Unbundling social protection: Sex-specific pathways between social grant receipt and adolescent sexual violence in South Africa.

INTRODUCTION: Social protection is a central component of violence prevention among adolescents, however, the mechanisms through which it may reduce the risk of sexual violence (SV) and transactional sex remain understudied, particularly in observational real-world contexts. METHODS: Based on a theory-informed a priori framework, we used mixed effect models and GSEM to examine pathways linking grant receipt and hypothesised familial, economic and schooling mediators at Wave1 to reduced odds of outcome at Wave2. Data are drawn from a South African prospective cohort of 1353 adolescents aged 10-24, 69% living with HIV (2014-2017). RESULTS: Past-year prevalence of contact/non-contact SV was comparable between males and females, ranging 2% to 9%. Transactional sex was higher among females than males only at baseline (11.2%vs1.5%). Baseline grant receipt (90%), schooling (95%), positive parenting (56%) and parental supervision (55%), and household necessities (58%) did not differ by sex. Food security (77%) was higher among males. Among females, grant receipt was associated with a lower likelihood of contact/non-contact SV and transactional sex through household necessities. Household necessities were associated with higher likelihood of schooling, and in turn, schooling was associated with lower likelihood of transactional sex. Among males, no indirect pathways were identified, although grant receipt was associated with a lower likelihood of contact/non-contact SV. Parental supervision was associated with lower likelihood of contact/non-contact SV among females and transactional sex among males. CONCLUSION: Social grants may reduce SV and transactional sex among adolescents through sex-specific economic and schooling pathways. Among females, integrating social protection with schooling and parental supervision may strengthen prevention efforts of contact/non-contact, while the mechanisms for males need further investigation.