Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jun 10:1:53.
doi: 10.1186/s43058-020-00042-4. eCollection 2020.

Is it time to RE-AIM? A systematic review of economic empowerment as HIV prevention intervention for adolescent girls and young women in sub-Saharan Africa using the RE-AIM framework

Juliet Iwelunmor  1 , Ucheoma Nwaozuru  1 , Chisom Obiezu-Umeh  1 , Florida Uzoaru  1 , John Ehiri  2 , Jami Curley  1 , Oliver Ezechi  3 , Collins Airhihenbuwa  4 , Fred Ssewamala  5
Affiliations
Review

Is it time to RE-AIM? A systematic review of economic empowerment as HIV prevention intervention for adolescent girls and young women in sub-Saharan Africa using the RE-AIM framework

Juliet Iwelunmor et al. Implement Sci Commun. .

Abstract

Background: Economic empowerment (EE) HIV prevention programs for adolescent girls and young women (AGYW) in sub-Saharan Africa are gaining traction as effective strategies to reduce HIV risk and vulnerabilities among this population. While intervention effectiveness is critical, there are numerous factors beyond effectiveness that shape an intervention's impact. The objective of this systematic review was to assess the reporting of implementation outcomes of EE HIV prevention programs for AGYW in SSA, as conceptualized in the RE-AIM (reach, efficacy/effectiveness, adoption, implementation, and maintenance) framework.

Methods: We searched PubMed, Ovid/MEDLINE, Science Direct, Ebscohost, PsycINFO, Scopus, and Web of Science for EE HIV interventions for AGYW in SSA. Study selection and data extraction were conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Two researchers coded each article using a validated RE-AIM data extraction tool and independently extracted information from each article. The reporting of RE-AIM dimensions were summarized and synthesized across included interventions.

Results: A total of 25 unique interventions (reported in 45 articles) met the predefined eligibility criteria. Efficacy/effectiveness 19(74.4%) was the highest reported RE-AIM dimension, followed by adoption 17(67.2%), reach 16(64.0%), implementation 9(38.0%), and maintenance 7(26.4%). Most interventions reported on RE-AIM components such as sample size 25(100.0%), intervention location 24(96.0%), and measures and results for at least one follow-up 24(96.0%). Few reported on RE-AIM components such as characteristics of non-participants 8(32.0%), implementation costs 3(12.0%), and intervention fidelity 0(0.0%).

Conclusions: Results of the review emphasize the need for future economic empowerment HIV prevention interventions for AGYW in SSA to report multiple implementation strategies and highlight considerations for translating such programs into real-world settings. Researchers should pay close attention to reporting setting-level adoption, implementation cost, and intervention maintenance. These measures are needed for policy decisions related to the full merit and worth of EE HIV interventions and their long-term sustainability for AGYW.

Keywords: Adolescent girls; Economic empowerment; RE-AIM; Sub-Saharan Africa; Young women.

PubMed Disclaimer

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests

Figures

Fig. 1
Fig. 1
Flow diagram of the search strategy. A total of 25 unique interventions reported in 45 articles were included in the review
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Karim QA, Baxter C, Birx D. Prevention of HIV in adolescent girls and young women: key to an AIDS-free generation. J Acquir Immune Defic Syndr. 2017;75:S17–S26. doi: 10.1097/QAI.0000000000001316. - DOI - PubMed
    1. Jewkes R, Morrell R. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention. J Int AIDS Soc. 2010;13(1):6. doi: 10.1186/1758-2652-13-6. - DOI - PMC - PubMed
    1. Muhanguzi FK. Gender and sexual vulnerability of young women in Africa: experiences of young girls in secondary schools in Uganda. Cult Health Sex. 2011;13(06):713–725. doi: 10.1080/13691058.2011.571290. - DOI - PubMed
    1. Women and HIV: A Spotlight on adolescent girls and young women [https://www.unaids.org/sites/default/files/media_asset/2019_women-and-hi...].
    1. UNAIDS: Women and HIV: spotlight on adolescent girls and young women. In. Geneva; 2019.