ArticlePloS one2018
Persistently high incidence of HIV and poor service uptake in adolescent girls and young women in rural KwaZulu-Natal, South Africa prior to DREAMS.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.
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Who cites it
55 citing papers in PubMed, 2 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- Strategies to increase couples HIV testing and counselling in sub-Saharan Africa: a systematic review.Journal of the International AIDS Society · 2023Pooled it
- Recent levels and trends in HIV incidence rates among adolescent girls and young women in ten high-prevalence African countries: a systematic review and meta-analysis.The Lancet. Global health · 2019Pooled it
- Interactive Transition Support for Adolescents Living with HIV Comparing Virtual and In-person delivery (InTSHA VIP): a stepped-wedge, cluster-randomised trial in South Africa.BMC health services research · 2026Trial
- Impact of family networks on uptake of health interventions: evidence from a community-randomized control trial aimed at increasing HIV testing in South Africa.Journal of the International AIDS Society · 2023Trial
- Trial
- Thetha Nami: participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa.BMC public health · 2021Trial
- Effect of peer-distributed HIV self-test kits on demand for biomedical HIV prevention in rural KwaZulu-Natal, South Africa: a three-armed cluster-randomised trial comparing social networks versus direct delivery.BMJ global health · 2021Trial
- Home-Based Intervention to Test and Start (HITS): a community-randomized controlled trial to increase HIV testing uptake among men in rural South Africa.Journal of the International AIDS Society · 2021Trial
- Trial
- The impact of COVID-19 on all-cause mortality and life expectancy: findings from a population-based cohort in uMkhanyakude district, northern KwaZulu-natal.Population health metrics · 2026Article
- Adaptation and Evaluation of a Multi-Component School-Based Sexual Reproductive Health Intervention Safer Choices Programme in Rural KwaZulu-Natal, South Africa - A Process Evaluation.Journal of the International AIDS Society · 2026Article
- Developing and pretesting a sexual reproductive health (SRH) school health promotion intervention (Safer Choices program) in rural South Africa: Study Protocol.Wellcome open research · 2026Article
- Observational
- Walking a tightrope: Social support in early adulthood in resource-constrained South Africa.Journal of social and personal relationships · 2025Article
- Leveraging Smartphone Mobility Data to Understand HIV Risk Among Rural South African Young Adults: Feasibility Study.JMIR mHealth and uHealth · 2025Article
- Understanding the mental health of adolescents and young adults in rural South Africa through participatory research.PLOS global public health · 2025Article
- Article
- Examining concordance of sexual-related factors and PrEP eligibility with HIV risk perception among adolescent girls and young women: cross-sectional insights from DREAMS sites in Kenya, Malawi, and Zambia.BMC public health · 2024Article
- Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa.PLOS global public health · 2024Article
- Assessing changes in adolescent girls' and young women's sexual and reproductive health service utilisation following a COVID-19 lockdown in eSwatini.Global health action · 2023Article
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Authors and funding
16 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundAdolescent girls and young women (AGYW) bear the brunt of the HIV epidemic in South Africa. 'DREAMS' aims to reduce HIV incidence through multi-level combination prevention. We describe HIV incidence and uptake of HIV and sexual reproductive health (SRH) by AGYW in KwaZulu-Natal (KZN), prior to DREAMS.
methodsLongitudinal and cross-sectional analysis of women (15-24 year old) in a population-based HIV incidence cohort within a demographic surveillance site in KZN. Observation time for HIV incidence was person-years at risk while resident. "Current use of contraceptives" and "having an HIV test in the past 12 months" was compared between 2011 and 2015.
resultsIn 2015, HIV prevalence was 11.0% and 34.1% and HIV incidence (2011-2015) was 4.54% (95%CI:3.89-5.30) and 7.45% (95%CI:6.51-8.51) per year in 15-19 and 20-24 year olds respectively, with no significant decline compared to 2006-2010. In 2015, 90.7% of 20-24-year-olds were unemployed, 36.4% and 51.7% of 15-19 and 20-24 year olds reported recent migration; 20.9% and 72.6% of 15-19 and 20-24 year olds had ever been pregnant. In 2015, less than 50% reported condom-use at last sex, 15.0% of 15-19 year olds and 48.9% of 20-24 year olds were currently using contraception and 32.0% and 66.7% of 15-19 and 20-24 year olds had tested for HIV in the past 12 months. There had been no improvement compared to 2011. Factors associated with AGYW testing for HIV in the past 12 months were, survey year-2011 more likely than 2015 (aOR = 0.50), number of partners (aOR = 3.25), ever been pregnant (aOR = 2.47) and knowing where to find ART (aOR = 1.54). Factors associated with contraception use were being older (aOR = 4.83); ever been pregnant (aOR = 12.62); knowing where to get ART (aOR = 1.79) and having had an HIV test in past 12 months (aOR = 1.74).
conclusionPrior to DREAMS, HIV incidence in AGYW was high. HIV and SRH service uptake did not improve and was suboptimal. Findings highlight the need for combination HIV prevention programmes for AGYW in this economically vulnerable area.
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