Sexual reproductive healthcare utilisation and HIV testing in an integrated adolescent youth centre clinic in Cape Town, South Africa

Background HIV prevalence is increasing among South African youth, but HIV counselling and testing (HCT) remains low. Adolescent pregnancy rates are also high. Objectives Innovative strategies are needed to increase HIV and pregnancy screening and prevention among youth. Method The Desmond Tutu HIV Foundation Youth Centre (DTHF-YC) offers integrated, incentivised sexual and reproductive health (SRH), educational and recreational programmes. We compared HCT and contraception rates between the DTHF-YC and a public clinic (PC) in Cape Town to estimate the impact of DTHF-YC on youth contraception and HCT utilisation. Results In 2015, females < 18 years had 3.74 times (confidence interval [CI]: 3.37-4.15) more contraception visits at DTHF-YC versus PC. There were no differences in the contraception and adherence was suboptimal. DTHF-YC youth (aged 15-24 years) were 1.85 times (CI: 1.69-2.01) more likely to undergo HCT versus PC, while male youth were 3.83 times (CI: 3.04-4.81) more likely to test at DTHF-YC. Youth were a third less likely to test HIV-positive at DTHF-YC versus PC. Female sex, older age, clinic attendance for contraception and sexually transmitted infections (STIs), redeeming incentives and high DTHF-YC attendance were all independent factors associated with increased HCT. Conclusion Youth were significantly more likely to access SRH services at DTHF-YC compared with the PC. The differences were greatest in contraception use by female adolescents < 18 years and HCT by male youth. Increased HCT did not increase youth HIV case detection. Data from DTHF-YC suggest that youth-friendly healthcare providers integrated into community youth spaces may increase youth HCT and contraception rates 2018. The Authors.