Are those most at risk reached? Participation in the My Journey Programme: a combination HIV prevention intervention for Adolescent Girls and Young Women in South Africa
1
South African Medical Research Council, Cape Town, South Africa
2
University of Cape Town, Cape Town, South Africa
3
American University, Washington DC, United States
4
University of Connecticut, Connecticut, United States
5
University of Kwa-Zulu Natal, Durban, South Africa
6
University of Stellenbosch, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2321
ABSTRACT
BACKGROUND:
A combination HIV prevention intervention for adolescent girls and young women (AGYW), the My Journey Programme, aimed to reduce HIV incidence, teenage pregnancy, and other associated HIV risk factors was implemented in 12 South African subdistricts from 2016 to 2024. We investigated the association between HIV risk factors and intervention exposure among AGYW living in the subdistricts where the My Journey Programme was implemented.
METHODS:
A cross-sectional household survey among AGYW aged 15─24 years was conducted in which participants completed a self-administered electronic questionnaire and dried blood spot specimens were used to test for HIV. We analysed survey data from 2,608 AGYW in the intervention arm using a random effects logistic model, accounting for clustering at three levels and included the risk factors age, ever had sex, maternal orphanhood, socio-economic status, and educational enrolment and attending school.
RESULTS:
Among AGYW living in the intervention subdistricts, 36% were enrolled into the My Journey Programme (N=955). Among enrolled participants, 68% had ever participated in the My Journey risk assessment (N=646). Factors associated with participation in the My Journey Programme included: younger age (OR: 0.96, IC: 0.92 – 1.00); attending school (OR: 1.29, IC: 1.05 – 1.59), lower socio-economic status (OR: 0.75, IC: 0.59 – 0.95), ever engaged in sexual activity (OR: 1.52, IC: 1.21 – 1.92), negative HIV status (OR: 0.74, IC: 0.55 – 0.98).
CONCLUSIONS:
The Programme appeared to have reached the most at-risk AGYW, with higher enrolment among younger AGYW, those from the lowest socio economic communities, and those who have ever been sexually active. However, AGYW living with HIV were less likely to be enrolled in the Programme; underscoring the importance of strengthening HIV prevention programmes to ensure they reach AGYW living with HIV, who remain a critical population requiring enhanced support, engagement, and linkage to comprehensive care.
A combination HIV prevention intervention for adolescent girls and young women (AGYW), the My Journey Programme, aimed to reduce HIV incidence, teenage pregnancy, and other associated HIV risk factors was implemented in 12 South African subdistricts from 2016 to 2024. We investigated the association between HIV risk factors and intervention exposure among AGYW living in the subdistricts where the My Journey Programme was implemented.
METHODS:
A cross-sectional household survey among AGYW aged 15─24 years was conducted in which participants completed a self-administered electronic questionnaire and dried blood spot specimens were used to test for HIV. We analysed survey data from 2,608 AGYW in the intervention arm using a random effects logistic model, accounting for clustering at three levels and included the risk factors age, ever had sex, maternal orphanhood, socio-economic status, and educational enrolment and attending school.
RESULTS:
Among AGYW living in the intervention subdistricts, 36% were enrolled into the My Journey Programme (N=955). Among enrolled participants, 68% had ever participated in the My Journey risk assessment (N=646). Factors associated with participation in the My Journey Programme included: younger age (OR: 0.96, IC: 0.92 – 1.00); attending school (OR: 1.29, IC: 1.05 – 1.59), lower socio-economic status (OR: 0.75, IC: 0.59 – 0.95), ever engaged in sexual activity (OR: 1.52, IC: 1.21 – 1.92), negative HIV status (OR: 0.74, IC: 0.55 – 0.98).
CONCLUSIONS:
The Programme appeared to have reached the most at-risk AGYW, with higher enrolment among younger AGYW, those from the lowest socio economic communities, and those who have ever been sexually active. However, AGYW living with HIV were less likely to be enrolled in the Programme; underscoring the importance of strengthening HIV prevention programmes to ensure they reach AGYW living with HIV, who remain a critical population requiring enhanced support, engagement, and linkage to comprehensive care.
| eISSN: | 2654-1459 |
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