Poverty is a structural driver of risky sexual behaviors. While cash transfers can mitigate some of this risk, complementary interventions have been posited as a way to further reduce multidimensional vulnerability. We examine the impacts of a multicomponent intervention targeted to Tanzanian adolescents on their sexual behaviors and reproductive health. The intervention comprised livelihood and life skills training, mentoring, and health facilities’ strengthening. Data come from a cluster randomized controlled trial, where one study arm received the intervention and the other was randomized to control, but both arms participated in a government cash transfer program. Among 1,933 adolescents interviewed over three rounds, we found increases in contraceptive and HIV knowledge. The program also increased health seeking and HIV testing among boys, but slightly reduced age at sexual debut among girls. There were no impacts on contraceptive use, number of sexual partners, or pregnancy. Findings support the value of an adolescent intervention, and the fact that it was delivered within a social protection platform suggests a potential for scalability. Additional efforts are required to delay sexual debut and reduce the number of sexual partners and pregnancy, possibly through addressing supply-side barriers and social norms, or through additional linkages to economic opportunities.

中文翻译：

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安全过渡到成年的“加号”模式：国家社会保护计划分层综合干预对坦桑尼亚青年性行为和健康寻求的影响

贫困是危险性行为的结构性驱动因素。虽然现金转移可以减轻部分风险，但补充性干预被认为是进一步减少多维脆弱性的一种方式。我们研究了针对坦桑尼亚青少年的多因素干预对他们的性行为和生殖健康的影响。干预措施包括生计和生活技能培训、指导和加强卫生设施。数据来自一项集群随机对照试验，其中一个研究组接受干预，另一个随机控制，但两个组都参与了政府现金转移计划。在三轮采访的 1,933 名青少年中，我们发现避孕和艾滋病知识有所增加。该计划还增加了男孩的健康寻求和艾滋病毒检测，但女孩初次性行为的年龄略有降低。对避孕药具的使用、性伴侣的数量或怀孕没有影响。调查结果支持青少年干预的价值，并且它是在社会保护平台内提供的事实表明具有可扩展性的潜力。需要进一步努力推迟首次性行为并减少性伴侣和怀孕的数量，可能通过解决供应方面的障碍和社会规范，或通过与经济机会的额外联系。