BACKGROUND Young women in sub-Saharan Africa remain at the epicentre of the HIV epidemic, with surveillance data indicating persistent high levels of HIV incidence. In South Africa, adolescent girls and young women (AGYW) account for a quarter of all new HIV infections. Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) is a strategy introduced by the United States President's Emergency Plan for AIDS Relief (PEPFAR) aimed at reducing HIV incidence among AGYW in 10 countries in sub-Saharan Africa by 25% in the programme's first year, and by 40% in the second year. This study will assess the change in HIV incidence and reduction in risk associated behaviours that can be attributed to the DREAMS initiative in South Africa, using a population-based cross-sectional survey. METHODS Data will be collected from a household-based representative sample of AGYW (between the ages 12-24 years) in four high prevalence districts (more than 10% of the population have HIV in these districts) in South Africa in which DREAMS has been implemented. A stratified cluster-based sampling approach will be used to select eligible participants for a cross-sectional survey with 18,500, to be conducted over 2017/2018. A questionnaire will be administered containing questions on sexual risk behaviour, selected academic and developmental milestones, prevalence of gender based violence, whilst examining exposure to DREAMS programmes. Biological samples, including two micro-containers of blood and self-collected vulvovaginal swab samples, are collected in each survey to test for HIV infection, HIV incidence, sexually transmitted infections (STIs) and pregnancy. This study will measure trends in population level HIV incidence using the Limiting antigen (LAg) Avidity Enzyme Immuno-Assay (EIA) and monitor changes in HIV incidence. DISCUSSION Ending the HIV/AIDS pandemic by 2030 requires the continual monitoring and evaluation of prevention programmes, with the aim of optimising efforts and ensuring the achievement of epidemic control. This study will determine the impact DREAMS interventions have had on HIV incidence among AGYW in a 'real world, non-trial setting'.

中文翻译：

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评估针对南非艾滋病毒高发区少女和年轻妇女的 DREAMS 艾滋病毒预防干预措施：横断面研究方案。


背景 撒哈拉以南非洲地区的年轻妇女仍然是艾滋病毒流行的中心，监测数据表明艾滋病毒发病率持续居高不下。在南非，少女和年轻女性 (AGYW) 占所有新艾滋病毒感染者的四分之一。 “坚定、有韧性、赋权、无艾滋病、指导和安全”(DREAMS) 是美国总统艾滋病紧急救援计划 (PEPFAR) 推出的一项战略，旨在将撒哈拉以南非洲 10 个国家的 AGYW 艾滋病毒感染率降低 25 %该计划第一年提高了 %，第二年提高了 40%。本研究将通过基于人口的横断面调查来评估南非 DREAMS 倡议带来的艾滋病毒发病率变化和风险相关行为的减少。方法 数据将从南非四个高流行地区（这些地区超过 10% 的人口感染艾滋病毒）以家庭为基础的 AGYW 代表性样本（年龄在 12-24 岁之间）中收集，DREAMS 已在这些地区开展。实施的。将采用基于分层整群的抽样方法来选择符合资格的参与者，以进行 18,500 人的横断面调查，该调查将于 2017/2018 年进行。将进行一份调查问卷，其中包含有关性危险行为、选定的学术和发展里程碑、基于性别的暴力的普遍程度的问题，同时检查 DREAMS 计划的接触情况。每次调查都会收集生物样本，包括两个微容器血液和自行采集的外阴阴道拭子样本，以检测艾滋病毒感染、艾滋病毒发病率、性传播感染（STI）和怀孕情况。 这项研究将使用限制抗原 (LAg) 亲和力酶免疫测定 (EIA) 来测量人群水平 HIV 发病率的趋势，并监测 HIV 发病率的变化。讨论 到 2030 年结束艾滋病毒/艾滋病流行需要对预防方案进行持续监测和评估，以优化工作并确保实现流行病控制。这项研究将确定 DREAMS 干预措施在“现实世界、非试验环境”中对 AGYW 中艾滋病毒发病率的影响。