Eastern and Southern Africa contain 63% of the world’s population living with HIV; Girls are particularly vulnerable, contracting HIV at young ages, and diverging from their male peers since they often date older partners who are exponentially more likely to have HIV.
In Botswana nearly 45% of forty year-old men are infected with HIV, 9x higher than young boys.
When surveyed, we found that 90% of young people in Botswana are unaware of the risks of older partners. Girls enter relationships with older partners thinking they are safer because they are “old, wise, and mature,” but in reality these relationships have lethal risks.
Zones addresses this information gap and ensures students have access to proven life saving information.
Zones, our flagship program, encourages youth to safely date age-mates instead of riskier older partners. The program is delivered by peer educators in schools and is realistic, simple, scalable, and inspired by rigorous evidence.
Zones was inspired by a 1-hour class delivered in government schools in Kenya and shown to reduce teen pregnancy— also a proxy for unprotected sex and HIV—by 28% in one year through a randomized control trial (RCT).
Young 1ove revitalized this promising evidence-based program and delivered it in Botswana. However, the context had changed and test was need to see if the program still worked. To this end, Young 1ove partnered with the University of Botswana, Ministry of Basic Education, Botswana-Baylor Children’s Clinical Center of Excellence, J-PAL and Evidence Action to conduct an RCT on an adapted version of the Kenya program, which we called "No Sugar", to see if it worked in the Botswana context.
The trial covered 42,000 students across a third of the nation. We had two implementers: teachers and peer educators. This was designed to inform the most cost-effective scale-up model. The trial ran from 2015-2016.
The results were promising: there was a reduction in our main measure of pregnancy of 40%, similar to the original Kenya trial. At the same time, the results indicated a need to adapt the program further before scale-up. For example, the messenger mattered: youth were more effective at delivering the intervention than teachers. Also, "sugar daddies" were younger than expected.
Now, we are transforming this evidence base into a version 2.0 of the program called "Zones." The program has the same goal: to encourage young people to avoid older partners and safely date each other. We are drawing on the wealth of rigorous evidence generated recently and locally to design the highest impact program possible.
We have also designed a rapid, rigorous iteration approach called "Rapid Impact Assessments (RIAs)." In 2020, we ran 10 rapid randomized trials in 10 months. Stay tuned for the results and a toolkit on how to conduct this rapid iteration process, which combines the best of rapid A/B testing typically done in the technology sector with large-scale randomized trials used for impact evaluation in the social sector.
Young 1ove has also conducted small-scale non-randomized pilots to test iterations to the intervention and its delivery model. These pilots have further enabled us to bring government and other stakeholders to the field to receive for their input, recommendations and engagement. These pilot include: working with Botswana’s National Service Program Tirelo Sechaba to reach 4,500 youth in northern Botswana. This pilot was funded by the Ministry of Youth, the National AIDS Coordinating Agency and MTV. Young 1ove also piloted an iteration of “No Sugar” for the United Nations as well as with the Botswana Ministry of Education in Ghanzi for the President’s National Bootcamp. Young 1ove has also partnered on pilots with organizations in Zimbabwe, Zambia and South Africa.