Abstract

With HIV rates as high as 33%, prevention should be a central component of strategies to tackle the HIV/AIDS epidemic in sub-Saharan Africa. Yet health resources are generally poorly optimized for prevention and almost without exception focused on the decision-enabled: those who have the agency to take preventive decisions and access services when they most need them. However, the most vulnerable groups - consisting mainly young women - are most often choice-disabled by any or all of gender, economics, violence and age.

This project aims to reduce HIV risk in Botswana, Namibia and Swaziland, three countries suffering from the HIV epidemic but with different state responses to the problem. Researchers will document the extent of choice-disability, including sexual violence, and identify protective associations with local AIDS prevention efforts. Using a pragmatic randomized controlled trial (RCT), they will test the impact of various AIDS prevention interventions on the choice-disabled, with a special focus on victims of sexual violence. They will also assess the impact of current increased investment in male circumcision, alone and in combination with interventions that favour the choice-disabled.

Recipient Institution(s)