{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:49:49Z","timestamp":1765889389289,"version":"3.41.2"},"reference-count":51,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001275","name":"Oak Foundation","doi-asserted-by":"publisher","award":["R46194\/AA001","OFIL\u201020\u2010057"],"award-info":[{"award-number":["R46194\/AA001","OFIL\u201020\u2010057"]}],"id":[{"id":"10.13039\/100001275","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000279","name":"Nuffield Foundation","doi-asserted-by":"publisher","award":["CPF\/41513"],"award-info":[{"award-number":["CPF\/41513"]}],"id":[{"id":"10.13039\/501100000279","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001337","name":"Claude Leon Foundation","doi-asserted-by":"publisher","award":["08 559\/C"],"award-info":[{"award-number":["08 559\/C"]}],"id":[{"id":"10.13039\/501100001337","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000275","name":"Leverhulme Trust","doi-asserted-by":"publisher","award":["PLP\u20102014\u2010095"],"award-info":[{"award-number":["PLP\u20102014\u2010095"]}],"id":[{"id":"10.13039\/501100000275","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013589","name":"Research England","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013589","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K43TW011434"],"award-info":[{"award-number":["K43TW011434"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Without effective, scalable interventions, we will fail to achieve the Global AIDS Targets of zero AIDS\u2010related deaths, zero HIV transmission and zero discrimination. This study examines associations of social protection and food security among adolescents living with HIV (ALHIV), with three Global AIDS Targets aligned outcomes: antiretroviral treatment (ART) adherence and viral suppression, HIV transmission risk behaviour and enacted stigma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted three study visits over 2014\u22122018 with 1046 ALHIV in South Africa's Eastern Cape province. Standardized surveys provided information on receipt of government\u2010provided cash transfers and past\u2010week food security, alongside self\u2010reported ART adherence, sexual debut and condom use, and enacted HIV\u2010related stigma. Viral load (VL) data was obtained through data extraction from patient files and linkage with National Health Laboratory Service test results (2014\u22122020). We used a multivariable random\u2010effects regression model to estimate associations between receiving government cash transfers and food security and three outcomes: ART adherence and viral suppression, delayed sexual debut or consistent condom use and no enacted stigma. We tested moderation by sex and age and fitted disaggregated models for each outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 933 ALHIV completing all three study visits, 55% were female, and the mean age was 13.6 years at baseline. Household receipt of a government cash transfer was associated with improvements on all outcomes: ART adherence and viral suppression (aOR 2.03, 95% CI 1.29\u22123.19), delayed sexual debut or consistent condom use (aOR 1.62, 95% CI 1.16\u22122.27) and no enacted stigma\u00a0(aOR 2.33, 95% CI 1.39\u22123.89). Food security was associated with improvements on all outcomes: ART adherence and viral suppression (aOR 1.73, 95% CI 1.30\u22122.30), delayed sexual debut or consistent condom use (aOR 1.30, 95% CI 1.03\u22121.64) and no enacted stigma (aOR 1.91, 95% CI 1.32\u22122.76). Receiving both cash transfers and food security increased the probability of ART adherence and VL suppression from 36% to 60%; delayed sexual debut or consistent condom use from 67% to 81%; and no enacted stigma from 84% to 96%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Government\u2010provided cash transfers and food security, individually and in combination, are associated with improved outcomes for ALHIV aligned with Global AIDS Targets. They may be important, and underutilized, accelerators for achieving these targets.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26369","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T12:52:07Z","timestamp":1728564727000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Are social protection and food security accelerators for adolescents to achieve the Global AIDS targets?"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0418-835X","authenticated-orcid":false,"given":"Lucie","family":"Cluver","sequence":"first","affiliation":[{"name":"Department of Social Policy and Intervention University of Oxford  Oxford UK"},{"name":"Department of Child and Adolescent Psychiatry University of Cape Town  Cape Town South Africa"},{"name":"Nuffield College University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-1244","authenticated-orcid":false,"given":"Siyanai","family":"Zhou","sequence":"additional","affiliation":[{"name":"Centre for Social Science Research University of Cape Town  Cape Town South Africa"},{"name":"School of Public Health and Family Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0306-5171","authenticated-orcid":false,"given":"Olanrewaju","family":"Edun","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis School of Public Health Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison Oman","family":"Lawi","sequence":"additional","affiliation":[{"name":"Nutrition Division United Nations World Food Programme  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nontokozo","family":"Langwenya","sequence":"additional","affiliation":[{"name":"Department of Social Policy and Intervention University of Oxford  Oxford UK"},{"name":"Nuffield College University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Chipanta","sequence":"additional","affiliation":[{"name":"UNAIDS  Windhoek Namibia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gayle","family":"Sherman","sequence":"additional","affiliation":[{"name":"Centre for HIV and STIs National Institute for Communicable Diseases  Johannesburg South Africa"},{"name":"Department of Molecular Medicine and Haematology Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"},{"name":"Department of Paediatrics and Child Health Faculty of Health Sciences University of the Witwatersrand  Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorraine","family":"Sherr","sequence":"additional","affiliation":[{"name":"Health Psychology Unit Institute of Global Health University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Social Policy and Intervention University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Yates","sequence":"additional","affiliation":[{"name":"Department of Social Policy and Intervention University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Gordon","sequence":"additional","affiliation":[{"name":"Department of Social Policy and Intervention University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3800-3173","authenticated-orcid":false,"given":"Elona","family":"Toska","sequence":"additional","affiliation":[{"name":"Department of Social Policy and Intervention University of Oxford  Oxford UK"},{"name":"Centre for Social Science Research University of Cape Town  Cape Town South Africa"},{"name":"Department of Sociology University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"UNAIDS.End inequalities. End AIDS. Global AIDS Strategy 2021\u201326.Geneva:UNAIDS;2021."},{"key":"e_1_2_12_3_1","unstructured":"UNAIDS.In Danger: UNAIDS Global AIDS Update 2022.Geneva:UNAIDS;2022."},{"key":"e_1_2_12_4_1","unstructured":"UNAIDS.Global AIDS Estimates.2021."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25488"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000003044"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25832"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2018.0320"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25741"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19073940"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-02822-4"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30526-1"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228370"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-001285"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178106"},{"volume-title":"COVID\u201019 and shrinking finance for social spending","year":"2022","author":"UNICEF Innocenti Office of Research","key":"e_1_2_12_16_1"},{"key":"e_1_2_12_17_1","unstructured":"UNDP.SDG accelerator and bottleneck assessment.New York:UNDP;2017."},{"key":"e_1_2_12_18_1","first-page":"67","volume-title":"HIV sensitive social protection in East and Southern Africa fast track countries","author":"ILO WFP","year":"2021"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-022-03645-1"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41562-022-01414-7"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2021.1966693"},{"key":"e_1_2_12_22_1","article-title":"Lived experiences of persons with disabilities living with HIV in accessing HIV services in Africa: a qualitative systematic review","author":"Philip AA","year":"2022","journal-title":"Disabil Rehabil"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2016.1179008"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0085473"},{"key":"e_1_2_12_25_1","unstructured":"JohnsonL DorringtonR.Modelling the impact of HIV in South Africa's provinces: 2024 update. Centre for Infectious Disease Epidemiology and Research Working Paper.2024."},{"volume-title":"District Health Barometer 2012\/13","year":"2013","author":"Massyn N","key":"e_1_2_12_26_1"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25176"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-133-1-200007040-00004"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1310\/M3JR-G390-LXCM-F62G"},{"key":"e_1_2_12_30_1","unstructured":"Department of Social Development SASSA UNICEF.The South African Child Support Grant Impact Assessment: evidence from a survey of children adolescents and their households.South Africa:UNICEF;2012."},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12187-016-9428-5"},{"volume-title":"South African social attitudes: changing times, diverse voices","year":"2006","author":"Pillay U","key":"e_1_2_12_32_1"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25044"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2018.1476664"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0281298"},{"volume-title":"The National Survey of HIV and Sexual Behaviour among Young South Africans","year":"2005","author":"Reproductive Health Research Unit (University of the Witwatersrand) and Lovelife","key":"e_1_2_12_36_1"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/17450128.2019.1709678"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-08468-0"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-003892"},{"key":"e_1_2_12_40_1","unstructured":"World Food Programme.World Food Programme Strategy for Support to Social Protection.World Food Programme;2021."},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gfs.2016.07.009"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(22)00101-8"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/cch.12948"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1086\/691552"},{"issue":"8","key":"e_1_2_12_45_1","article-title":"Food security reduces multiple HIV infection risks for high\u2010vulnerability adolescent mothers and non\u2010mothers in South Africa: a cross\u2010sectional study","volume":"25","author":"Cluver L","year":"2022","journal-title":"African Rev Reprod Gynaecol. Endosc"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0276411"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2020.1775867"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2014.12.002"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41043-023-00441-y"},{"key":"e_1_2_12_50_1","unstructured":"UNAIDS.Global AIDS Strategy 2021\u20132026 \u2014 End Inequalities. End AIDS.UNAIDS:2021."},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.2989\/16085906.2016.1194299"},{"key":"e_1_2_12_52_1","unstructured":"Food and Agriculture Organisation.Food Security.Rome:FAO;2006."}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.26369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T03:45:42Z","timestamp":1729827942000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.26369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":51,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1002\/jia2.26369"],"URL":"https:\/\/doi.org\/10.1002\/jia2.26369","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"type":"print","value":"1758-2652"},{"type":"electronic","value":"1758-2652"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2023-09-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e26369"}}