ArticleAIDS (London, England)2022
The association of exposure to DREAMS on sexually acquiring or transmitting HIV amongst adolescent girls and young women living in rural South Africa.
Article in AIDS (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Systematic review of cash plus or bundled interventions targeting adolescents in Africa to reduce HIV risk.BMC public health · 2024Pooled it
- Trial
- Article
- 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
- Article
- Impact of layered behavioral, socio-economic and school-based interventions on selected behavioral and biomarker indicators among adolescent girls and young women in Uganda.PLOS global public health · 2025Article
- HIV interventions across the care continuum for adolescents in high-burden countries: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Programme Science: a route to transformative change to improve population-level impact for global HIV and sexually transmitted infections.Journal of the International AIDS Society · 2024Article
- Interventions to Improve Adolescent HIV Care Outcomes.Current HIV/AIDS reports · 2023Review
- Multisectoral, Combination HIV Prevention for Adolescent Girls and Young Women: A Qualitative Study of the DREAMS Implementation Trajectory in Zambia.Global health, science and practice · 2022Article
- Episodic Use of Pre-Exposure Prophylaxis Among Young Cisgender Women in Siaya County, Kenya.AIDS patient care and STDs · 2022Article
Corrections and comments
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Authors and funding
16 authors at 4 institutions in 3 countries.
Funding
Abstract
objectiveWe investigate how risk of sexually acquiring or transmitting HIV in adolescent girls and young women (AGYW) changed following the real-world implementation of DREAMS (Determined, Resilient, Empowered, AIDS free, Mentored and Safe) HIV prevention programme.
designA representative population-based prospective cohort study of AGYW living in rural KwaZulu-Natal.
methodsBetween 2017 and 2019, we interviewed a random sample of AGYW aged 13-22 years annually. We measured exposure to DREAMS as self-reported receipt of an invitation to participate and/or participation in DREAMS activities that were provided by DREAMS implementing organizations. HIV and herpes simplex virus type 2 (HSV-2) statuses were ascertained through blood tests on Dried Blood Spot (DBS). We used multivariable regression analysis to assess the association between exposure to DREAMS and risk of acquiring HIV: measured as incident HSV-2 (a proxy of sexual risk) and incident HIV;and the risk of sexually transmitting HIV: measured as being HIV positive with a detectable HIV viral load (≥50 copie/ml) on the last available DBS. We adjusted for sociodemographic, sexual relationship, and migration.
resultsTwo thousand one hundred and eighty-four (86.4%) of those eligible agreed to participate and 2016 (92.3%) provided data for at least one follow-up time-point. One thousand and thirty (54%) were exposed to DREAMS;HIV and HSV-2 incidence were 2.2/100 person-years [95% confidence interval (CI) 1.66-2.86] and 17.3/100 person-years (95% CI 15.5-19.4), respectively. There was no evidence that HSV-2 and HIV incidence were lower in those exposed to DREAMS: adjusted rate ratio (aRR) 0.96 (95% CI 0.76-1.23 and 0.83 (95% CI 0.46-1.52), respectively. HIV viral load was detectable for 169 (8.9%) respondents;there was no evidence this was lower in those exposed to DREAMS with an adjusted risk difference, compared with those not exposed to DREAMS, of 0.99% (95% CI-1.52 to 3.82]. Participants who lived in peri-urban/ urban setting were more likely to have incident HIV and transmissible HIV. Both HSV-2 incidence and the transmissible HIV were associated with older age and ever having sex. Findings did not differ substantively by respondent age group.
conclusionDREAMS exposure was not associated with measurable reductions in risk of sexually acquiring or transmitting HIV amongst a representative cohort of AGYW in rural South Africa.
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