In 2014, South Africa was home to the world’s largest population of people living with HIV (PLHIV) and pregnant PLHIV. Twenty percent of women aged 20–24 had begun their childbearing years by age 18, and among pregnant women aged 15–24, prevalence was 21.7 percent. Though as many as 43 percent of girls aged 15-19 were already sexually active, provider bias against youth’s sexual activity—particularly for young PLHIV—persisted. As youth pregnancy similarly carried stigma among providers, the environment for young pregnant PLHIV was particularly ill-suited for their improved health outcomes. Given the country’s large proportion of sexually active young people and young people perinatally infected—many of whom were entering their reproductive years—the need for services supportive of their right to safely plan for their reproductive goals was pressing.
Under this CDC-funded project, Pathfinder has worked with three different models of youth-friendly services in South Africa, and identified aspects that could be effectively scaled up. These models include:
- Youth-friendly services integrated within a primary health care setting but with a separate youth zone where young people can interact with peer educators while they wait to be seen
- A separate youth-friendly clinic with a dedicated provider within a primary health care setting
- Stand-alone youth centers