Inclusive HIV Prevention in South Africa: Reaching Foreign Migrant Adolescent Girls

Miriam Temin,Jonathan Cockburn,Cecilia Milford,Debbie Van Zyl,Mags Beksinska

doi:10.3389/frph.2021.629246

Abstract

Within South Africa's HIV epidemic, foreign migrant adolescent girls and young women (AGYW) face unique challenges in an environment typified by xenophobia and structural inequity. The intersection of age, gender, and migrant-related factors creates threats that may exacerbate their HIV risk, including discrimination, limited social capital, and economic dependency. This paper explores HIV-related determinants of risk from the perspective of foreign migrant AGYW who participated in a Girls' Club project implemented by Community Media Trust. Within clubs, foreign migrant AGYW met weekly with a female mentor to discuss HIV, safety planning, financial literacy, and other topics. Focus group discussions (FGDs) were conducted with club members and parents to learn about pressing challenges in a context characterized by early sexual debut, high rates of teenage pregnancy, and relationships typified by material exchange. FGDs addressed HIV risk factors such as social isolation and limited access to services, exacerbated by migrant-related stigma and discrimination and lack of identity documents. The foreign migrant AGYW appreciated the role of the Girls' Clubs and mentors in helping them overcome barriers to school and health services as well as building their social and other assets. FGD results indicate that HIV prevention in South Africa should prioritize action to address the specific determinants of foreign migrant AGYW's HIV risk, as well as inclusive policies that recognize migrants' heterogeneity based on gender and age.

Highlights

South Africa has the largest HIV epidemic in the world, with an estimated 7.5 million people living with HIV [1]
This paper explores the ways that being a young female migrant in South Africa can drive risk, including barriers and facilitators to uptake of sexual and reproductive health (SRH) services
The foreign migrant AGYW who participated in Focus group discussions (FGDs) were broadly similar between Durban and Johannesburg, with a few notable differences (Table 1)

Summary

Introduction

South Africa has the largest HIV epidemic in the world, with an estimated 7.5 million people living with HIV [1]. A number of campaigns have been designed and implemented with the goal of reducing adolescent girls’ and young women’s (AGYW) HIV incidence. Up to 4 million foreign migrants lived in South Africa in 2017 according to a UN Department of Economic and Social Affairs (UNDESA) estimate [6]. Within this population, the large number of foreign migrant AGYW may face unique challenges above and beyond the broad challenges AGYW face in South Africa. While adolescent-specific evidence is limited, focus group discussions carried out with 79 mixed female migrants in Cape Town indicated that all participants experienced xenophobia at both the community and official levels [7]

Methods

Results

Discussion

Conclusion