An individually randomized controlled trial of a mother-daughter HIV/STI prevention program for adolescent girls and young women in South Africa: IMARA-SA study protocol

Background South Africa has the world's largest HIV epidemic, but South African adolescent girls and young women (AGYW) acquire HIV at twice the rate of and seroconvert on average 5-7 years earlier than their male peers. Female caregivers (FC) are an untapped resource for HIV/STI prevention in...

Full description

Saved in:
Bibliographic Details
Published in:BMC public health 2021-09, Vol.21 (1), p.1-1708, Article 1708
Main Authors: Donenberg, Geri R, Atujuna, Millicent, Merrill, Katherine G, Emerson, Erin, Ndwayana, Sheily, Blachman-Demner, Dara, Bekker, Linda Gail
Format: Article
Language:English
Subjects:
Adolescent girls and women
Adolescents
Antiretroviral therapy
Clinical trials
Communication
Cost analysis
Curricula
Disease prevention
Education
Epidemics
Epidemiology
Families & family life
Girls
Health aspects
Health promotion
Health risks
HIV
HIV infection
HIV prevention
Human immunodeficiency virus
Infections
Methods
Mother-daughter intervention
Mothers and daughters
Parents & parenting
Prevention
Prevention programs
Public health
Randomization
Reproductive health
Sexual behavior
Sexually transmitted diseases
Social aspects
South Africa
STD
Study Protocol
Teenage girls
Teenagers
Women
Word of mouth advertising
Young women
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background South Africa has the world's largest HIV epidemic, but South African adolescent girls and young women (AGYW) acquire HIV at twice the rate of and seroconvert on average 5-7 years earlier than their male peers. Female caregivers (FC) are an untapped resource for HIV/STI prevention in South Africa and offer a novel opportunity to strengthen AGYW prevention efforts. This study will evaluate the effectiveness and cost-effectiveness of an evidence-based mother-daughter HIV/STI prevention program tested in the United States and adapted for South Africa, Informed Motivated Aware and Responsible Adolescents and Adults (IMARA), to decrease STI incident infections and increase HIV testing and counseling (HTC) and PrEP uptake in AGYW. Methods This is a 2-arm individually randomized controlled trial comparing IMARA to a family-based control program matched in time and intensity with 525 15-19-year-old Black South African AGYW and their FC-dyads in Cape Town's informal communities. AGYW will complete baseline, 6-, and 12-month assessments. Following randomization, AGYW-FC dyads will participate in a 2-day group workshop (total 10 h) that includes joint and separate mother and daughter activities. Primary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 6 months. Secondary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 12 months, sexual behavior (e.g., condom use, number of partners), HIV incidence, and ART/PrEP adherence and intervention cost-effectiveness. AGYW who test positive for a STI will receive free treatment at the study site. HIV positive participants will be referred to ART clinics. Discussion Primary prevention remains the most viable strategy to stem new STI and HIV transmissions. HIV and STI disparities go beyond individual level factors, and prevention packages that include supportive relationships (e.g., FC) may produce greater reductions in HIV-risk, improve HTC and PrEP uptake, and increase linkage, retention, and adherence to care. Reducing new HIV and STI infections among South African AGYW is global public health priority. Trial registration ClinicalTrials.gov Number NCT04758390, accepted 02/16/2021. Keywords: HIV prevention, Adolescent girls and women, South Africa, Mother-daughter intervention
ISSN:1471-2458
1471-2458
DOI:10.1186/s12889-021-11727-3