Sista2Sista program improves HIV, other health outcomes among youths in Zimbabwe
Click Here to Manage Email Alerts
Zimbabwean adolescent girls and young women who graduated from a program supporting girls-only clubs were more likely to take an HIV test and less likely to drop out of school, among other positive outcomes, researchers reported.
In 2013, the Zimbabwe Ministry of Health and Child Care partnered with the United Nations Population Fund to design and implement a structured peer group behavioral intervention program called Sista2Sista that was geared toward adolescent girls and young women (AGYW) aged between 10 and 24 years.
Dagmar Hanisch, MPH, technical specialist for HIV prevention and sexual reproductive health for the United Nations Population Fund, and colleagues analyzed data on 91,612 AGYW enrolled in Sista2Sista from 2013 to 2019.
“Using logistic regression, we evaluated Sista2Sista program exposure as a factor in a set of predetermined variables, including HIV testing, marriage, school attendance, family planning, pregnancy and reported sexual abuse,” Hanisch said in a presentation at the International AIDS Conference. “We followed up with a subset of graduates 1 year later, to assess the sustainability of outcomes.”
In order to be considered a graduate of the program, participants must have completed at least 30 of the 40 available exercises the program offers. A total of 58,471 (63.82%) AGYW completed at least 30 exercises.
Graduates were more likely to take an HIV test (OR = 2.78; 95% CI, 2.52-3.10), less likely to get married (OR = 0.63; 95% CI, 0.55-0.73) and less likely to drop out of school (OR = 0.6; 95% CI, 0.53-0.69), the researchers reported.
“Attrition from the program was low. Just 384 participants dropped out over a 7-year period, which is less than half of 1%,” Hanisch said.
Participants who completed all 40 of the offered exercises were more likely to go back to school (OR = 1.41; 95% CI, 1.18-1.69), report the use of a family planning method (OR = 1.38; 95% CI, 1.21-1.56) and report sexual abuse (OR = 1.76; 95% CI, 1.17-2.66), according to the researchers. They were also less likely to become pregnant as adolescents (OR = 0.41; 95% CI, 0.24-0.72).
“It is worth noting here that all of the outcomes [assessing] pregnancy rates were the most resistant to change,” Hanisch said. “This is consistent with similar program evaluations in the region, which have shown this to be a particularly stubborn indicator.”
The researchers said strategies to retain participants in the program for a longer period should be explored.
“Follow-up data on a subset of our graduates showed that more than 80% were either staying in school or advancing to formal and informal employment,” Hanisch said. “Some have even started their own businesses.”
Collapse
Hanisch D, et al. Effectiveness of the Sista2Sista program on improving HIV and other sexual and reproductive health outcomes among vulnerable adolescent girls and young women in Zimbabwe. Presented at: International AIDS Conference; July 6-10, 2020 (virtual meeting).
Click Here to Manage Email Alerts