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Randomized Controlled Trial
. 2021 Feb 2;35(2):275-285.
doi: 10.1097/QAD.0000000000002722.

Impact of a community-wide combination HIV prevention intervention on knowledge of HIV status among adolescents

Kwame Shanaube  1 , Ab Schaap  1   2 , Graeme Hoddinott  3 , Constance Mubekapi-Musadaidzwa  3 , Sian Floyd  2 , Peter Bock  3 , Richard Hayes  2 , Sarah Fidler  4 , Helen Ayles  1   2 ; HPTN 071 (PopART) Study Team
Affiliations
Randomized Controlled Trial

Impact of a community-wide combination HIV prevention intervention on knowledge of HIV status among adolescents

Kwame Shanaube et al. AIDS. .

Abstract

Objective: To determine the impact of a community-wide combination HIV-prevention package (PopART Intervention) that includes universal testing and treatment (UTT) on knowledge of HIV status, among adolescents aged 15--19 years.

Design: The HPTN 071 (PopART) for Youth (P-ART-Y) study was nested within HPTN 071 (PopART), a three-arm, cluster-randomized trial conducted from 2013 through 2018 in 21 communities in Zambia and South Africa. Communities were randomly assigned to arm A (combination prevention intervention with universal ART), arm B (prevention intervention with ART provided according to local guidelines), or arm C (standard-of-care).

Methods: Knowledge of HIV status was measured using data collected during the third round of the PopART intervention in arms A and B (October 2016 to December 2017) and by conducting a cross-sectional survey (August to November 2017) in arm C communities to provide comparative data. The survey was conducted among ∼200 randomly selected adolescents in each community. We used linear regression of the 21 community-level values to make comparisons among trial arms.

Results: Knowledge of HIV status was 78.2% (23 544/30 089) in arm A and 76.0% (24 417/32 148) in arm B communities, compared with 32.9% (698/2120) in arm C communities. Knowledge of HIV status varied by country, triplet, sex, and age. The adjusted mean difference was 42.3% between arm A with arm C, 95% CI 28.1-56.6, P less than 0.001 and 40.4% between arm B with arm C, 95% CI 24.6-56.2, P < 0.001).

Conclusion: Implementation of a community-wide combination HIV-prevention package that includes UTT substantially enhanced knowledge of HIV status among adolescents.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
(a) Participation of adolescents aged 15--19 years in round 3 of the PopART intervention in eight communities (arms A and B) in Zambia. (b) Participation of adolescents aged 15--19 years in round 3 of the PopART intervention in six communities (arms A and B) in South Africa. (c) Participation of adolescents aged 15--19 years in the cross-sectional survey in four arm C communities in Zambia. (d) Participation of adolescents aged 15-19 years in the cross-sectional survey in 3 Arm C communities in South Africa.
Fig. 1 (Continued)
Fig. 1 (Continued)
(a) Participation of adolescents aged 15--19 years in round 3 of the PopART intervention in eight communities (arms A and B) in Zambia. (b) Participation of adolescents aged 15--19 years in round 3 of the PopART intervention in six communities (arms A and B) in South Africa. (c) Participation of adolescents aged 15--19 years in the cross-sectional survey in four arm C communities in Zambia. (d) Participation of adolescents aged 15-19 years in the cross-sectional survey in 3 Arm C communities in South Africa.
Fig. 2
Fig. 2
(a) Knowledge of HIV status in adolescents aged 15--19 years in Zambia by PopART trial arm, age, and sex. (b) Knowledge of HIV status in adolescents aged 15--19 years in South Africa by PopART trial arm, age, and sex.
Fig. 3
Fig. 3
Community-level summaries of age--sex standardized knowledge HIV status in adolescents aged 15--19 years in all 21 PopART communities overall and by country.
See this image and copyright information in PMC

References

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