Unintended pregnancies among adolescent girls in the region remain high. In each intervention zone, a community-based hub, staffed by peer support workers, was established to provide SRH services.
In , a census was conducted in all zones; all consenting AYP aged 15 to 24 were given a Yathu Yathu card, which allowed them to accrue points for accessing SRH services at the hub and health facility intervention arm or the health facility only control arm. Points could be exchanged for rewards, thus acting as an incentive to use SRH services in both arms. We conducted a cross-sectional survey in to estimate the impact of Yathu Yathu on the primary outcome: knowledge of HIV status self-reporting living with HIV or HIV testing in the last 12 months and secondary outcomes, including use of pre-exposure prophylaxis PrEP in the last 12 months, current use of antiretroviral therapy ART , and met need for contraceptive services.
Across zones, knowledge of HIV status ranged from Adjusting for age, sex, and community, knowledge of HIV status was higher in the intervention arm compared to control By age and sex, results were similar.
There was no evidence for impact on any secondary outcomes, including current use of ART and met need for contraceptives. There were no adverse events reported in either arm. Scaling up the highly effective Yathu Yathu strategy has the potential to make a substantial contribution to increasing access to HIV prevention and care services for young people. However, additional implementation research is needed to understand how to improve uptake of broader SRH services, beyond uptake of HIV testing.
PLoS Med 20 4 : e This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Across sub-Saharan Africa, the population of adolescents and young people AYP aged 15 to 24 years is growing rapidly.
