Evidence to support HIV prevention for adolescent girls and young women (AGYW) and their male partners: Results from Malawi Dreams studies with AGYW, male partners of AGYW, men living with HIV, and program implementing partners

Pilgrim, Nanlesta; Mwapasa, Victor; Chipeta, Effie; Chimwaza, Wanangwa; Jani, Nrupa; McClair, Tracy; Tenthani, Lyson; Mathur, Sanyukta

doi:10.31899/hiv11.1005

Cited by 5 publications

(9 citation statements)

References 1 publication

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More needs to be done to expand HIV testing among AGYW in Malawi beyond traditional facility-based testing to modalities that are preferred by adolescents. 51 52 In a recent HIV testing study in Kenya, most AGYW participants (77.5%) chose staff-aided testing either at home or at a mobile event; (22.4%) chose self-testing; and only 2 (.2%) chose facility referral. 53 Even with the elevated risk that AGYW face, young men aged 15–24 in our surveillance also had high rates of new infections, and in multivariable analysis only young age remained significant, clearly indicating a need for renewed focus on HIV prevention in all youth aged 15–24 in Malawi.…”

Section: Discussionmentioning

confidence: 99%

Characterising persons diagnosed with HIV as either recent or long-term using a cross-sectional analysis of recent infection surveillance data collected in Malawi from September 2019 to March 2020

et al. 2022

View full text Add to dashboard Cite

ObjectivesIn Malawi, a recent infection testing algorithm (RITA) is used to characterise infections of persons newly diagnosed with HIV as recent or long term. This paper shares results from recent HIV infection surveillance and describes distribution and predictors.SettingData from 155 health facilities in 11 districts in Malawi were pooled from September 2019 to March 2020.ParticipantsEligible participants were ≥13 years, and newly diagnosed with HIV. Clients had RITA recent infections if the rapid test for recent infection (RTRI) test result was recent and viral load (VL) ≥1000 copies/mL; if VL was <1000 copies/mL the RTRI result was reclassified as long-term. Results were stratified by age, sex, pregnancy/breastfeeding status and district.Results13 838 persons consented to RTRI testing and 12 703 had valid RTRI test results and VL results after excluding clients not newly HIV-positive, RTRI negative or missing data (n=1135). A total of 12 365 of the 12 703 were included in the analysis after excluding those whose RTRI results were reclassified as long term (n=338/784 or 43.1%). The remainder, 446/12 703 or 3.5%, met the definition of RITA recent infection. The highest percentage of recent infections was among breastfeeding women (crude OR (COR) 3.2; 95% CI 2.0 to 5.0), young people aged 15–24 years (COR 1.6; 95% CI 1.3 to 1.9) and persons who reported a negative HIV test within the past 12 months (COR 3.3; 95% CI 2.6 to 4.2). Factors associated with recent infection in multivariable analysis included being a non-pregnant female (adjusted OR (AOR) 1.4; 95% CI 1.2 to 1.8), a breastfeeding female (AOR 2.2; 95% CI 1.4 to 3.5), aged 15–24 years (AOR 1.6; 95% CI 1.3 to 1.9) and residents of Machinga (AOR 2.0; 95% CI 1.2 to 3.5) and Mzimba (AOR 2.4; 95% CI 1.3 to 4.5) districts.ConclusionsMalawi’s recent HIV infection surveillance system demonstrated high uptake and identified sub-populations of new HIV diagnoses with a higher percentage of recent infections.

show abstract

Section: Discussionmentioning

confidence: 99%

Characterising persons diagnosed with HIV as either recent or long-term using a cross-sectional analysis of recent infection surveillance data collected in Malawi from September 2019 to March 2020

et al. 2022

View full text Add to dashboard Cite

show abstract

“…This study was nested in a larger implementation science study (IS) that aimed to assess the implementation of the DREAMS initiative, including outreach and retention in the programs and HIV risk reduction among AGYW and male partners in Machinga and Zomba districts, Malawi [19]. In the DREAMS project, the AGYW who ranged between 10 and 24 years, were recruited to participate in girl-only clubs called Go Girl clubs.…”

Section: Methodsmentioning

confidence: 99%

“…The districts were purposefully selected for the DREA MS project due to high HIV prevalence (13 and 16.3% [19].…”

Section: Study Sitesmentioning

confidence: 99%

“…Among the interventions is the Go Girl Club initiative which is being implemented by One Community project in Zomba and Machinga districts. Evidence from the implementation science that sought to measure the impact of the initiative among AGYW aged between 15 and 24 showed a positive impact where there were significant improvements in comprehensive knowledge about HIV, condoms, and prevention of mother-to-child transmission; significantly higher levels of support for equitable gender norms and higher relationship power among AGYW; fewer experiences of STI symptoms, and increased use of HIV testing and post-gender-based violence care; and there was a decrease in reported sexual violence from partners and non-partners among AGYW overtime [19]. In this paper, we report on first-hand accounts of experiences of VYA girls aged between 10 and 14 who participated in Go Girl clubs, and the clubs influence on their SRH knowledge to reduce the risk for HIV and negative sexual health outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Girl-only clubs’ influence on SRH knowledge, HIV risk reduction, and negative SRH outcomes among very young adolescent girls in rural Malawi

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Early adolescence is an important period to lay the foundation for positive sexual health development that can overcome sexual and reproductive health (SRH) challenges faced by very young adolescents (VYAs) as they reach puberty and sexual debut. In this study, we explored the following questions: first, what are the experiences of VYA girls on DREAMS’ Go Girl club participation? Second, how does club participation influence the VYAs SRH knowledge to reduce their risk for HIV and negative sexual health outcomes? Methods This was a qualitative study in which twenty-three in-depth interviews were conducted with VYA girls aged 12–14 years. These girls were enrolled in girl-only clubs in two rural southern districts in Malawi. The clubs were a part of larger comprehensive HIV prevention project called DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) which provided an evidence-based core package of interventions to VYAs to prevent HIV. Interventions included improved access to key health services, education support, social skills, asset building, and economic strengthening. Narrative inquiry was used to generate first-hand accounts of the girls’ experiences with club participation. Thematic analysis was used to generate themes from the transcribed stories. Results Six main themes were generated: 1) reasons for joining the clubs with desire to learn about SRH as a motivation for joining the clubs.; 2) influence on gender norms and roles whereby participants described a change of gender roles and norms at home; 3) influence on child abuse practices whereby participants reported a decline in child abusive practices at home;4) influence on life skills and social networks whereby participants described learning about networking; 5) support to go back to school whereby out-of-school girls described how economic empowerment of their guardians facilitated their return to school; and 6) influence of clubs on SRH knowledge acquisition and behaviours whereby participants described acquiring knowledge on sexual health issues. Conclusion Girls-only HIV and SRH programs coupled with economic empowerment for their families can be effective in keeping VYA girls in school and improving SRH knowledge and health seeking behavior.

show abstract

“…The districts were purposefully selected for the DREAMS project due to high HIV prevalence (13% and 16.3% among 15-49 year olds, in Zomba and Machinga respectively), HIV treatment gaps, high proportions of orphans and vulnerable children, high prevalence of early sexual initiation, high rates of childbearing during the teen years, and high school drop-out rates among girls (15).…”

Section: Study Sitesmentioning

confidence: 99%

Girl-Only Clubs’ Influence on SRH Knowledge, HIV Risk Reduction, and Negative SRH Outcomes among Very Young Adolescent Girls in Rural Malawi

Manda

Pilgrim

Kamndaya

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundEarly adolescence is an important period to lay the foundation for positive sexual health development that can overcome sexual and reproductive health challenges faced by very young adolescents (VYAs) as they reach puberty and sexual debut. We report on first-hand accounts of experiences of VYA girls who participated in girl-only clubs, and explore the club participation influence on their SRH knowledge to reduce the risk for HIV and negative sexual health outcomes. MethodsThis was a qualitative study in which twenty-three in-depth interviews were conducted with VYA girls aged 12-14 years. These girls were enrolled in girl-only clubs in two rural southern districts in Malawi. The clubs were a part of larger comprehensive HIV prevention project called DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) which provided an evidence-based core package of interventions to VYAs to prevent HIV. Interventions included improved access to key health services, education support, social skills, asset building, and economic strengthening. Narrative inquiry was used to generate first-hand accounts of the girls’ experiences with club participation. A thematic analysis was used to generate themes from the transcribed stories. ResultsSix main themes were generated: 1) reasons for joining the clubs with desire to learn about SRH issues serving as the main motivation; 2) influence on gender norms and roles whereby participants described a change of gender roles and norms at home; 3) influence on child abuse practices whereby participants reported a decline in child abusive practices at home ;4) influence on life skills and social networks whereby participants described learning about networking; 5) influence of clubs on school attendance whereby out-of-school girls described how economic empowerment of their guardians facilitated their return to school; and 6) influence of clubs on SRH knowledge acquisition and behaviours whereby participants described acquiring knowledge on sexual health issues.Conclusion Girls-only HIV and SRH programs coupled with economic empowerment for their families can be effective in keeping VYA girls in school and improving SRH knowledge and health seeking behavior.

show abstract

Evidence to support HIV prevention for adolescent girls and young women (AGYW) and their male partners: Results from Malawi Dreams studies with AGYW, male partners of AGYW, men living with HIV, and program implementing partners

Cited by 5 publications

References 1 publication

Characterising persons diagnosed with HIV as either recent or long-term using a cross-sectional analysis of recent infection surveillance data collected in Malawi from September 2019 to March 2020

Characterising persons diagnosed with HIV as either recent or long-term using a cross-sectional analysis of recent infection surveillance data collected in Malawi from September 2019 to March 2020

Girl-only clubs’ influence on SRH knowledge, HIV risk reduction, and negative SRH outcomes among very young adolescent girls in rural Malawi

Girl-Only Clubs’ Influence on SRH Knowledge, HIV Risk Reduction, and Negative SRH Outcomes among Very Young Adolescent Girls in Rural Malawi

Contact Info

Product

Resources

About