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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

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Abstract

This paper addresses the issue of how to target interventions to girls 15–19 and young women 20–24 in a resource poor setting of Hwange District, Zimbabwe. The Priorities for Local AIDS Control efforts methodology was used to understand where these young people socialize and also to understand whether age disparate relationships were a common occurrence. Findings indicated prevention efforts for those 15–19 would need to focus on “everyday” sites as these are the places where the majority of girls socialized. However, the girls 15–19 with the riskiest sexual behaviors were found at venues affiliated with alcohol. Prevention efforts for those 20–24 would also need to largely focus on venues affiliated with alcohol. Women at such sites generally reported more risky behaviors than women in other types of venues. Reporting of a partner 5 or more years older was common across age groups and across venues. Tackling HIV in Zimbabwe will take a multifaceted approach targeted towards the places girls 15–19 and young women 20–24 are meeting new partners.

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References

  • Anderson, R. (1999). Transmission dynamics of sexually transmitted infections. In K. Holmes, P. Mardh, & P. Sparling (Eds.), Sexually transmitted diseases (pp. 25–37). New York: McGraw-Hill.

    Google Scholar 

  • Anderson, R., & May, R. (1988). Epidemiological parameters of HIV transmission. Nature, 333, 514–519. doi:10.1038/333514a0.

    Article  CAS  PubMed  Google Scholar 

  • Central Statistical Office (CSO) of Zimbabwe, Macro International Inc. (2007). Zimbabwe demographic and health survey 2005–06. Calverton, Maryland: Author.

    Google Scholar 

  • Chinake, H., Dunbar, M., van der Straten, A., Esim, S., Makunike, B., & Padian, N. (2002). Intergenerational sex among adolescents in Zimbabwe. Paper presented at the Fourteenth International AIDS Conference, Barcelona, 7–12 July.

  • Cleland, J., Boerma, J., Carael, M., & Weir, S. (2004). Monitoring sexual behavior in general populations: A synthesis of lessons of the past decade. Sexually Transmitted Infections, 78(Suppl 11), ii1–ii7. doi:10.1136/sti.2004.013151.

    Article  Google Scholar 

  • Cowan, F. M., Langhaug, L., Mashungupa, G. P., Nyamurera, T., Hargive, J., Jaffar, S., et al. (2002). School-based HIV prevention in Zimbabwe: Feasibility and acceptability of evaluation trials using biological outcomes. AIDS (London, England), 16(12), 1673–1678. doi:10.1097/00002030-200208160-00013. Regai Dzive Shiri Project.

    Google Scholar 

  • Fenton, K., Johnson, A., McManus, S., & Erens, B. (2001). Measuring sexual behavior: Methodological challenges in survey research. Sexually Transmitted Infections, 77, 84–92. doi:10.1136/sti.77.2.84.

    Article  CAS  PubMed  Google Scholar 

  • Fisher, J., Bang, H., & Kapiga, S. (2007). The association between HIV infection and alcohol use: A systematic review and meta-analysis of African studies. Sexually Transmitted Diseases, 11, 856–863. doi:10.1097/OLQ.0b013e318067b4fd.

    Article  Google Scholar 

  • Fritz, K. E., Woelk, G. B., Bassett, M., McFarland, W. C., Routh, J. A., Tobaiwa, O., et al. (2002). The association between alcohol use, sexual risk behavior and HIV infection among men attending beerhalls in Harare, Zimbabwe. AIDS and Behavior, 6(3), 221–228. doi:10.1023/A:1019887707474.

    Article  Google Scholar 

  • Grassly, N., Garnett, G., Schwartlander, B., Gregson, S., & Anderson, R. (2001). The effectiveness of HIV prevention and the epidemiologic context. Bulletin of the World Health Organization, 79, 1121–1132.

    CAS  PubMed  Google Scholar 

  • Gregson, S., Nyamukapa, C. A., Garnett, G. P., Wambe, M., Lewis, J. J. C., Mason, P. R., et al. (2002). Sexual mixing patterns and sex-differentials in teenage exposure to HIV infection in rural Zimbabwe. Lancet, 359(9321), 1896–1903. doi:10.1016/S0140-6736(02)08780-9.

    Article  PubMed  Google Scholar 

  • Huygens, P., Kajura, E., Seeley, J., & Barton, T. (1996). Rethinking methods for the study of sexual behavior. Social Science and Medicine, 42, 221–231. doi:10.1016/0277-9536(95)00088-7.

    Article  CAS  PubMed  Google Scholar 

  • Kalichman, S., Simbayi, L., Kaufman, M., Cain, D., & Jooste, S. (2007). Alcohol use and sexual risks for HIV/AIDS in sub-Saharan Africa: Systematic review of empirical findings. Prevention Science, 8, 141–151. doi:10.1007/s11121-006-0061-2.

    Article  PubMed  Google Scholar 

  • Kalichman, S., Simbayi, L., Vermaak, R., Jooste, S., & Cain, D. (2008). HIV/AIDS Risks among men and women who drink at informal alcohol serving establishments (shebeens) in Cape Town, South Africa. Prevention Science, 9, 55–62. doi:10.1007/s11121-008-0085-x.

    Article  PubMed  Google Scholar 

  • Katz, I., & Low-Beer, D. (2008). Why has HIV stabilized in South Africa, yet not declined further? Age and sexual behavior patterns among youth. Sexually Transmitted Diseases, 35(10), 837–842. doi:10.1097/OLQ.0b013e31817c0be5.

    Article  PubMed  Google Scholar 

  • Kelly, R., Gray, R., Sewankambo, N., Serwadda, D., Wabwirre-Mangen, F., Lutalo, F., et al. (2003). Age differences in sexual partners and risk of HIV-1 infection in rural Uganda. Journal of Acquired Immune Deficiency Syndromes, 32(4), 446–451. doi:10.1097/00126334-200304010-00016.

    Article  PubMed  Google Scholar 

  • Lewis, J. J., Garnett, G. P., Mhlanga, S., Nyamukapa, C. A., Donnelly, C. A., & Gregson, S. (2005). Beer halls as a focus for HIV prevention activities in rural Zimbabwe. Sexually Transmitted Diseases, 32, 364–369. doi:10.1097/01.olq.0000154506.84492.61.

    Article  PubMed  Google Scholar 

  • Luke, N. (2003). Age and economic asymmetries in the sexual relationships of adolescent girls in sub-Saharan Africa. Studies in Family Planning, 34(2), 67–86. doi:10.1111/j.1728-4465.2003.00067.x.

    Article  PubMed  Google Scholar 

  • MACRO International Inc. (2008). HIV prevalence estimates from the demographic and health surveys. Calverton, Maryland: Macro International Inc.

    Google Scholar 

  • Madlala, S. (2008). Age-disparate and intergenerational sex in southern Africa: The dynamics of hypervulnerability. AIDS (London, England), 22(Suppl 4), S17–S25. doi:10.1097/01.aids.0000341774.86500.53.

    Google Scholar 

  • Marindi, R., Pearson, S., & Casterline, J. (2003). Condom use and abstinence among unmarried young people in Zimbabwe: Which strategy, whose agenda?. New York: Population Council.

    Google Scholar 

  • Mataure, P., McFarland, W., Fritz, K., Kim, A., Woelk, G., Ray, S., et al. (2002). Alcohol use and high-risk sexual behavior among adolescents and young adults in Harare, Zimbabwe. AIDS and Behavior, 6(3), 211–219. doi:10.1023/A:1019835723404.

    Article  Google Scholar 

  • MEASURE Evaluation Project. (2005). Priorities for local AIDS control efforts 2005. A manual for implementing the PLACE method. Chapel Hill, NC: MEASURE Evaluation Project: University of North Carolina at Chapel Hill.

  • Morojele, N. K., Kachieng’a, M. A., Mokoko, E., Nkoko, M. A., Parry, C. D. H., Nkowane, A. M., et al. (2006). Alcohol use and sexual behavior among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa. Social Science and Medicine, 62, 217–227. doi:10.1016/j.socscimed.2005.05.031.

    Article  PubMed  Google Scholar 

  • Singh, K., Sambisa, W., Munyati, S., Chandiwana, B., Chingono, A. M., & Mashange, W. (2008). PLACE in Zimbabwe: Identifying gaps in HIV prevention among young people in Hwange District, 2006. Chapel Hill, NC: MEASURE Evaluation Project: University of North Carolina at Chapel Hill.

  • Tate, J., Singh, K., Ndubani, P., Kwmwanga, J., & Buckner, B. (2008). Measurement of HIV prevention indicators: A comparison of the PLACE method and a household survey in Zambia. AIDS and Behavior. doi:10.1007/s10461-008-9505-y.

  • UNAIDS. (2000). National AIDS programmes: A guide to monitoring and evaluation. Geneva: Author.

    Google Scholar 

  • UNAIDS. (2006). 2006 Report on the global AIDS epidemic, May 2006. Geneva: Author.

    Google Scholar 

  • UNAIDS. (2008). 2008 Report on the global AIDS epidemic, August 2008. Geneva: Author.

    Google Scholar 

  • UNICEF. (2005). Zimbabwe’s Forgotten Children (Retrieved December 10, 2008 from http://www.unicef.org/media/media_25617.html).

  • Wasserheit, J., & Aral, S. (1996). The dynamic topology of sexually transmitted disease epidemics: Implications for prevention strategies. The Journal of Infectious Diseases, 174(Suppl 2), S201–S213.

    PubMed  Google Scholar 

  • Weir, S., Figueroa, J., Byfield, L., Hall, A., Cummings, S., & Suchindran, C. (2008). A randomized controlled trial to investigate impact of site-based safer sex programs in Kingston, Jamaica: Trial design, methods and baseline findings. Tropical Medicine & International Health, 13(6), 801–813.

    CAS  Google Scholar 

  • Weir, S., Pailman, C., Mahlalela, X., Coetzee, N., Meidany, F., & Boerma, J. (2003). From people to places: Focusing AIDS prevention efforts where it matters most. AIDS (London, England), 17(6), 895–903. doi:10.1097/00002030-200304110-00015.

    Google Scholar 

  • Weir, S. S., Tate, J. E., Zhusupov, B., & Boerma, J. T. (2004). Where the action is: Monitoring local trends in sexual behavior. Sexually Transmitted Infections, 80(Suppl 2), 63–68. doi:10.1136/sti.2004.012336.

    Google Scholar 

  • WHO. (2006). Country health system fact sheet 2006 Zimbabwe. (Retrieved December 10, 2008 from http://www.who.int/countries/zwe/en/).

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Acknowledgments

This study was funded by the US Agency for International Development (USAID) under the terms of Cooperative Agreement GPO-A-00-03-00003-00. UNICEF Zimbabwe also provided funding for this study. The authors wish to thanks the study participants, Ilene Speizer for her helpful comments and Elizabeth Jackson for her assistance during the fieldwork.

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Correspondence to Kavita Singh.

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Singh, K., Sambisa, W., Munyati, S. et al. Targeting HIV Interventions for Adolescent Girls and Young Women in Southern Africa: Use of the PLACE Methodology in Hwange District, Zimbabwe. AIDS Behav 14, 200–208 (2010). https://doi.org/10.1007/s10461-009-9572-8

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