Youth engagement in developing an implementation science research agenda on adolescent HIV testing and care linkages in sub-Saharan Africa

HIV prevention efforts across sub-Saharan Africa are increasingly focused on engaging men, for their own health and that of their partners and families. We examined whether and how HIV risk and protective factors are changing among men in Eswatini (formerly Swaziland)—a country with a substantial HIV burden. The study is part of the Population Council’s implementation science research portfolio on the DREAMS Partnership1, a large-scale initiative to reduce new HIV infections among adolescent girls and young women (AGYW) and their partners.

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Hearing from men in Uganda: Experiences with HIV services and prevention programming, and perceptions of DREAMS—Findings from DREAMS implementation science research

10.31899/hiv16.1001 ◽

2021 ◽

Author(s):

Keyword(s):

Implementation Science ◽

Adolescent Girls ◽

Large Scale ◽

Hiv Infections ◽

Science Research ◽

Sub Saharan Africa ◽

Prevention Programming ◽

Hiv Services ◽

Engaging Men ◽

Sub Saharan

HIV prevention efforts across sub-Saharan Africa are increasingly focused on engaging men, for their own health and that of their partners and families. We examined experiences with HIV services and prevention programing among men in Uganda whose partners were enrolled in DREAMS, a large-scale initiative to reduce new HIV infections among adolescent girls and young women (AGYW). The study is part of the Population Council’s implementation science research portfolio on the DREAMS Partnership.

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Editorial review: Male circumcision, gender and HIV prevention in sub-Saharan Africa: a (social science) research agenda

SAHARA-J Journal of Social Aspects of HIV/AIDS ◽

10.1080/17290376.2007.9724889 ◽

2007 ◽

Vol 4 (3) ◽

pp. 658-667 ◽

Cited By ~ 24

Author(s):

Karl Peltzer ◽

Cheikh I Niang ◽

Adamson S. Muula ◽

Kasonde Bowa ◽

Linus Okeke ◽

...

Keyword(s):

Hiv Prevention ◽

Social Science ◽

Male Circumcision ◽

Research Agenda ◽

Social Science Research ◽

Science Research ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Editorial Review

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High-Yield HIV Testing, Facilitated Linkage to Care, and Prevention for Female Youth in Kenya (GIRLS Study): Implementation Science Protocol for a Priority Population (Preprint)

10.2196/preprints.8200 ◽

2017 ◽

Author(s):

Irene Inwani ◽

Nok Chhun ◽

Kawango Agot ◽

Charles M Cleland ◽

Jasmine Buttolph ◽

...

Keyword(s):

High Risk ◽

Hiv Prevention ◽

Hiv Testing ◽

Implementation Science ◽

Text Message ◽

Linkage To Care ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Age Range ◽

Hiv Negative

BACKGROUND Sub-Saharan Africa is the region with the highest HIV burden. Adolescent girls and young women (AGYW) in the age range of 15 to 24 years are twice as likely as their male peers to be infected, making females in sub-Saharan Africa the most at-risk group for HIV infection. It is therefore critical to prioritize access to HIV testing, prevention, and treatment for this vulnerable population. OBJECTIVE Using an implementation science framework, the purpose of this research protocol was to describe the approaches we propose to optimize engagement of AGYW in both the HIV prevention and care continuum and to determine the recruitment and testing strategies that identify the highest proportion of previously undiagnosed HIV infections. METHODS We will compare two seek recruitment strategies, three test strategies, and pilot adaptive linkage to care interventions (sequential multiple assignment randomized trial [SMART] design) among AGYW in the age range of 15 to 24 years in Homa Bay County, western Kenya. AGYW will be recruited in the home or community-based setting and offered three testing options: oral fluid HIV self-testing, staff-aided rapid HIV testing, or referral to a health care facility for standard HIV testing services. Newly diagnosed AGYW with HIV will be enrolled in the SMART trial pilot to determine the most effective way to support initial linkage to care after a positive diagnosis. They will be randomized to standard referral (counseling and a referral note) or standard referral plus SMS text message (short message service, SMS); those not linked to care within 2 weeks will be rerandomized to receive an additional SMS text message or a one-time financial incentive (approximately US $4). We will also evaluate a primary prevention messaging intervention to support identified high-risk HIV-negative AGYW to reduce their HIV risk and adhere to HIV retesting recommendations. We will also conduct analyses to determine the incremental cost-effectiveness of the seek, testing and linkage interventions. RESULTS We expect to enroll 1200 participants overall, with a random selection of 100 high-risk HIV-negative AGYW for the SMS prevention intervention (HIV-negative cohort) and approximately 108 AGYW who are living with HIV for the SMART design pilot of adaptive linkage to care interventions (HIV-positive cohort). We anticipate that the linkage to care interventions will be feasible and acceptable to implement. Lastly, the use of SMS text messages to engage participants will provide pilot data to the Kenyan government currently exploring a national platform to track and support linkage, adherence to treatment, retention, and prevention interventions for improved outcomes. CONCLUSIONS Lessons learned will inform best approaches to identify new HIV diagnoses to increase AGYW’s uptake of HIV prevention, testing, and linkage to care services in a high HIV-burden African setting. CLINICALTRIAL ClinicalTrials.gov NCT02735642; https://clinicaltrials.gov/ct2/show/NCT02735642 (Archived by WebCite at http://www.webcitation.org/6vgLLHLC9)

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Hearing from men in South Africa: Shifts in HIV risk and service uptake—Findings from DREAMS implementation science research

10.31899/hiv16.1002 ◽

2021 ◽

Author(s):

Keyword(s):

South Africa ◽

Implementation Science ◽

Adolescent Girls ◽

Hiv Risk ◽

Large Scale ◽

Hiv Infections ◽

Science Research ◽

Sub Saharan Africa ◽

Engaging Men ◽

Sub Saharan

HIV prevention efforts across sub-Saharan Africa are increasingly focused on engaging men, for their own health and that of their partners and families. We examined whether and how HIV risk and protective factors are changing among men in Durban, South Africa—a country with a substantial HIV burden. The study is part of the Population Council’s implementation science research portfolio on the DREAMS Partnership, a large-scale initiative to reduce new HIV infections among adolescent girls and young women and their partners.

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Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study

PLoS ONE ◽

10.1371/journal.pone.0164052 ◽

2016 ◽

Vol 11 (10) ◽

pp. e0164052 ◽

Cited By ~ 30

Author(s):

Ibitola O. Asaolu ◽

Jayleen K. Gunn ◽

Katherine E. Center ◽

Mary P. Koss ◽

Juliet I. Iwelunmor ◽

...

Keyword(s):

Hiv Testing ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Sectional Study ◽

Cross Sectional ◽

Sub Saharan

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How to reduce HIV risk among adolescent girls and young women in sub-Saharan Africa? Implementation science around the DREAMS Initiative

10.31899/hiv7.1009 ◽

2016 ◽

Author(s):

Keyword(s):

Implementation Science ◽

Adolescent Girls ◽

Young Women ◽

Hiv Risk ◽

Sub Saharan Africa ◽

Sub Saharan

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HIV Prevalence Trends and Disparities by Gender and Urban-rural Residence Among Adolescents in Sub-saharan Africa

10.21203/rs.3.rs-52929/v1 ◽

2020 ◽

Author(s):

Reka Maulide Cane ◽

Dessalegn Melesse ◽

Nkomba Kayeyi ◽

Abubakar Manu ◽

Yohannes Dibaba Wado ◽

...

Keyword(s):

Hiv Testing ◽

Hiv Transmission ◽

Hiv Prevalence ◽

Sub Saharan Africa ◽

Annual Rate ◽

Lower Prevalence ◽

Average Annual Rate ◽

African Countries ◽

Urban Rural ◽

Sub Saharan

Abstract Background In sub-Saharan Africa HIV transmission is a major challenge in adolescents, especially among girls and those living in urban settings. Major international efforts have aimed at reducing sexual transmission. This analysis aims to assess the trends in HIV prevalence by gender in adolescents, as well as urban-rural disparities. Methods HIV prevalence data were obtained for 30 countries with a national survey since 2010 and for 23 countries with one survey circa 2005 and a recent survey circa 2015. Countries were grouped into 2% or higher and lower than 2% HIV prevalence among girls 15–19 years in the first survey. Country medians and average annual rates of changes were used to summarize the trends. Data on HIV incidence at ages 15–24 and prevalence at 5–9 and 10–14 years were reviewed from 11 recent national surveys. Trends in urban-rural disparities in HIV prevalence and selected indicators of sexual and HIV testing behaviours were assessed for females and males 15–24 years, using the same surveys. Results HIV prevalence among girls 15–19 years declined in the higher HIV prevalence group from 5.7–2.6% during 2005–2015, corresponding with an average annual rate of reduction of 6.5% per year. Among boys, the median HIV prevalence declined from 2.1–1.2% in the higher prevalence group. Smaller changes were observed in the lower prevalence country group where median HIV prevalence among girls decreased from 0.7–0.4% (average annual rate of reduction 5.9%). Girl – boy differences at 10–14 years were small with a country median HIV of 1.0% and 1.3%, respectively. Urban females and males 15–24 had at least 1.5 times higher HIV prevalence than their rural counterparts, and all experienced similar declines during 2005–2015. Condom use and HIV testing increased among adolescents in both higher and lower prevalence countries, but indicators of sexual activity showed little change over time. Conclusions HIV prevalence declined in almost all countries during the last decade, in both urban and rural settings, for both sexes. The urban-rural gap persisted and HIV transmission to girls, but not boys, is still a major challenge in eastern and southern African countries.

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