Project 460881

Adolescent girls and young women (AGYW) are disproportionately burdened by HIV infection. In fact, in sub-Saharan Africa (SSA), one out of every five new HIV infections happens among AGYW. There is an urgent need to reach AGYW with diverse, evidence-based HIV prevention programs to curtail HIV-related health inequities. In 2015, PEPFAR (the United States President's Emergency Plan for AIDS Relief) launched the DREAMS Partnership, a package of interventions in 10 SSA countries. The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) Partnership aimed to reduce HIV incidence by 40% among AGYW in SSA over two years by addressing multiple causes of AGYW vulnerability. The Gates Foundation awarded the London School of Hygiene & Tropical Medicine a 4-year grant to evaluate the impact of the DREAMS Partnership and track the impact in Kenya, South Africa, and Zimbabwe. In this proposed research project, I will analyze the individual-level data collected from two of the six SSA sites (i.e., Kenyan settings) during the DREAMS evaluations (study period: 2016-2019). Specifically, this project aims to: (1) Identify the modes by which DREAMS integrated HIV prevention efforts within sexual and reproductive health (SRH) services and the impact on HIV and pregnancy prevention outcomes; and (2) Explore barriers to integrating HIV prevention efforts within SRH services in both community-based and health facility care models. Through this research I plan to develop evidence-based recommendations that improve future HIV/SRH integration efforts and address HIV-related health inequities among youth at highest risk.