Evidence brief: Samata intervention to increase secondary school completion and reduce child marriage among adolescent girls from marginalised communities

The Samata trial assessed the impact of a multi-level structural and norms-based intervention developed by the Indian not-for-profit organisation, Karnataka Health Promotion Trust (KHPT). The trial was designed to reduce secondary school dropout and child marriage among marginalised scheduled caste/scheduled tribe (SC/ST) adolescent girls living in rural settings in South India. 

A number of structural and norms-based factors function as drivers of under-age marriage, early sexual debut and school dropout.

Technical brief: Social Norms

A number of structural inequalities and harmful practices are associated with increased HIV vulnerability. The concept of social norms provides a way to understand what sustains these practices and structures. By addressing problematic norms, it is possible to challenge these structures and thus reduce HIV risk.

Technical brief: Alcohol and HIV risk

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Hazardous alcohol use contributes to the acquisition of HIV through sexual risk and speeds the progression of the disease.

Strategies exist to successfully reduce the harms caused by hazardous alcohol use, including HIV, but these have focused on individual-level interventions while neglecting the powerful role of unfettered alcohol availability, low prices and heavy advertising and promotion in low- and middle-income countries. 

Technical brief: Co-financing for development synergies

Upstream structural barriers undermine the potential of HIV programmes to deliver on ambitious targets to prevent new infections and save lives. Interventions addressing these upstream factors are considered to be beyond the remit of the HIV response and too expensive for the HIV budget. This reflects conventional priority-setting and financing frameworks that consider only HIV outcomes and budgets.

Technical brief: HIV-related stigma and discrimination

Research confirms that reducing HIV-related stigma is critical to the success of prevention, care and treatment efforts.

Impact case study: Question on transactional sex in the DHS

As of 2015, the Demographic and Health Surveys (DHS) include improved questions to capture the practice of transactional sex for women and men. Similar questions are now included in the Violence against Children surveys (VACS), evaluations of the Transfer project and other cash transfer studies in South Africa and Tanzania and numerous individual studies including at least one surveillance site. As a result, survey data can be expected to shed light on:

Conference report: Successfully tackling the structural drivers of HIV

We will post the report of our one-day pre-conference session at AIDS 2018 on this page. Meanwhile, you can read about and register for the session here.

The HIV Prevention Cascade

A new framework called the HIV Prevention Cascade helps us to use everything we know about the virus for more effective prevention. This infographic explains how the Prevention Cascade works, using the example of PrEP as a direct prevention mechanism for the population of vulnerable adolescent girls and young women in sub-Saharan Africa.

A shorter version of the infographic is available here.

Related reading

Impact case study: Co-financing for HIV and development synergies

STRIVE researchers have concieved and applied an innovative way to estimate the economic value of structural interventions to reduce HIV vulnerability. The STRIVE approach, called 'co-financing' addresses a central concern: upstream interventions may prove effective in studies but how to finance them after that?

STRIVE's answer: share the cost between sectors in proportion to the benefits per sector.

The co-financing approach:

STRIVE roadmap to AIDS 2018

STRIVE partners are presenting at the International AIDS Conference in Amsterdam, Netherlands, 23-27 July 2018. The theme of AIDS 2018 - "Breaking Barriers, Building Bridges" - draws attention to the rights-based approaches that are crucial to reaching key populations.