Targeting HIV Interventions for Adolescent Girls and Young Women in Southern Africa: Use of the PLACE Methodology in Hwange District, Zimbabwe

A venue-based HIV prevention study which included Voluntary Counseling and Testing (VCT) was conducted in three diverse areas of Kenya— Malindi, Nanyuki and Rachounyo. Aims of the study were to: 1) assess the acceptability of VCT for the general population, men who have sex with men (MSM), and injecting drug users (IDUs) within the context of a venue-based approach; 2) determine if there were differences between those agreeing and not agreeing to testing; and 3) study factors associated with being HIV positive. Approximately 98% of IDUs and 97% of MSM agreed to VCT, providing evidence that populations with little access to services and whose behaviors are stigmatized and often considered illegal in their countries can be reached with needed HIV prevention services. Acceptability of VCT in the general population ranged from 60% in Malindi to 48% in Nanyuki. There were a few significant differences between those accepting and declining testing. Notably in Rachuonyo and Malindi those reporting multiple partners were more likely to accept testing. There was also evidence that riskier sexual behavior was associated with being HIV positive for both men in Rachounyo and women in Malindi. Overall HIV prevalence was higher among the individuals in this study compared to individuals sampled in the 2008–2009 Kenya Demographic and Health Survey, indicating the method is an appropriate means to reach the highest risk individuals including stigmatized populations.

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“…[21] The nightlife/drinking sites include places where people go to eat, drink, dance etc. Often alcohol is consumed at such sites.…”

Section: Methodsmentioning

confidence: 99%

A Venue-Based Approach to Reaching MSM, IDUs and the General Population with VCT: A Three Study Site in Kenya

et al. 2011

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“…Many HIV-positive AGYW in Zimbabwe are engaged in age-disparate relationships. They have sexual relationships with much older men, a sexual mixing pattern that has been reported frequently in Zimbabwe and in Africa in general [3,10,63,64]. Relationships with male partners more than 10 years older was more prevalent among rural than urban participants.…”

Section: Discussionmentioning

confidence: 89%

“…Among young men, HIV prevalence holds steady at around 2.5% until the age of 23-24, when it increases to 6.0% [2]. Age-disparate sex, multiple partnership, transactional sex, early sexual debut, social and gender norms, and gaps in knowledge have been identified as factors that contribute to HIV infection among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA) and Zimbabwe in particular [3][4][5][6][7][8][9]. The identification of these important determinants of HIV transmission led to several studies aimed at describing the socio-demographic characteristics and sexual behaviors of male partners of AGYW and implementing more targeted interventions [10,11].…”

Section: Introductionmentioning

confidence: 99%

Urban-rural disparity in sociodemographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women and their perspectives on their male sexual partners: A cross-sectional study in Zimbabwe

et al. 2020

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We conducted a cross sectional survey in Zimbabwe to describe urban-rural disparity in socio-demographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women (AGYW) and their male sexual partners. Between September and November 2016, we interviewed 360 sexually active HIV positive AGYW, aged 15-24 years attending ART and PMTCT clinics in urban and rural health facilities in Harare and Mazowe district respectively. HIV positive AGYW in rural areas as compared to those in urban areas were older, less educated, more frequently married or cohabiting, had lower number of male sexual partners in their lifetime and in the last 12 months preceding the survey. They were mostly heterosexually infected, more likely to disclose their status to a family member and to be more adherent to ART (OR = 2.5-95% CI = 1.1-5.5). Most recent male sexual partners of HIV positive AGYW in urban areas as compared to those from rural areas were mainly current or former boyfriends, single, more educated, less likely to have a child with them and to engage in couple voluntary counseling and testing (CVCT). They were more likely to patronize dancing and drinking venues and involved in transactional sex (OR = 2.2-95% CI: 1.2-4). They were also more likely to be circumcised (OR = 2.3-95% CI: 1.3-4.1) and to use condom more consistently in the last 12 months preceding the survey. Our study findings called for the strengthening of HIV prevention interventions in urban areas among HIV positive AGYW who had more than one partner in their lifetime or are patronizing dancing and drinking venues. In Zimbabwe, promotion of CVCT, index testing, male circumcision and condom use should be sustained to engage male sexual partners of both urban and rural HIV positive AGYW in HIV prevention.

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“…The PLACE method is designed to involve local stakeholders in collecting data to inform the HIV epidemic response. PLACE systematically identifies and maps public venues where people meet new sexual partners, and then uses these maps as a sampling frame to reach, interview and test populations at risk of HIV . UNAIDS recommends PLACE for biobehavioural surveys and KP size estimates .…”

Section: Methodsmentioning

confidence: 99%

The burden of HIV among female sex workers, men who have sex with men and transgender women in Haiti: results from the 2016 Priorities for Local AIDS Control Efforts (PLACE) study

et al. 2019

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Introduction Despite the higher risk of HIV among female sex workers (FSWs), men who have sex with men (MSM) and transgender women (TGW), these populations are under‐represented in the literature on HIV in Haiti. Here, we present the first nationally representative estimates of HIV prevalence and the first care and treatment cascade for FSWs, MSM and TGW in Haiti. We also examine the social determinants of HIV prevalence in these groups and estimate FSW and MSM population size in Haiti. Methods Data were collected between April 2016 and February 2017 throughout the 10 geographical departments of Haiti. The Priorities for Local AIDS Control Efforts (PLACE) method was used to: (1) recruit participants for a behavioural survey; (2) provide rapid testing, counselling and linkage to care for syphilis and HIV; and (3) measure viral load using dried blood spots for participants testing HIV positive. Results Study participants included 990 FSWs, 520 MSM and 109 TGW. HIV prevalence was estimated at 7.7% (95% CI 6.2%, 9.6%) among FSWs, 2.2% (0.9%, 5.3%) among MSM and 27.6% (5.0%, 73.5%) among TGW. Of participants who tested positive for syphilis, 17% of FSWs, 19% of MSM and 74% of TGW were co‐infected with HIV. Economic instability and intimate partner violence (IPV) were significantly associated with HIV among MSM; food insecurity, economic instability and history of rape were significantly associated with HIV among TGW. Fewer than one‐third of participants living with HIV knew their status, and more than a quarter of those who knew their status were not on treatment. While approximately four in five FSW and MSM participants on treatment for HIV were virally suppressed, viral suppression was less common among TGW participants at only 46%. Conclusions This study demonstrates a need for targeted interventions to prevent and treat HIV among key populations in Haiti. Potential high‐impact interventions may include venue‐based, peer navigator‐led outreach and testing for HIV and syphilis and improving screening and case management for structural violence and IPV. TGW are in urgent need of such interventions due to our observations of alarmingly high HIV prevalence and low frequency of HIV viral suppression among TGW.

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Targeting HIV Interventions for Adolescent Girls and Young Women in Southern Africa: Use of the PLACE Methodology in Hwange District, Zimbabwe

Cited by 17 publications

References 23 publications

A Venue-Based Approach to Reaching MSM, IDUs and the General Population with VCT: A Three Study Site in Kenya

A Venue-Based Approach to Reaching MSM, IDUs and the General Population with VCT: A Three Study Site in Kenya

Urban-rural disparity in sociodemographic characteristics and sexual behaviors of HIV-positive adolescent girls and young women and their perspectives on their male sexual partners: A cross-sectional study in Zimbabwe

The burden of HIV among female sex workers, men who have sex with men and transgender women in Haiti: results from the 2016 Priorities for Local AIDS Control Efforts (PLACE) study

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