Protocol for a cluster randomized controlled trial among young people and their peers to reduce substance use and inequitable gender beliefs in Southern Africa

Background and aims: Substance use and the internalization of traditional gender norms, or inequitable gender beliefs, are co-occurring risk behaviors for poorer health and well-being in young people in Southern Africa. Addressing the social and structural factors that reinforce substance use and inequitable gender beliefs, including peer influence and socioeconomic adversity, such as lack of education or employment, is necessary to support sustainable change in these behaviors. However, most existing interventions focus only on changing individual behavior. This study will therefore aim to address this limitation by testing the efficacy of an intervention to reduce substance use and promote equitable gender beliefs, delivered to peer groups and embedded within existing vocational training (VT) programs.