{"doi":"10.21203/rs.3.rs-42209/v2","title":"Thetha Nami : Participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa","abstract":"Abstract Background: Despite effective biomedical tools, HIV remains the largest cause of morbidity/mortality in South Africa – especially among adolescents and young people. We used community-based participatory research (CBPR) informed by principles of social justice, to develop a peer-led biosocial intervention for HIV prevention in rural KwaZulu-Natal (KZN). Methods : Between March 2018 and September 2019 we used CBPR to iteratively co-create and contextually adapt a biosocial peer-led intervention to support HIV prevention. Men and women aged 18-30 years were selected by community leaders of 21 intervention implementation areas (izigodi) and underwent 20 weeks of training as peer-navigators. We synthesised quantitative and qualitative data collected during a 2016-2018 study into 17 vignettes illustrating the local drivers of HIV. During three participatory intervention development workshops and community mapping sessions, the peer-navigators critically engaged with vignettes, brainstormed solutions and mapped the components to their own izigodi. The intervention components were plotted to a Theory of Change which, following a six-month pilot and process evaluation, the peer-navigators refined. The intervention will be evaluated in a randomised controlled trial (NCT04532307). Results: Following written and oral assessments, 57 of the 108 initially selected participated in two workshops to discuss the vignettes and co-create the Thetha Nami (`talk to me’). The intervention. included peer-led health promotion to improve self-efficacy and demand for HIV prevention, referrals to social and educational resources , and aaccessible youth-friendly clinical services to improve uptake of HIV prevention. During the pilot the peer-navigators approached 6871 young people, of whom 6141 (89%) accepted health promotion and 438 linked to care. During semi-structured interviews peer-navigators described the appeal of providing sexual health information to peers of a similar age and background but wanted to provide more than just “ onward referral ”. In the third participatory workshop 54 peer-navigators refined the Thetha Nami intervention to add three components structured assessment tool to tailor health promotion and referrals ; safe spaces and community advocacy to create an enabling environment; peer-mentorship and navigation of resources to improve retention in HIV prevention. Conclusion: Local youth were able to use evidence to develop a contextually adapted peer-led intervention to deliver biosocial HIV prevention.","journal":"Research Square","year":2021,"id":222438,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9448,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":566660,"name":"Nonhlanhla Okesola","orcid":null,"position":1,"is_corresponding":false},{"id":304703,"name":"Natsayi Chimbindi","orcid":"0000-0003-3125-978X","position":2,"is_corresponding":false},{"id":304706,"name":"Thembelihle Zuma","orcid":"0000-0002-8374-2354","position":3,"is_corresponding":false},{"id":304705,"name":"Nondumiso Mthiyane","orcid":"0000-0002-9881-7267","position":4,"is_corresponding":false},{"id":393191,"name":"Oluwafemi Adeagbo","orcid":"0000-0003-1462-9275","position":5,"is_corresponding":false},{"id":371608,"name":"Jaco Dreyer","orcid":"0000-0002-9966-5744","position":6,"is_corresponding":false},{"id":481534,"name":"Carina Herbst","orcid":"0000-0001-8759-8620","position":7,"is_corresponding":false},{"id":566661,"name":"Sakhile Mdl","orcid":null,"position":8,"is_corresponding":false},{"id":326664,"name":"Nuala McGrath","orcid":"0000-0002-1039-0159","position":9,"is_corresponding":false},{"id":250367,"name":"Guy Harling","orcid":"0000-0001-6604-491X","position":10,"is_corresponding":false},{"id":299799,"name":"Lorraine Sherr","orcid":"0000-0002-5902-8011","position":11,"is_corresponding":false},{"id":250373,"name":"Janet Seeley","orcid":"0000-0002-0583-5272","position":12,"is_corresponding":false},{"id":250376,"name":"Maryam Shahmanesh","orcid":"0000-0001-7129-8535","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-18T23:54:03.549854Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}