Evidence map›Paper›PMID 34518330›Full record

ArticleJournal of epidemiology and community health2022

Early impact of the DREAMS partnership on young women's knowledge of their HIV status: causal analysis of population-based surveys in Kenya and South Africa.

Isolde Birdthistle, Daniel J Carter, Nondumiso T Mthiyane, Benedict O Orindi, Sheru Muuo, Natsayi Chimbindi, Abdhalah Ziraba, Maryam Shahmanesh, Kathy Baisley, Sian Floyd

Open access · hybridAbstract read
In one paragraph

Article in Journal of epidemiology and community health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
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  4. Experiences of adolescent girls and young women of oral PrEP uptake in rural KwaZulu-Natal.African journal of primary health care & family medicine · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Isolde BirdthistleEpidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK isolde.birdthistle@lshtm.ac.uk.ORCID 0000-0001-5742-6588
Daniel J CarterPublic Health & Policy, London School of Hygiene & Tropical Medicine, London, UK.
Nondumiso T MthiyaneDepartments of Population and Social Sciences, Africa Health Research Institute, Durban, Kwa-Zulu Natal, South Africa.
Benedict O OrindiDepartment of Epidemiology & Demography, Kenya Medical Research Institute, Kilifi, Kenya.
Sheru MuuoHealth and Systems for Health, African Population and Health Research Center, Nairobi, Kenya.
Natsayi ChimbindiDepartments of Population and Social Sciences, Africa Health Research Institute, Durban, Kwa-Zulu Natal, South Africa.
Abdhalah ZirabaHealth and Systems for Health, African Population and Health Research Center, Nairobi, Kenya.
Maryam ShahmaneshInstitute for Global Health, University College London, London, UK.
Kathy BaisleyEpidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Sian FloydEpidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK.
London School of Hygiene & Tropical Medicine · GBAfrica Health Research Institute · ZAAfrican Population and Health Research Center · KEKenya Medical Research Institute · KEUniversity College London · GB

Funding

Medical Research Council MR/R010161/1
6 · The paper itself

Abstract

backgroundKnowledge of one's HIV status is the gateway to treatment and prevention, but remains low among young people. We investigated the early impact (2016-2017) of Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS), a multisectoral HIV prevention package, on knowledge of HIV status among adolescent girls and young women (AGYW).

methodsIn 2017, randomly selected AGYW were enrolled into surveys, N=1081 aged 15-22 years in Nairobi slum settlements, and N=2174 aged 13-22 years in rural KwaZulu-Natal. We estimated the causal effect of being a DREAMS beneficiary on knowledge of HIV status (those who self-reported as HIV-positive or tested HIV-negative in the past year), accounting for an AGYW's propensity to be a DREAMS beneficiary.

resultsIn Nairobi, knowledge of HIV status was higher among DREAMS beneficiaries compared with non-beneficiaries (92% vs 69%, adjusted OR=8.7; 95% CI 5.8 to 12.9), with DREAMS predicted to increase the outcome by 28%, from 65% if none were a DREAMS beneficiary to 93% if all were beneficiaries. The increase attributable to DREAMS was larger among younger participants: 32% and 23% among those aged 15-17 and 18-22 years, respectively. In KwaZulu-Natal, knowledge of status was higher among DREAMS beneficiaries aged 13-17 years (37% vs 26% among non-beneficiaries), with a 9% difference due to DREAMS (95% CI 4.8% to 14.4%), and no evidence of effect among 18-22 years (-2.8%; 95% CI -11.1% to 5.7%).

conclusionDREAMS substantially increased knowledge of HIV status among AGYW in Nairobi, and among younger but not older AGYW in KwaZulu-Natal. Adolescent girls can be reached early (before age 18) with community-based HIV testing programmes in diverse high-prevalence settings, with a large impact on the proportion who know their HIV status.

Indexed as

HIV InfectionsAdolescentFemaleHIV TestingHumansKenyaRural PopulationSexual BehaviorSouth AfricaYoung AdultadolescentepidemiologyHIVinequalitiessexual health

Identifiers

PMID34518330
PMCPMC8762002
OpenAlexW3201215853

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.