{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T06:53:36Z","timestamp":1774853616946,"version":"3.50.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Safe Spaces are community-based settings where adolescent girls and young women (AGYW) are offered biomedical, behavioral, and structural services without discrimination. We investigated the uptake and acceptability of sexual and reproductive health (SRH) and related services provided to AGYW through Safe Spaces as part of the My Journey Programme, a large-scale combination human immunodeficiency virus (HIV) prevention program implemented in South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from the HERStory3 study\u2014mixed methods impact evaluation of the My Journey Programme. The quantitative component comprised a household survey of AGYW aged 15\u201324\u202fyears in which participants completed a self-administered electronic questionnaire, and dried blood spot specimens were used to test for HIV. We analyzed survey data from 2,608 AGYW living in the 12 subdistricts in which the intervention was implemented. A multilevel model was used to determine the association between spending time at a Safe Space in the past year and uptake of SRH services, educational enrolment, and wellbeing. A subsample of 68 survey participants took part in qualitative in-depth interviews, which were audio-recorded, transcribed, translated into English, and analyzed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among participants who spent time at a Safe Space in the past year (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f1,201), HIV testing (51.2%) and homework support (24.4%) were the most common services received by participants, and 81.3% were satisfied or very satisfied with the services they received, as reiterated in participants\u2019 narratives. Participants who spent time at a Safe Space in the past year were 33% more likely to have had an HIV test in the past 6 months (95% CI: 1.06\u20131.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.014), 69% more likely to be enrolled in an educational institution (95% CI: 1.32\u20132.16;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001), and 40% (95% CI: 1.14\u20131.71;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001) more likely to be flourishing. Interview participants also expressed appreciation for the welcoming staff at the Safe Spaces, who provided them with valuable information that increased their knowledge and uptake of SRH services.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Given the high levels of acceptability for Safe Spaces and positive health and health-related outcomes, Safe Spaces should be included as an important component of youth-friendly SRH programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1797269","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T05:26:48Z","timestamp":1774848408000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Uptake and acceptability of health services for adolescent girls and young women provided through Safe Spaces in South Africa"],"prefix":"10.3389","volume":"14","author":[{"given":"R.","family":"Stofile","sequence":"first","affiliation":[{"name":"Health System Research Unit, South African Medical Research Council","place":["Cape Town, South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Sindi","sequence":"additional","affiliation":[{"name":"Health System Research Unit, South African Medical Research Council","place":["Cape Town, South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Bergh","sequence":"additional","affiliation":[{"name":"Health System Research Unit, South African Medical Research Council","place":["Cape Town, South Africa"]},{"name":"Department of Psychology, University of Cape Town","place":["Cape Town, South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z.","family":"Duby","sequence":"additional","affiliation":[{"name":"Health System Research Unit, South African Medical Research Council","place":["Cape Town, South Africa"]},{"name":"School of Public Health, University of Cape Town","place":["Cape Town, South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Ebrahim","sequence":"additional","affiliation":[{"name":"Health System Research Unit, South African Medical Research Council","place":["Cape Town, South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Jankie","sequence":"additional","affiliation":[{"name":"Networking HIV & Aids Community of Southern Africa","place":["Cape Town, South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Mathews","sequence":"additional","affiliation":[{"name":"Health System Research Unit, South African Medical Research Council","place":["Cape Town, South Africa"]},{"name":"School of Public Health, University of Cape Town","place":["Cape Town, South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Jonas","sequence":"additional","affiliation":[{"name":"Health System Research Unit, South African Medical Research Council","place":["Cape Town, South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/s12978-021-01183-y","article-title":"Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review","volume":"18","author":"Ninsiima","year":"2021","journal-title":"Reprod Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"S11","DOI":"10.1016\/j.jadohealth.2016.05.022","article-title":"Improving adolescent sexual and reproductive health: a systematic review of potential 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