» Articles » PMID: 31948429

Evaluating DREAMS HIV Prevention Interventions Targeting Adolescent Girls and Young Women in High HIV Prevalence Districts in South Africa: Protocol for a Cross-sectional Study

Abstract

Background: Young women in sub-Saharan Africa remain at the epicentre of the HIV epidemic, with surveillance data indicating persistent high levels of HIV incidence. In South Africa, adolescent girls and young women (AGYW) account for a quarter of all new HIV infections. Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) is a strategy introduced by the United States President's Emergency Plan for AIDS Relief (PEPFAR) aimed at reducing HIV incidence among AGYW in 10 countries in sub-Saharan Africa by 25% in the programme's first year, and by 40% in the second year. This study will assess the change in HIV incidence and reduction in risk associated behaviours that can be attributed to the DREAMS initiative in South Africa, using a population-based cross-sectional survey.

Methods: Data will be collected from a household-based representative sample of AGYW (between the ages 12-24 years) in four high prevalence districts (more than 10% of the population have HIV in these districts) in South Africa in which DREAMS has been implemented. A stratified cluster-based sampling approach will be used to select eligible participants for a cross-sectional survey with 18,500, to be conducted over 2017/2018. A questionnaire will be administered containing questions on sexual risk behaviour, selected academic and developmental milestones, prevalence of gender based violence, whilst examining exposure to DREAMS programmes. Biological samples, including two micro-containers of blood and self-collected vulvovaginal swab samples, are collected in each survey to test for HIV infection, HIV incidence, sexually transmitted infections (STIs) and pregnancy. This study will measure trends in population level HIV incidence using the Limiting antigen (LAg) Avidity Enzyme Immuno-Assay (EIA) and monitor changes in HIV incidence.

Discussion: Ending the HIV/AIDS pandemic by 2030 requires the continual monitoring and evaluation of prevention programmes, with the aim of optimising efforts and ensuring the achievement of epidemic control. This study will determine the impact DREAMS interventions have had on HIV incidence among AGYW in a 'real world, non-trial setting'.

Citing Articles

DYnamics of Contraception in Eswatini (DYCE): protocol for a high-frequency, longitudinal cell phone survey.

Greenleaf A, Nhlabatsi B, Mahlalela K, Masangane Z, Ndlangamandla M, Philips N BMJ Open. 2024; 14(11):e090686.

PMID: 39542494 PMC: 11575318. DOI: 10.1136/bmjopen-2024-090686.


Age-disparate and intergenerational sex partnerships and HIV: the role of gender norms among adolescent girls and young women in Malawi.

Reed D, Radin E, Kim E, Wadonda-Kabondo N, Payne D, Gillot M BMC Public Health. 2024; 24(1):575.

PMID: 38389081 PMC: 10885496. DOI: 10.1186/s12889-024-17868-5.


Mapping factors influencing initiation of antiretroviral treatment among adolescents living with HIV/AIDS in sub-Saharan Africa: A scoping review protocol.

Likoti P, Kuupiel D, Khuzwayo N PLoS One. 2024; 19(2):e0289515.

PMID: 38386673 PMC: 10883572. DOI: 10.1371/journal.pone.0289515.


HIV Care Profiling and Delivery Status in the Mobile Health Clinics of eThekwini District in KwaZulu Natal, South Africa: A Descriptive Evaluation Study.

Ngcobo S, Makhado L, Sehularo L Nurs Rep. 2023; 13(4):1539-1552.

PMID: 37987408 PMC: 10661302. DOI: 10.3390/nursrep13040129.


Assessing Condom Use and Views on HIV Counselling and Testing among TVET College Students in Limpopo Province, South Africa.

Teffo M, Mokgatle M Int J Environ Res Public Health. 2023; 20(11).

PMID: 37297648 PMC: 10252341. DOI: 10.3390/ijerph20116044.


References
1.
Duong Y, Qiu M, DE A, Jackson K, Dobbs T, Kim A . Detection of recent HIV-1 infection using a new limiting-antigen avidity assay: potential for HIV-1 incidence estimates and avidity maturation studies. PLoS One. 2012; 7(3):e33328. PMC: 3314002. DOI: 10.1371/journal.pone.0033328. View

2.
Dellar R, Dlamini S, Abdool Karim Q . Adolescent girls and young women: key populations for HIV epidemic control. J Int AIDS Soc. 2015; 18(2 Suppl 1):19408. PMC: 4344544. DOI: 10.7448/IAS.18.2.19408. View

3.
Kharsany A, Cawood C, Lewis L, Yende-Zuma N, Khanyile D, Puren A . Trends in HIV Prevention, Treatment, and Incidence in a Hyperendemic Area of KwaZulu-Natal, South Africa. JAMA Netw Open. 2019; 2(11):e1914378. PMC: 6826647. DOI: 10.1001/jamanetworkopen.2019.14378. View

4.
Mahajan R . Real world data: Additional source for making clinical decisions. Int J Appl Basic Med Res. 2015; 5(2):82. PMC: 4456898. DOI: 10.4103/2229-516X.157148. View

5.
Francis S, Mthiyane T, Baisley K, Mchunu S, Ferguson J, Smit T . Prevalence of sexually transmitted infections among young people in South Africa: A nested survey in a health and demographic surveillance site. PLoS Med. 2018; 15(2):e1002512. PMC: 5828358. DOI: 10.1371/journal.pmed.1002512. View