'A spade was called a spade...it was not called a gardening tool...': Youth and intervention implementers' perceptions of a resilience-based HIV prevention intervention for reducing risky sexual behaviors among youth in South Africa
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- Fungai Mbengo; Esther Adama; Amanda Towell-Barnard; Maggie Zgambo
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Background: Youth (15-24 years) in South Africa remain at high risk of HIV infection despite interventional efforts to control the disease. Programs directed at promoting resilience or protective factors in youth have been recommended as a multifaceted approach to mitigate risky sexual behaviors associated with HIV infection among youth. However, limited research exists on how relevant stakeholders, such as youth and intervention implementers perceive resilience-based HIV prevention interventions targeting youth. This study explored youth and intervention implementers’ perceptions of a resilience-based HIV prevention intervention (You Only Live Once) aimed at reducing risky sexual behaviors among youth in South Africa. Methods: Semi-structured interviews were conducted with 10 youth who participated in the intervention and four intervention implementers at a not-for-profit organization in Maluti-a-Phofung Local Municipality, South Africa. Data were analyzed using thematic analysis. Results: Three main themes emerged from the data: (1) Acceptability and impact of the intervention– the intervention was perceived as important and helpful in fostering positive behavior change among youth and enhancing their sexual health and social skills knowledge; self-confidence; and relationships with parents and peers. (2) Factors influencing intervention implementation – participants reported several multi-level factors which impeded or promoted the implementation of the intervention. (3) Recommendations to improve intervention implementation – participants made suggestions on how intervention implementation could be enhanced. Conclusion: These findings suggest that resilience-based HIV prevention interventions are acceptable to young people in South Africa and have potential to mitigate their vulnerability to HIV. Implementation of resilience-based HIV prevention interventions targeting youth is linked to several multi-level factors that need to be considered for successful implementation.