Grant: Travel Awards - Institute Community Support

Despite considerable investment in HIV control, 22% of adults in Botswana are HIV+ and thousands continue to contract HIV every year. Women are especially affected; in the age group 15-29 years, up to 74% of HIV+ persons is female. Conventional HIV prevention measures fail, as many young women are unable to negotiate abstinence or condom use, due to structural factors, such as poverty, lack of education, and gender violence. Botswana NGO, CIET Trust, and the National AIDS Coordinating Agency address these underlying drivers of HIV through a national HIV prevention trial called INSTRUCT. As part of INSTRUCT, my research project aims to tailor existing government support programs to lived realities of those most at risk of HIV infection: vulnerable young women (15-29 y.; unemployed/out-of-school). Access to support programs that offer small business opportunities or back-to-school programs would empower them, thus enabling them to protect themselves against HIV. Unfortunately, few vulnerable young women benefit from these programs, as these programs are not designed for them. I therefore explore why they do not benefit from support programs and how we can improve their access. We use innovative methods whereby vulnerable young women and program officers map underlying causes; subsequently analyze these maps and co-design solutions. This information is then presented to national policy makers who decide which solutions to implement. After their implementation in intervention districts, I assess whether co-designed solutions contributed to improved access. Through national surveys, the larger INSTRUCT trial will measure whether HIV prevalence reduced in intervention districts compared to districts without intervention. A first national level trial of its kind, my research project represents an historic opportunity to learn whether including vulnerable young women in policy design is an effective way of finding feasible solutions to reverse the global HIV epidemic.