Evaluating DREAMS HIV prevention interventions targeting adolescent girls and young women in high HIV prevalence districts in South Africa: protocol for a cross-sectional study
Evaluating DREAMS HIV prevention interventions targeting adolescent girls and young women in high HIV prevalence districts in South Africa: protocol for a cross-sectional study
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DOI：
10.1186/s12905-019-0875-2
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发表时间：
2020-01-16
影响因子：
2.5
通讯作者：
Kharsany, Ayesha B. M.
中科院分区：
文献类型：
--
作者：
George, Gavin;Cawood, Cherie;Kharsany, Ayesha B. M.
撒哈拉以南非洲的年轻妇女仍然是艾滋病毒流行的中心，监测数据表明艾滋病毒发病率持续高水平。在南非，少女和年轻妇女占所有新感染艾滋病毒者的四分之一。坚定、有韧性、有能力、无艾滋病、有指导和安全（DREAMS）是美国总统艾滋病紧急救援计划（PEPFAR）提出的一项战略，旨在将撒哈拉以南非洲10个国家的AGYW中的艾滋病毒感染率在该方案的第一年减少25%，在第二年减少40%。这项研究将使用基于人口的横断面调查，评估南非DREAMS倡议导致的艾滋病毒发病率的变化和与风险相关的行为的减少。方法数据将收集从一个家庭为基础的代表性样本AGYW（年龄在12-24岁之间）在四个高流行区（超过10%的人口有艾滋病毒在这些地区），在南非的梦想已经实施。将采用分层整群抽样方法，选择符合条件的参与者，在2017/2018年进行一项18，500人的横断面调查。将管理一份问卷，其中包含有关性风险行为，选定的学术和发展里程碑，基于性别的暴力的流行率的问题，同时检查接触梦想方案。在每次调查中收集生物样本，包括两个微量血液容器和自行收集的外阴阴道拭子样本，以检测艾滋病毒感染、艾滋病毒发病率、性传播感染和怀孕情况。本研究将使用限制性抗原（LAg）亲合力酶免疫测定（EIA）测量人群水平HIV发病率的趋势，并监测HIV发病率的变化。讨论到2030年结束艾滋病毒/艾滋病大流行需要持续监测和评估预防方案，以优化工作并确保实现流行病控制。本研究将确定DREAMS干预措施在“真实的世界，非试验环境”中对AGYW中艾滋病毒发病率的影响。
Background Young women in sub-Saharan Africa remain at the epicentre of the HIV epidemic, with surveillance data indicating persistent high levels of HIV incidence. In South Africa, adolescent girls and young women (AGYW) account for a quarter of all new HIV infections. Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) is a strategy introduced by the United States President's Emergency Plan for AIDS Relief (PEPFAR) aimed at reducing HIV incidence among AGYW in 10 countries in sub-Saharan Africa by 25% in the programme's first year, and by 40% in the second year. This study will assess the change in HIV incidence and reduction in risk associated behaviours that can be attributed to the DREAMS initiative in South Africa, using a population-based cross-sectional survey. Methods Data will be collected from a household-based representative sample of AGYW (between the ages 12-24 years) in four high prevalence districts (more than 10% of the population have HIV in these districts) in South Africa in which DREAMS has been implemented. A stratified cluster-based sampling approach will be used to select eligible participants for a cross-sectional survey with 18,500, to be conducted over 2017/2018. A questionnaire will be administered containing questions on sexual risk behaviour, selected academic and developmental milestones, prevalence of gender based violence, whilst examining exposure to DREAMS programmes. Biological samples, including two micro-containers of blood and self-collected vulvovaginal swab samples, are collected in each survey to test for HIV infection, HIV incidence, sexually transmitted infections (STIs) and pregnancy. This study will measure trends in population level HIV incidence using the Limiting antigen (LAg) Avidity Enzyme Immuno-Assay (EIA) and monitor changes in HIV incidence. Discussion Ending the HIV/AIDS pandemic by 2030 requires the continual monitoring and evaluation of prevention programmes, with the aim of optimising efforts and ensuring the achievement of epidemic control. This study will determine the impact DREAMS interventions have had on HIV incidence among AGYW in a 'real world, non-trial setting'.