ArticleBMJ global health2022
Impact of the DREAMS Partnership on social support and general self-efficacy among adolescent girls and young women: causal analysis of population-based cohorts in Kenya and South Africa.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Better Together?: A Systematic Review of the Effectiveness of HIV Prevention Interventions that Build or Strengthen Social Ties.AIDS and behavior · 2025Pooled it
- Systematic review of cash plus or bundled interventions targeting adolescents in Africa to reduce HIV risk.BMC public health · 2024Pooled it
- Uptake and acceptability of health services for adolescent girls and young women provided through Safe Spaces in South Africa.Frontiers in public health · 2026Article
- How can complex interventions be adapted to context? A qualitative analysis of the implementation of DREAMS in three Kenyan settings.PLOS global public health · 2026Article
- Tackling the Triple Threat in Kenya: Factors Associated with Protection against HIV Risk, Gender-Based Violence, and Pregnancy among Adolescent Girls and Young Women.AIDS and behavior · 2025Article
- Empowerment among treatment-engaged individuals living with schizophrenia in Tanzania.BMC psychiatry · 2025Article
- Impact of a multilevel HIV prevention programme on adolescent girls and young women's empowerment for risk reduction: A mixed methods evaluation in Kenya.PLOS global public health · 2025Article
- What combination of interventions can optimise HIV prevention for adolescent girls and young women? Cohort analysis of DREAMS participation in urban and rural Kenya.PLOS global public health · 2025Article
- The effect of multi-level HIV prevention interventions on common mental disorders among adolescents and young adults in rural South Africa.PLOS global public health · 2025Article
- Gender-transformative HIV and SRHR programme approaches for adolescents and young people: a realist review to inform policy and programmes.BMJ global health · 2024Review
- Article
- Incident pregnancy and mental health among adolescent girls and young women in rural KwaZulu-Natal, South Africa: an observational cohort study.International journal of adolescence and youth · 2024Article
- Social support and very young adolescent girl's knowledge on sexual relationships: A comparative qualitative study of Girl Only Clubs' participants and non-participants in rural Malawi.PLOS global public health · 2023Article
- Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women.The international journal of behavioral nutrition and physical activity · 2022Article
- Introduction and integration of PrEP and sexual and reproductive health services for young people: Health provider perspectives from South Africa.Frontiers in reproductive health · 2022Article
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Authors and funding
14 authors at 4 institutions in 3 countries.
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Abstract
introductionThe Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) Partnership aimed to influence psychosocial processes that promote empowerment among adolescent girls and young women (AGYW), and reduce HIV incidence. We estimated the impact of DREAMS on aspects of AGYW's collective and individual agency (specifically, social support and self-efficacy), in three settings where DREAMS was implemented from 2016 until at least end 2018.
methodsResearch cohorts of ~1500 AGYW aged 13-22 were randomly selected from demographic platforms in Kenya (Nairobi; Gem) and South Africa (uMkhanyakude) and followed up from 2017 to 2019. Social support was based on questions about female networks and access to safe places to meet with peers; general self-efficacy was measured using a scale previously validated in other settings. We conducted multivariable logistic regression, and estimated the causal effect of invitation to DREAMS on each outcome in 2018 and 2019 by comparing counter-factual scenarios in which all, vs no, AGYW were DREAMS invitees.
resultsIn Nairobi, Gem and uMkhanyakude, respectively, 74%, 57% and 53% were invited to DREAMS by 2018. Social support was higher among DREAMS invitees versus non-invitees (eg, adjusted OR 2.0 (95% CI 1.6 to 2.6), Gem, 2018). In 2018, DREAMS increased social support in all settings and age groups, for example, from 28% if none were DREAMS invitees to 43% if all were invitees (+15% (95% CI 10% to 20%)) in Gem. Effects were strongest in Kenya, but weakened in 2019, particularly among older AGYW. In uMkhanyakude, DREAMS invitees had greater self-efficacy compared with non-invitees in 2018 (+9% (95% CI 3% to 13%), 2018) but less so in 2019. In Kenyan settings, there was weak evidence for impact on self-efficacy among younger AGYW in Gem (+6% (95% CI 0% to 13%)) and older AGYW in Nairobi (+9% (95% CI -3% to +20%)) in 2019.
conclusionsDREAMS impacted on social support and, less consistently, on self-efficacy. Weakening effects over time may reflect changes in access to safe spaces and social networks as AGYW age and change circumstances, and withdrawal of DREAMS from uMkhanyakude in 2018, highlighting the importance of programme sustainability and improving programming for older participants.
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