What question did this study set out to answer?

To examine the experiences and perceptions of adolescents, young people, and peer navigators regarding a community-based peer support intervention for HIV prevention in rural South Africa.

August 23, 2026AIDS Care0 citationsOpen Access

Harnessing the social capital of rural communities for adolescent and youth biosocial HIV prevention: exploring young people’s experiences and perceptions of a peer navigator intervention in KwaZulu-Natal, South Africa

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TZThembelihle ZumaHoward College JSJanet SeeleyLondon School of Hygiene & Tropical Medicine DGDumisani GumedeAfrica Health Research Institute

Key Points

To examine the experiences and perceptions of adolescents, young people, and peer navigators regarding a community-based peer support intervention for HIV prevention in rural South Africa.
Interventional trial substudy (NCT04532307) conducted within the Africa Health Research Institute surveillance area in KwaZulu-Natal, South Africa.
Purposive sampling of adolescents, young people, and intervention implementers delivering the Thetha Nami peer navigator program.
Qualitative in-depth interviews conducted in isiZulu, transcribed, translated into English, and evaluated via thematic analysis.
Shared community residency and common life experiences between peer navigators and youth significantly fostered trust and local resilience.
Peer navigation alone was insufficient to mitigate community-level stigma and restrictive sexual norms surrounding adolescent sexual and reproductive health service uptake.
The program only partially succeeded in linking youth to broader supportive networks, demonstrating that peer support must be reinforced with wider structural interventions.

Abstract

Novel interventions are required to reduce risky sexual behavior among adolescents and young people (AYP). We interviewed a purposive sample comprising AYP residing in the Africa Health Research Institute’s surveillance area and individuals involved in delivering a community-based peer navigator support intervention. Interviews were conducted in isiZulu, transcribed and translated into English for thematic analysis. We found that community resilience and trust were enhanced by “having lived in the area for a long time” and having both participants and peers coming from the same community with shared life experiences. Peer support did not mitigate the impact of stigma and community sexual norms toward the use of sexual and reproductive health services by AYP. Due to the focus on health through peer support, Thetha Nami only partially succeeded in linking AYP to supportive networks. The study highlights the importance of strengthening structural interventions to enhance linkages that address AYPs multifaceted needs.Trial registration: NCT04532307, clincialtrials.gov, March 2020, https://clinicaltrials.gov/ct2/show/NCT04532307

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Harnessing the social capital of rural communities for adolescent and youth biosocial HIV prevention: exploring young people’s experiences and perceptions of a peer navigator intervention in KwaZulu-Natal, South Africa

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Abstract

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