How socio-structural inequities become embodied as health inequities: Examining pathways of gender inequities, inflammation and reproductive health outcomes among adolescent girls and young women

Bacterial vaginosis (BV) is highly prevalent among adolescent girls and young women (AGYW) in South Africa. AGYW are also at higher risk of gender inequities. Stress, resulting from experiences of gender inequity, is associated with increased risk of vaginal tract infections. Chronic inflammation that results from persistent, over-activation of the immune system in response to stress is proposed to affect this relationship. Scant, community-informed research has investigated the causal pathways between gender inequities, chronic inflammation, and BV among AGYW. The overall aim of this proposed research program is to examine how chronic inflammation acts as a pathway through which gender inequities can lead to BV, using survey, clinical, and biological data from a study that includes 247 AGYW from South Africa. Using a community-engaged approach, young people with lived experience of gender inequities will be engaged at each stage of the research process. I will co-design with youth peer-researchers knowledge outputs to share back to community members and policy makers. This research program will contribute to understandings of how social experiences impact sexual and reproductive health outcomes.