Table 1.

Descriptions for iterventions for young people

Intervention/country	Aim	Intervention method/design & duration	Target group &Sample size	Outcomes/results
Economic empowerment of women
1) Shaping the Health of Adolescents in Zimbabwe (SHAZ!) Program[20]	Increased knowledge, Increased economic empowerment, Reduced inter-generational TS	Pilot study	- 50 poor orphaned, out-of-school, girls aged 16-19 years	- Increase in HIV-related knowledge and relationship
		- Uncontrolled study for 6 months		- Power, no significant change in current sexual activity or condom use at last sex
		- Microcredit loans	- Living on the	- Increased relationship power[21]
		- Business skills training	outskirts of Harare, Zimbabwe	- Increased HIV risk through new mobility and economic strategies
		- Mentorship	- 315 aadolescent girls, orphans, average age 18	- Increase in HIV-related knowledge and relationship power, no significant change in current sexual activity or condom use at last sex
		Phase II study:
		Randomized clinical trial (RCT)
		Study		- Decrease in food insecurity
		Duration 24 months, Adaptation of Stepping Stones, including expanded training including negotiation skills, Integrated social support		- Increase in equitable gender norms
				- Physical and sexual violence reduce by 58% over a 2-year period
		Access to HIV and reproductive health services
2) Intervention with Microfinance for AIDS & Gender Equity (IMAGE)[22, 23], South Africa	Reduced HIV risk behaviour	Cluster randomised trial, duration of 3 year	- A sample of 430 poor women aged 14-35 years identified through participatory wealth ranking	- 55% increase in experience of IPV after 1 year
				- Increase in HIV knowledge, communication, testing & risk reduction
				- 32% reduction in communication with household members to young people in households
				- Greater involvement in collective action and social groups
				- No impact on HIV incidence in wider community
				- No difference in unprotected sex at last occurrence with non-spousal partner in past 12 months
				- 11% increase in condom use
				At last sex
		- Microfinance (individual borrowing and repayment of loans over 10 or 20 week cycles)
		- Participatory learning and action curriculum integrated into loan meetings (10 training sessions done within centre meetings every 2 weeks (approx. 6 months)) Community mobilization for 6 to 9 months following initial training
		- HIV prevention education
3) The Tap & Reposition Youth (TRY)[24, 25], Kenya	Increased reproductive health & HIV knowledge Increased sexual negotiation skills Increased Income & savings	Pre-test, post-test design, with matched comparison (222 pairs), length of participation ranged from <1 year (n = 71), 1 to 2 years (n = 81) and 2 to 3 years (n = 70)	- A total of Out-of-school females aged 16-22 years	- Increase Savings
		- Group-based microfinance loans, Livelihoods skills training
		- RH & HIV prevention training
				- Increase in liberal attitudes towards gender roles
			- Living in low income & slum areas of Nairobi	- 1.7 times more likely to refuse sex than girls in control group
				- 3 times more likely to insist on condom use than girls in control group
4) Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania[26]	To evaluate the use of conditional cash transfers as a HIV and sexually transmitted infection prevention strategy to incentivise safe sex	An unblended, individually randomised controlled trial	- A sample of 2399 persons aged 18-30 years	- High value CCT arm v.s. controls: adjusted RR = 0.073 (95% CI 0.47-0.99)
		- Intervention arms: low value conditional cash transfer v.s., high value conditional cash transfer		- High value CCT arm v.s., low value CCT arm: RR = 0.76 (95% CI0.49 -0.92)
				- Significant reduction in the combined point prevalence of four curable STIs among high value CCT arm
		- Tested participants every 4 months over a 12 months period for the presence of common STIs
5) Survival skills training for orphans (SSTOP)[27], Mozambique	To reduce transactional sex	Intervention:	- Females aged 14-19 years	Qualitative & anecdotal evidence found:
			- Responsible for	- Increased financial organization
		Income generating skills	caring for younger siblings, & other disadvantaged girls	- Increase vocational skills - Reduction in early marriage
				- Increased economic empowerment
		- Girls aged 9-13 learned to make soap, candles, sewing, or knitting		- Reduction in early sexual activity without protection
		- Girls aged 14-19 attended sewing classes; HIV prevention education; & gender training including legal protection for women
6) Creating futures[28] (Durban, South Africa)	Objective 1:	Pilot intervention combining Stepping Stones and Creating Futures	- Piloted in urban informal settlements in with 232 young people (110 men, 122 women)	Objective 1:
	To strengthen young people’s livelihoods and economic power through reflection and action
				- Livelihoods improved for women and men after the intervention
		- The study design was an interrupted time-series design, with baseline measures at zero and two weeks and follow-ups at six and 12 months post-baseline.
			- Average age of 21.7 years
				- Mean earnings in the past month increased over the 12 months. For women this increased from US$14 at baseline to US$49 (a 345% increase (p < 0.0001)) at 12 months and for men from US$36 at baseline to US$104 (a 283% increase (p < 0.0001)) at 12 months
	Objective 2: Aimed to reduce women’s experience and men’s perpetration of physical or sexual IPV
		- Consisted of livelihoods and economic power intervention involving 21 sessions of three hours, delivered by trained peer facilitators
				For objective 2:
				Women reported a statistically significant reduction in their experience of sexual or physical IPV in the past three months from 29.9% at baseline to 18.9% at 12 months (a 37% reduction (p < 0.046)
				- Women’s experience of sexual IPV also declined significantly from 11.1% at baseline to 3.6% at 12 months (p < 0.018)
				- Men’s perpetration of physical or sexual IPV in the past 3 months, while declining from 25% to 21.9% (a 23% reduction) was not statistically
				Significant
Economic empowerment plus school attendance
7) Zomba cash transfer[29], Malawi	Increased income Increased EducationReduce HIV risk	Randomised control trial, 2 years Cash transfers (CTs) conditional and on regular school attendance v.s. unconditional CTs (average amount US $10)	A sample of 1289 never married girls aged 13-22 years in 176 enumeration areas in Zomba	One-year follow-up:
				- Reduced onset of sexual activity by 31.1%
				At 18 months follow-up:
				- Intervention group had 64% reduction in HIV prevalence and 76% reduction in HSV-2 prevalence
				- Reduced age of partners in those in intervention
				- No significant differences between conditional and unconditional intervention group, although the study was not powered to show this
8) Western Kenya schooling intervention[30]	To reduce HIV incidence in schools	Randomised control trial, 4 years, Comparing 4 school-based HIV/AIDS interventions:	A sample of 70,000 school boys and girls in school	Teacher training:
				- No impact childbearing
				- Increase in HIV knowledge If pregnant, more likely to be married
		- Training teachers in HIV/AIDS curriculum		Critical thinking:
				- Increase knowledge & condom use
		- Critical thinking on role of condoms		- No impact on sexual activitySchool uniforms:
				- Reduction in dropout rates 17% in boys, 14% in girls
		- Reducing the cost of education by providing school uniforms
				- Reduction in teen marriage 9% in girls
				- Reduced childbearing 12%Relative risks:
		- Relative risk campaign
				- Reduction in childbearing 28%
				- Increased sexual activity in boys
				- No impact on pregnant teen couples
				- Reduction in cross-generational pregnancies 61%
Gender empowerment and safe spaces for young people
9) Binti Pamoja Centre (Daughters United centre)[31, 32], Kenya	Create safe spaces for girls to reduce: violence, Female genital mutilation, Sexual abuse, Rape, Prostitution Poverty and Increase: Reproductive health knowledge, Financial education, Leadership & personal skills	Community intervention:	Girls aged 11-18 living in the Kibera slum	2002 to present
		- Sampled adolescents from 4 ethically distinct villages in Kibera		- Baseline data highlights social isolation for many girls & 55% of girls live with neither or only one parent
		- Mapped all safe spaces in the community
				- >30 safe spaces established reaching >1000 girls
		- Used photography, drama, writing & group discussion
				- Positive changes in social networks, mobility & gender norms
				- Increased financial literacy, banking services usage, savings, & communication with parents/guardian on financial issues
		- Peer education & empowerment workshops
		- Developing skills in budgeting, savings, setting financial goals
				- Increased confidence & positive self-esteem
		- Provided educational scholarships
10) Siyakha Nentsha[33], South Africa	A life-orientation program to improve lifelong skills & well being of young people	Quasi-experimental, control arm, 18 month follow-up, 4 years Three study arms:	Boys & girls aged 14-16 in schools	- Increased autonomy for girls in how they spend their money & control their lives
				- Increased HIV related knowledge
				- Young men had reduced onset of sexual activity and fewer partners
		- SRH/HIV, social support, financial education
		- SRH/HIV & social support
		- Delayed Intervention (i.e. control group)
11) ICRW Vitu Newala[34], Tanzania	Understand specific vulnerabilities of adolescent girls and empower them, increase girls positive attitudes and beliefs on girls’ social protection	Pilot project Qualitative assessments throughout:	Adolescent girls	- Video parlours, discos & traditional initiation ceremonies identified as places where girls felt unsafe
		- Repeating the same participatory learning activities,		- Community put in place laws & changed practices to provide social protection
		- Series of IDIs with young people,
		- An evaluation workshop
Comprehensive sexuality and behaviour change communication
12) Soul City Institute for health & development[35], South Africa	Increase: social change, Social mobilization, Advocacy and reduce HIV incidence	Promoting health & social change via TV, radio, & print Soul Buddyz:	Soul buddyz:	Soul City & Soul Buddys exposure
		- Spin off of Soul City TV series using edutainment	- Children aged 8-14 years, their teachers & their caregivers	- Increased: Self-perceptions on risk, Resistance to peer pressure
		One love:
			- One love: Adults
				- Statically significant shifts in social norms, especially sexual norms
				- Reduced Perception of
		- Challenged social norms on multiple & concurrent partnership		women’s dependence on men (68% vs. 61%, p < 0.05)
13) Stepping Stones[36, 37], South Africa	Increase: Sexual health knowledge, Communication skills, Ccritical reflection and reduce Sexual health risk	Cluster randomised controlled trial, 2 years	A sample of 1077 HIV negative Persons aged 15-26 years, mostly attending school	- HIV IRR = 0.85 (95%CI: 0.60, 1.20; p = 0.35)
				- HSV2 IRR = 0.69 (95%CI: 0.47, 1.03; p = 0.07)
		- 70 villages randomized to either 13 3-hour sessions and 3 peer group meetings, or a 3-hour session on safer sex and HIV.
				- Men’s disclosure of perpetrating severe Intimate partner violence reduced at 12 & 24 months (p = 0.11 & p = 0.05)
				- Reduced Problem drinking among men
Parenting and socialisation
14) Families Matter! (FMP),[38, 39], Kenya	Reduce age at first sex and increase ppositive parenting practices	Community-based intervention using parent-child dyads, 2 years (2004-2006)	375 Parents/carers of 10-12 year-olds	- Increased Parenting skills & communication about sexuality & risk reduction
		Five consecutive 3-hour sessions on sexual risks and effective parent-child communication		- Parents’ attitudes regarding sexuality education changed positively.
				Five of the six composite parenting scores reported by parents, and six of six reported by children, increased significantly at 1 year post-intervention.
15) Mema kwa Jamii (Good Things for Communities, MkJ),[40, 41], Tanzania	Reduce SRH risks in youth through improved parenting	Community-based pilot parenting intervention, 2007-2010	Approximately 1355 parents of young people aged 10-18 years	Qualitative indications of impact on:
				- Parents socialised their male children differently from female
		Opinion leaders in four communities trained to training peer parents on parenting following diffusion of innovation theory over a period of 1 year
				- Improved parent-child relationships and collective efficacy