More than one in seven people in Botswana have HIV — the third highest rate in the world, falling only behind the other African countries of Eswatini and Lesotho in prevalence.
The HIV virus attacks the immune system, leading to fever, muscle pains, mouth sores, diarrhea, and more. When left untreated, it can lead to acquired immunodeficiency syndrome (AIDS), a deadly condition that eliminates the body’s ability to fight off most infections.
Moitshepi Matsheng saw the devastating effects of this epidemic in Botswana first-hand. “When I was 6 years old, my mother died of HIV, but I was never told what happened to her,” Matsheng said at the 10th UNESCO Youth Forum in 2017. After learning the true cause of her mother’s death as a teenager, Matsheng became passionate about ending the taboo around discussing safe sex and HIV.
“Silence is the real killer, not HIV in itself,” Matsheng told me.
Matsheng began studying law at the University of Botswana, where she met Noam Angrist, a Boston native and Massachusetts Institute of Technology graduate who was completing his Fulbright research at the university. The pair witnessed young female students run out of money at the end of the month and resort to “sugar daddies” to make ends meet. These older men preyed on the young female students, offering them gifts in exchange for sex (oftentimes unprotected). That same year, in 2014, Angrist told Matsheng about a research project in Kenya where a “sugar daddy” awareness class reduced teen pregnancy rates by 28 percent (with pregnancy serving as a proxy for unprotected sex that also leads to HIV cases).
Together, Angrist and Matsheng questioned why this awareness class had never been replicated or implemented on a larger scale. They saw a missed opportunity to save lives with safe sex education and came together to build what is now a trailblazing organization, Youth Impact. The nonprofit is based out of Botswana’s capital of Gaborone and aims to bridge the gap between research and action, taking data-backed health and education solutions and scaling them.
To see if it could replicate the success of the Kenyan research in Botswana, Youth Impact conducted a randomized control trial with 42,000 student participants between 2015 and 2016. Rather than promoting abstinence (the common form of sex education in the country), Youth Impact taught safe sex practices and about how dating younger, more age-appropriate partners is safer not only due to the power dynamics but also the lower risk of HIV. (Nearly 45 percent of 40-year-old men in Botswana are infected with HIV, which is nine times higher than rates in teenage boys.) Youth Impact’s trial revealed that peer educators — young people around the same age as the students — were most effective at teaching about safe sex and destigmatizing the discussion.
Youth Impact now offers three programs: the safe-sex education program, a pandemic-induced distance learning initiative, and an education program aimed at improving students’ numeracy and literacy skills. Through a partnership with the Botswana government, the numeracy and literacy program, Teaching At The Right Level, is offered in approximately 50 percent of all primary schools, and by 2025 should be available in all primary schools. Botswana’s public school system enrolls approximately 522,000 students.
A little less than a decade since its inception, the organization has reached over 100,000 youth in Southern Africa with its sexual health and basic numeracy intervention courses. And its work is now being expanded to Namibia, South Africa, and the Philippines.
“Doctors both sometimes practice and do surgery, as well as research. But in the social sector, we have far too little crossover between research and practice,” Angrist told me. ”If you can carry the baton, in addition to passing it, then you can really connect the dots. Then the evidence actually meets the action.”