If I Were Thabo: Optimisation and feasibility trial of a gender transformative sexual and reproductive health intervention in South Africa and Lesotho
Medical Research Council
Stellenbosch University
A key social determinant of sexual and reproductive health-related (SRH) morbidity and mortality in Southern Africa is unequal gender norms. The importance of working with men as well as women using Gender-Transformative (GT) approaches, in order to reduce gender inequality and improve SRH outcomes for all is well-recognised. However, a recent systematic review showed that only 8% of SRH interventions that target adolescent men are GT. We aim to develop and feasibility test a co-produced relationships and sexuality education intervention, If I Were Thabo, for 13-14 years old adolescents, to address gender inequality as a social determinant of SRH. The study will be conducted in the Eastern Cape, South Africa, and Maseru District, Lesotho, two countries where adolescent pregnancy and HIV rates are among the highest in the world. There are two phases to the project; a development phase followed by a cluster randomised feasibility trial. The aim of the development phase is to work with stakeholders to co-produce and optimise intervention materials and outcome measures for use in the trial. This will involve working with adolescents, their caregivers, teachers and other stakeholders to develop materials for the feasibility testing phase. The aim of the feasibility trial is to determine the value and feasibility of conducting an effectiveness trial of Thabo in schools and community groups in LE and SA. To achieve this we will implement the Thabo intervention in both settings using a cluster randomised design in 10 clusters, and measure baseline, 3 month and 9 month outcomes. We will measure self-reported engagement in unprotected sex as the primary outcome. Secondary outcomes will include knowledge, attitudes, skills, intentions relating to avoiding adolescent pregnancy, and self-reported HIV and STI diagnosis. Qualitative interviews, focus groups and observational data will be gathered to assess acceptability, feasibility, fidelity and barriers to the programme.
3.1 Primary prevention interventions to modify behaviours or promote well-being / Research Grant