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The project manager (MN) and field work coordinators in Mthatha identified and randomised the clusters and then enrolled participants.

The setting was historically a subsistence farming region within a radius of 1.5 hours’ drive from the town of Mthatha, where contemporary households are primarily supported by contributions from family working elsewhere, grants, and pensions.

There was a difference between the actual and intended age of participants, which is discussed in detail elsewhere.13 Most were recruited from schools.

In each cluster recruitment started with general community mobilisation, and the study was explained to key local figures.

In each cluster we recruited about 20 men and 20 women volunteers.

Those eligible were aged 16-23, normally resident in the village where they were at school, and mature enough to understand the study and the consent process.

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The form explained the procedures that would occur in some detail.

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