Population Council, Washington, DC, USA.
Population Council Consulting Private Limited.
AIDS. 2022 Jun 15;36(Suppl 1):S75-S83. doi: 10.1097/QAD.0000000000003242.
To assess how exposure to multiple, layered interventions predicts HIV-related outcomes among adolescent girls (15-19 years) and young women (20-24 years) in Kenya.
Survey data from adolescent girls and young women (n = 736) with 14-16 months of engagement with DREAMS, a comprehensive HIV prevention program that provides a range of health education, life skills, social protection, and social and behaviour change interventions.
Nonparametric recursive partitioning technique - classification and regression tree (CART) - to identify the best predictors (DREAMS interventions) for achieving the desired HIV-related outcomes (consistent condom use and no transactional sex or sexual violence).
Among adolescent girls, schooling support reduced the likelihood of engaging in transactional sex, whereas schooling support and exposure to parenting program reduced the likelihood experiencing sexual violence. Likelihood of consistent condom use increased among adolescent girls with exposure to preexposure prophylaxis (PrEP), schooling support, and the violence prevention programming. Among young women, multiple pathways reduced the likelihood of engaging in transactional sex: exposure to the male sexual partner program; exposure to the youth fund program; exposure to the violence prevention program; or exposure/engagement with schooling support, parenting programming, and the youth fund program. For young women, consistent condom use increased with schooling support and male partner engagement. Additionally, engagement in violence prevention program and male partner engagement increased the likelihood of not experiencing sexual violence among young women.
Exposure to a combination of DREAMS interventions predicted outcomes that can reduce HIV risk among AGYW, though the pathways differed by outcome and age group.
评估肯尼亚青少年女孩（15-19 岁）和年轻妇女（20-24 岁）接触多种分层干预措施对艾滋病毒相关结局的影响。
来自接受 DREAMS（一项综合性艾滋病毒预防计划）的青少年女孩和年轻妇女（n=736）的调查数据，该计划提供了一系列健康教育、生活技能、社会保护以及社会和行为改变干预措施。
非参数递归分区技术-分类和回归树（CART）-用于识别实现期望的艾滋病毒相关结局（持续使用避孕套和无交易性性行为或性暴力）的最佳预测因素（DREAMS 干预措施）。
在青少年女孩中，学校支持降低了从事交易性性行为的可能性，而学校支持和父母教育计划的接触降低了遭受性暴力的可能性。接触暴露前预防（PrEP）、学校支持和暴力预防编程增加了青少年女孩持续使用避孕套的可能性。对于年轻妇女，多种途径降低了从事交易性性行为的可能性：接触男性性伴侣计划；接触青年基金计划；接触暴力预防计划；或接触/参与学校支持、父母教育计划和青年基金计划。对于年轻妇女，学校支持和男性伴侣参与增加了持续使用避孕套的可能性。此外，参与暴力预防计划和男性伴侣参与增加了年轻妇女不遭受性暴力的可能性。
接触 DREAMS 干预措施组合预测了可以降低 AGYW 艾滋病毒风险的结果，但途径因结局和年龄组而异。
