School-based girls' clubs as a means of addressing sexual and gender-based violence in Swaziland

Background Sexual and gender based violence (SGBV) is a global health and human rights problem which is of particular concern in sub-Saharan Africa because of the compounding effects of high HIV prevalence. In Swaziland a small, land-locked country of just over one million people women and girls face the disproportionate burden of both SGBV and HIV: Nearly half (48%) of those aged 13-24 years reported having experienced some form of sexual violence (including rape, threat of rape, unwanted touching or groping), and among those of secondary school age (13-17), only 37% reported that their first sexual experience was voluntary [1]. Although available evidence suggests that most SGBV cases occur in the home or community, schools are not entirely safe places for girls. For example, findings from a national survey on violence against children in Swaziland indicate that among incidents of sexual violence experienced before age 18 in Swaziland, 10% occurred at school and another 10% on the way to and from school [1]. There is growing evidence of direct and indirect links between SGBV and HIV, with violence being both a cause and outcome of HIV infection [2,3]. The national HIV prevalence among adults (15-49) in Swaziland is among the highest in the world, at 26% [4]. This study aimed to assess the effectiveness of a girls’ empowerment intervention in regard to changing in-school girls’ knowledge, attitudes, and practices related to SGBV. Materials and methods Study design The study used a preand post-intervention design without a comparison group and included three co-educational secondary day schools in the Lubombo Region of Eastern Swaziland.