Table 1.
Reasons provided by adolescents for acceptability and unacceptability of interventions, by type of intervention
| Type of intervention | Reasons given for acceptability | Reasons given for unacceptability |
| eHealth | Knowledge provided on sexual health and HIV25 34 | Visual content considered not culturally appropriate23 |
| Privacy23 48 | Conservative views about certain topics discussed (eg, oral sex)25 65 | |
| Increased self-efficacy to manage risky situations34 | Concerns around access and inclusiveness, as not all youth owned devices65 73 | |
| Ease of use34 | Fear of accidental disclosure of confidential information through device-sharing73 | |
| Supportive mentors29 | Technical glitches with devices48 65 | |
| Freedom to talk openly to mentors about HIV status and disclosure29 | ||
| Vaccines | Protection from HPV in the case of sexual abuse or transactional sex36 | Distrust of government and scientists61 |
| Protection from HIV infection when the transmission risk is out of an individual’s control45 61 | Association of vaccine uptake with promiscuity61 | |
| Desire to have unprotected sex for childbearing (women on HIV-vaccine)61 | Fear of HIV testing and HIV stigma61 | |
| Being able to have unprotected sex and multiple sexual partners (male adolescents on HIV vaccine)61 | Cost of vaccine61 | |
| Protection in serodiscordant relationships while avoiding the HIV stigma and costs related to buying condoms (male adolescents on HIV vaccine)45 |
Fear of vaccine side effects51 61 63 77 | |
| Fear of injection77 | ||
| Lack of knowledge about vaccine and cervical cancer36 52 56 | ||
| HIV testing | Confidentiality of HIV self-testing at schools44,76 74 | Concern with validity of HIVST self-test kit results64 76 |
| Ease of use of HIV self-test44 76 | Costs of HIV test kit64 | |
| Fast results of self-test44 | Lack of emotional support with self-test64 76 | |
| Ability to test independently with self-test64 | Fear of the procedure (finger prick)30 75 | |
| Opportunity to know HIV status, for peace of mind and to plan for the future (provider-initiated testing)39 | Belief that school is not the right place for HIV testing74 | |
| Lower waiting time, less distance to facility, and friendlier staff at mobile (vs ‘conventional’) clinic67 | Lack of privacy and risk of stigma through school testing74 | |
| Support group | Emotional and social support provided42 47 53 55 | |
| Knowledge and skills provided42 55 | ||
| Enjoyed participating53 | ||
| Stigma free environment54 | ||
| Confidential space to openly discuss sexual health and behaviour42 53 | ||
| Greater decision-making autonomy to negotiate safer sexual relationships42 | ||
| SRH education | Increased knowledge on sexual and reproductive health24 41 | Conservative views about certain topics discussed (linked to sexual intercourse)41 |
| Supportive teachers at youth clubs41 | ||
| Girls more comfortable attending school during menstruation24 | ||
| VMMC | Material support provided during the intervention (eg, food, shelter and security)58 | Penile swelling after removal and transient discolouration of inner foreskin111 |
| Knowledge gained through participation58 | ||
| Economic support | Increased school retention28 38 78 | Concerns with sustainability and impact of transfer termination78 |
| Financial autonomy28 78 | Exclusion of certain households or individuals in the community from receiving transfers28 38 | |
| Easy access to cash transfer28 | Perception that selection process was unfair38 | |
| Lack of interest in family planning services accessible through (conditional) benefit cards112 | ||
| Contraception | Ease of use of self-injectable and female contraceptives66 113 | Conservative views on condom use and messaging (eg, using condoms is a sin, condoms may encourage early sexual debut)32 70 |
| Privacy and convenience of self-injectable contraceptives113 | Belief that adolescents are too young for condom promotion and sexual activity3 | |
| Female autonomy to control female contraceptive use45 66 | Fear of needles and self-injection for injectable contraceptives113 | |
| Condom fatigue and HIV fear45 | Concerns with not being able to use condoms properly70 | |
| Belief that condoms cause AIDS and other diseases70 | ||
| Concerns about the effect of cervical contraceptive being in the body for a long time66 | ||
| Concern with stigma45 | ||
| Waiting times at health facilities45 | ||
| PrEP | Prevents transmission in serodiscordant couples45 | Conflict with traditional methods and beliefs45 |
| Easy to use45 | Fear of side effects45 | |
| Psychosocial home-based care | Programme more relevant to caregiver vs adolescent needs72 | |
| Lack of financial support in a context of widespread poverty72 |
PrEP, pre-exposure prophylaxis; VMMC, voluntary medical male circumcision.