Extracurricular School-Based Social Change Communication Program Associated with Reduced HIV Infection Among Young Women in South Africa
Outcomes: Human Immunodeficiency Virus, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways This study highlights the potential of extracurricular, school-based interventions to shift social norms related to sexual behavior and health among young women. The Soul Buddyz Clubs fostered collective action, built self-esteem, and emphasized responsible health behaviors—components that appear to influence norms around condom use and sexual partnerships. The intervention’s emphasis on participation, community, and empowerment, rather than solely on knowledge, may have driven the observed long-term behavioral and health outcomes.
Objectives The study aimed to assess the long-term impact of participation in Soul Buddyz Clubs on HIV status and related risky sexual behaviors—including condom use, sexual debut, transactional and age-disparate sex, and pregnancy—among young women in South Africa.
Methods A retrospective cohort design was used, comparing 403 women aged 18–28 years who had been members of Soul Buddyz Clubs between 2004 and 2008 with matched community controls who had not participated. Data were collected via face-to-face structured interviews and HIV testing, with multivariate logistic regression analyses conducted to assess associations between club participation and sexual health outcomes.
Intervention Details Soul Buddyz Clubs were extracurricular school-based clubs linked to a national television series. They aimed to promote children’s health and well-being by providing a platform for life skills development and social change communication. Club activities, driven by trained facilitators and student members, included discussions, debates, competitions, and community projects aligned with health and social priorities. The program emphasized empowerment, participation, and critical engagement over top-down knowledge dissemination.
Results Club participants (ex-Buddyz) were significantly more likely to report safer sexual behaviors, including using condoms at first sex and having only one sexual partner in the past year. Ex-Buddyz were nearly three times more likely to be HIV negative than controls, even a decade after program participation. While not all risky behaviors showed significant differences, ex-Buddyz also reported lower rates of teenage pregnancy and unintended pregnancies.
Conclusions The Soul Buddyz Clubs had a lasting protective effect on young women’s sexual behavior and HIV risk, suggesting that early, participatory, school-based interventions that incorporate social change communication and link to broader media campaigns can positively shift social norms and health outcomes. These findings support the importance of combining structural and behavioral approaches to HIV prevention that engage youth over the long term.
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