Stepping Stones

TB/HIV Care: Safeguarding the young women of South Africa

Photo Credit: Community Media Trust

TB/HIV Care’s vision is clear: to empower all communities (wherever they are and whoever they might be) to be healthy and free of TB and HIV. This includes high-risk or vulnerable populations, for example, sex workers, inmates and people who inject drugs. Noone can be left behind.

One of South Africa’s most vulnerable groups is adolescent girls and young women (AGYW). In fact, UNAIDS tells us that adolescent girls and young women are eight times more likely to be living with HIV than young men of the same age. Eight times . It is clear that if South Africa has any hope of stopping the spread of HIV, we need to safeguard our young women.

TB/HIV Care is rolling out three activities specifically designed to look after the health and well-being of SA’s adolescent girls and young women.

1. DREAMS. An AIDS-free future for young women

The first is DREAMS. An international effort aimed at ten countries in sub-Saharan Africa, DREAMS stands for Determined, Resilient, Empowered, AIDS-free, Mentored and Safe. Everything we could hope for the young women in our communities.

Together with our funders, PEPFAR, the Bill & Melinda Gates Foundation, the Nike Foundation and Girl Effect and other implementing partners , TB/HIV Care is rolling out DREAMs initiatives in South Africa as we work towards an AIDS-free future for our girls and women.

These strategies include:
• Targeting our HIV prevention programmes and health care interventions at AGYW, their families, their sexual partners (e.g. education around Voluntary Medical Male Circumcision) and their larger communities
• Developing guidelines and projects around Pre-exposure prophylaxis (PrEP)
• Interventions to protect girls from coerced or forced sex and to change community norms, behaviour and beliefs.

2. Stepping Stones. 11 Steps to confident, healthy adolescents

The second is Stepping Stones. Stepping Stones (the very embodiment of the values of DREAMS) is run in 75 schools across the country. It has been implemented in the City of Cape Town (including Khayelitsha and Mitchells Plain) and uMgungundlovu, and, in partnership with Community Media Trust, the City of Tshwane, and the City of Johannesburg metropoles.

The programme is made up of a series of 11 workshops. It is designed to promote sexual health, boost self-esteem and foster healthy relationships between young women and men.

There are many programmes aimed at safer sex and protection against HIV, but what makes Stepping Stones unique is its focus on gender equity, communication and empowerment.

It tackles a range of topics, including:
• What is love?
• The difference between happy and unhappy sexual relationships
• The joys and problems of sex
• Gender violence
• Caring for people with HIV or affected by HIV
• Assertiveness
• Communication (partners and community).

3. Families Matter. Developing trust and open communication

Families Matter is an evidence-based intervention which trains parents and guardians of pre-adolescent children (aged 9-12). This age group has been identified as a critical group to address with regards to education on sexual health and behaviour.

The aim of the programme is to enhance protective parenting practices to help reduce sexual risk amongst adolescents. It helps parents develop a positive and open approach to communication, one which fosters trust between parent and child.

Parents who participate in the Families Matter workshops are required to attend five weekly sessions, followed by a follow up session which takes place 6-18 months after training to reinforce key messages and discuss experiences.

The need for ongoing support

TB/HIV Care recognises that keeping young girls and women HIV and AIDS-free is absolutely critical – and an urgent and sustained response is required. We’ll continue to support and empower women to make the very best decisions for themselves, their bodies, their health, their relationships and their future.