Early impact of the DREAMS partnership on young women's knowledge of their HIV status: causal analysis of population-based surveys in Kenya and South Africa.
Early impact of the DREAMS partnership on young women's knowledge of their HIV status: causal analysis of population-based surveys in Kenya and South Africa.
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DOI：
10.1136/jech-2020-216042
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发表时间：
2022-03
影响因子：
6.3
通讯作者：
Floyd S
中科院分区：
文献类型：
--
作者：
Birdthistle I;Carter DJ;Mthiyane NT;Orindi BO;Muuo S;Chimbindi N;Ziraba A;Shahmanesh M;Baisley K;Floyd S
了解自己的艾滋病毒状况是获得治疗和预防的途径，但在年轻人中仍然很低。我们调查了决心，弹性，赋权，无艾滋病，指导和安全（梦想）的早期影响（2016-2017），一个多部门的艾滋病毒预防包，对青春期女孩和年轻女性（AGYW）的艾滋病毒状况的知识。2017年，随机选择的AGYW参加了调查，内罗毕贫民窟居住区15-22岁的N=1081人，夸祖鲁-纳塔尔农村13-22岁的N=2174人。我们估计的因果关系的影响，是一个梦想的受益人对艾滋病毒状况的知识（那些谁自我报告为艾滋病毒阳性或测试艾滋病毒阴性，在过去的一年），占AGYW的倾向是一个梦想的受益人。在内罗毕，DREAMS受益者对艾滋病毒状况的了解高于非受益者（92% vs 69%，调整后OR=8.7; 95% CI 5.8 - 12.9），DREAMS预计将结果提高28%，从没有DREAMS受益者的65%提高到所有受益者的93%。在年轻的参与者中，归因于DREAMS的增加更大：15-17岁和18-22岁的参与者分别为32%和23%。在夸祖鲁-纳塔尔，13-17岁的DREAMS受益者对身份的了解更高（37%对非受益者的26%），由于DREAMS而产生9%的差异（95% CI 4.8%至14.4%），并且没有证据表明18-22岁之间的影响（-2.8%; 95% CI-11.1%至5.7%）。DREAMS大大增加了内罗毕青年男女总干事和夸祖鲁-纳塔尔青年男女总干事对艾滋病毒状况的了解。在各种高流行率环境中，可以通过基于社区的艾滋病毒检测方案及早（在18岁之前）接触到少女，这对了解其艾滋病毒状况的人的比例产生很大影响。
Knowledge of one’s HIV status is the gateway to treatment and prevention, but remains low among young people. We investigated the early impact (2016–2017) of Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS), a multisectoral HIV prevention package, on knowledge of HIV status among adolescent girls and young women (AGYW). In 2017, randomly selected AGYW were enrolled into surveys, N=1081 aged 15–22 years in Nairobi slum settlements, and N=2174 aged 13–22 years in rural KwaZulu-Natal. We estimated the causal effect of being a DREAMS beneficiary on knowledge of HIV status (those who self-reported as HIV-positive or tested HIV-negative in the past year), accounting for an AGYW’s propensity to be a DREAMS beneficiary. In Nairobi, knowledge of HIV status was higher among DREAMS beneficiaries compared with non-beneficiaries (92% vs 69%, adjusted OR=8.7; 95% CI 5.8 to 12.9), with DREAMS predicted to increase the outcome by 28%, from 65% if none were a DREAMS beneficiary to 93% if all were beneficiaries. The increase attributable to DREAMS was larger among younger participants: 32% and 23% among those aged 15–17 and 18–22 years, respectively. In KwaZulu-Natal, knowledge of status was higher among DREAMS beneficiaries aged 13–17 years (37% vs 26% among non-beneficiaries), with a 9% difference due to DREAMS (95% CI 4.8% to 14.4%), and no evidence of effect among 18–22 years (−2.8%; 95% CI −11.1% to 5.7%). DREAMS substantially increased knowledge of HIV status among AGYW in Nairobi, and among younger but not older AGYW in KwaZulu-Natal. Adolescent girls can be reached early (before age 18) with community-based HIV testing programmes in diverse high-prevalence settings, with a large impact on the proportion who know their HIV status.
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影响因子：
2.9
作者：
Birdthistle, Isolde J.;Mayhew, Susannah H.;Fenty, Justin
通讯作者：
Fenty, Justin
影响因子：
3.7
作者：
Chimbindi N;Mthiyane N;Birdthistle I;Floyd S;McGrath N;Pillay D;Seeley J;Zuma T;Dreyer J;Gareta D;Mutevedzi T;Fenty J;Herbst K;Smit T;Baisley K;Shahmanesh M
通讯作者：
Shahmanesh M
影响因子：
3.7
作者：
Saul, Janet;Bachman, Gretchen;Beamon, Ta'Adhmeeka
通讯作者：
Beamon, Ta'Adhmeeka
影响因子：
5
作者：
Hernan, Miguel A.;Robins, James M.
通讯作者：
Robins, James M.
影响因子：
6
作者：
Hatzold, Karin;Gudukeya, Stephano;Corbett, Elizabeth L.
通讯作者：
Corbett, Elizabeth L.