Introduction: Advances in biomedical technologies provide potential for adolescent HIV prevention and HIV-positive survival.
The UNAIDS 909090 treatment targets provide a new roadmap for ending the HIV epidemic, principally through antiretroviral
treatment, HIV testing and viral suppression among people with HIV. However, while imperative, HIV treatment and testing
will not be sufficient to address the epidemic among adolescents in Southern and Eastern Africa. In particular, use of condoms
and adherence to antiretroviral therapy (ART) remain haphazard, with evidence that social and structural deprivation is
negatively impacting adolescents’ capacity to protect themselves and others. This paper examines the evidence for and potential
of interventions addressing these structural deprivations.
Discussion: New evidence is emerging around social protection interventions, including cash transfers, parenting support
and educational support (‘‘cash, care and classroom’’). These interventions have the potential to reduce the social and economic
drivers of HIV risk, improve utilization of prevention technologies and improve adherence to ART for adolescent populations in the
hyper-endemic settings of Southern and Eastern Africa. Studies show that the integration of social and economic interventions
has high acceptability and reach and that it holds powerful potential for improved HIV, health and development outcomes.
Conclusions: Social protection is a largely untapped means of reducing HIV-risk behaviours and increasing uptake of and
adherence to biomedical prevention and treatment technologies. There is now sufficient evidence to include social protection
programming as a key strategy not only to mitigate the negative impacts of the HIV epidemic among families, but also to
contribute to HIV prevention among adolescents and potentially to remove social and economic barriers to accessing treatment.
We urge a further research and programming agenda: to actively combine programmes that increase availability of biomedical
solutions with social protection policies that can boost their utilization.
Keywords: social protection; HIV/AIDS; adolescents; HIV prevention; adherence.