Development of a Theory of Change for the Implementation Framework for the Prevention and Control of HIV, TB & STI's Among the ABYM in South Africa

UNFPA commissioned Strategic Analytics and Management to develop a Theory of Change to for the implementation framework on the prevention and control of HIV, TB and STI’s among adolescent boys and young men (ABYM) in south Africa on behalf of South African National AIDS Council (SANAC).

The implementation framework sets out to guide the implementation of a set of interventions ensuring a more holistic response for ABYM. The selection of interventions are based on the recognition for the need to address social and structural challenges facing ABYM. The social and structural challenges include gender inequality, gender-based violence, food insecurity, school retention and poor access to health services. A key outcome remains improving ABYM access to the economy.

The implementation framework targeting adolescent boys and young men (ABYM) highlights the commitment of SANAC to mitigating the impact of HIV on ABYM. Addressing the social and structural factors facilitating HIV risk, remains paramount. There is also the realization that ABYM must be better engaged in HIV, TB and STI prevention and treatment initiatives. Improving ABYM’s access to prevention and treatment services benefit ABYM directly, but also their sexual partners, their families, and the broader community.

The implementation framework provides a guide to mitigating the impact of HIV, but also addressing the structural challenges facing ABYM. This framework offers four focal areas through which interventions are to be organized and implemented. A set of evidence-informed interventions and activities have been listed within these focal areas, together with a monitoring and evaluating framework with the aim of mounting an effective response to the prevention and control of HIV among ABYM in South Africa.

The four key strategic focal areas are:

Focal Area-1: Address Structural and Social Barriers: Ensure that policies, social conditions, and cultural norms positively shape and promote healthy behavior and the development of ABYM. Interventions will aim to address harmful gender and social norms, stigma and discrimination, violence against women and girls, alcohol and drug dependence, school retention, food security and access to health services.

Focal Area-2: Economic participation and opportunities: Ensure ABYM receive the necessary skills and opportunities to facilitate meaningful participation in the economy.

Focal Area-3: Sustain health and well-being for ABYM: Ensuring there are sustained prevention efforts to reduce new HIV, TB and STI infections, whilst increasing programmes aimed at improving testing rates, initiation and adherence to HIV, TB and STI treatment among ABYM.

Focal Area-4: Build resilient leaders with agency: The success of this implementation framework relies on building resilient leaders who exercise their agency. This framework will promote the development of leaders and is a guide for interventions aiming to improve health and development outcomes among ABYM.