Abstract
Efforts to engage adolescent girls and young women (AGYW) in HIV services have struggled, in part, due to limited awareness of services and stigma. Strategic marketing is a promising approach, but the impact on youth behavior change is unclear. We report findings from a mixed methods evaluation of the Girl Champ campaign, designed to generate demand for sexual and reproductive services among AGYW, and piloted in three clinics in the Manzini region of eSwatini. We analyzed and integrated data from longitudinal, clinic-level databases on health service utilization among AGYW before and after the pilot, qualitative interviews with stakeholders responsible for the implementation of the pilot, and participant feedback surveys from attendees of Girl Champ events. Girl Champ was well received by most stakeholders based on event attendance and participant feedback, and associated with longitudinal improvements in demand for HIV services. Findings can inform future HIV demand creation interventions for youth.
Highlights
In Sub-Saharan Africa, four in five new human immunodeficiency virus (HIV) infections occur among adolescents aged 15–19 years old, with adolescent girls and young women (AGYW) disproportionately affected [1,2,3,4,5]
Efforts to improve the uptake of sexual and reproductive health (SRH) services globally including pre-exposure prophylaxis (PrEP) and HIV testing and care among adolescent girls and young women have been hindered by fragmented programs and services, poor outreach and communication, and limited service demand [12,13,14,15,16,17,18,19]
Girl Champ was piloted in the tinkhundla served by three clinics in the Manzini region: Project Last Mile (PLM) worked with local stakeholders to co-create Girl Champ using participatory market research approaches that are typically deployed in the private sector to design communications that attract consumers to brands and products [46,47,48,49,50]
Summary
In Sub-Saharan Africa, four in five new human immunodeficiency virus (HIV) infections occur among adolescents aged 15–19 years old, with adolescent girls and young women (AGYW) disproportionately affected [1,2,3,4,5]. HIV prevalence is five-times higher among young women 20–24 years old (20.9%) than young men of the same age (4.2%) [6]. Despite their high risk, youth continue to have lower HIV testing and treatment rates, poorer sexual and reproductive health (SRH) outcomes, and are consistently missed by large-scale “treatment as prevention” efforts in Sub-Saharan Africa [7,8,9,10,11]. Efforts to improve the uptake of SRH services globally including pre-exposure prophylaxis (PrEP) and HIV testing and care among adolescent girls and young women have been hindered by fragmented programs and services, poor outreach and communication, and limited service demand [12,13,14,15,16,17,18,19]. Strategic marketing has been used to develop effective messaging to promote voluntary medical male circumcision
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