whether the programme has resulted in changes in sexual behavior, risk perception, and uptake of health services. In addition, the baseline findings will also contribute to understanding the pathways through which structural and behavioral risk factors shape HIV risk for young women.