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
. 2024 May 31;4(5):e0003258.
doi: 10.1371/journal.pgph.0003258. eCollection 2024.

Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa

Nondumiso Mthiyane  1   2 , Maryam Shahmanesh  1   2   3 , Andrew Copas  2 , Natsayi Chimbindi  1   2   3 , Jaco Dreyer  1 , Thembelihle Zuma  1   2   3 , Nuala McGrath  1   3   4 , Kathy Baisley  1   5 , Sian Floyd  5 , Isolde Birdthistle  5 , Lorraine Sherr  2 , Janet Seeley  1   6 , Guy Harling  1   2   7   8
Affiliations

Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa

Nondumiso Mthiyane et al. PLOS Glob Public Health. .

Abstract

Combination HIV prevention packages have reduced HIV incidence and improved HIV-related outcomes among young people. However, there is limited data on how package components interact to promote HIV-related prevention behaviours. We described the uptake of HIV prevention interventions supported by Determined, Resilient, Empowered, AIDS-free, Motivated and Safe (DREAMS) Partnership and assessed the association between uptake and HIV-related behaviours among young people in rural KwaZulu-Natal, South Africa. We analysed two cohorts followed from May 2017 to December 2019 to evaluate the impact of DREAMS, covering 13-29 year-old females, and 13-35 year-old males. DREAMS interventions were categorised as healthcare-based or social. We described the uptake of interventions and ran logistic regression models to investigate the association between intervention uptake and subsequent protective HIV-related outcomes including no condomless sex and voluntary medical male circumcision (VMMC). For each outcome, we adjusted for socio-demographics and sexual/pregnancy history and reported adjusted odds ratios (aOR) and 95% confidence intervals (CI). Among 5248 participants, uptake of healthcare interventions increased from 2018 to 2019 by 8.1% and 3.7% for males and females respectively; about half of participants reported receiving both healthcare and social interventions each year. The most utilised combinations of interventions included HIV testing and counselling, school-based HIV education and cash transfers. Participation in social interventions only compared to no intervention was associated with reduced condomless sex (aOR = 1.60, 95%CI: 1.03-2.47), while participation in healthcare interventions only was associated with increased condomless sex. The uptake of interventions did not significantly affect subsequent VMMC overall. Among adolescent boys, exposure to school-based HIV education, cash transfers and HIV testing and counselling was associated with increase in VMMC (aOR = 1.79, 95%CI: 1.04-3.07). Multi-level HIV prevention interventions were associated with an increase in protective HIV-related behaviours emphasizing the importance of accessible programs within both school and community settings for young people.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Recruitment and participation flowchart.
Fig 2
Fig 2. Causal model indicating the hypothesized exposure-outcome relationship.
Fig 3
Fig 3. Uptake of interventions, by age, gender and year of survey.
Fig 4
Fig 4. Uptake of multi-level interventions, by age and year of survey.
Fig 5
Fig 5. Uptake of combination of HIV prevention interventions in 2018.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Simbayi LC, Zuma K, Zungu N, Moyo S, Marinda E, Jooste S, et al.. South African National HIV Prevalence, Incidence, Behaviour and Communication Survey.2017. Cape Town: HSRC Press; 2019. [cited 2023 December 20]. Available from: https://www.hsrcpress.ac.za/books/south-african-national-hiv-prevalence-....
    1. Kanyemba R, Govender K, Dzomba A, Mashamba TP, Mantell JE. HIV Focused Sexual Risk-Reduction Interventions Targeting Adolescent Boys and Young Men in Sub-Saharan Africa: A Scoping Review. AIDS Behav. 2023;27(10):3356–91. doi: 10.1007/s10461-023-04054-8 - DOI - PMC - PubMed
    1. Pettifor A, Nguyen NL, Celum C, Cowan FM, Go V, Hightow-Weidman L. Tailored combination prevention packages and PrEP for young key populations. Journal of the International AIDS Society. 2015;18(2 Suppl 1):19434. doi: 10.7448/IAS.18.2.19434 - DOI - PMC - PubMed
    1. Pettifor A, Stoner M, Pike C, Bekker L-G. Adolescent lives matter: preventing HIV in adolescents. Curr Opin HIV AIDS. 2018;13(3):265–73. doi: 10.1097/COH.0000000000000453 - DOI - PMC - PubMed
    1. Fatti G, Shaikh N, Jackson D, Goga A, Nachega JB, Eley B, et al.. Low HIV incidence in pregnant and postpartum women receiving a community-based combination HIV prevention intervention in a high HIV incidence setting in South Africa. PloS one. 2017;12(7):e0181691. doi: 10.1371/journal.pone.0181691 - DOI - PMC - PubMed

LinkOut - more resources