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A Systematic Review of HIV Interventions for Young Women in Sub-Saharan Africa

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Abstract

Adolescent girls and young women (AGYW) ages (15–24 years old) in Southern and Eastern Africa account for nearly 30% of all new HIV infections. We conducted a systematic review of studies examining the effectiveness of behavioral, structural, and combined (behavioral + structural) interventions on HIV incidence and risky sexual behaviors among AGYW. Following PRISMA guidelines, we searched PubMed, CINAHL, Web of Science, and Global Health. Twenty-two studies met inclusion criteria conducted in Eastern and Southern Africa and comprised behavioral, structural, or combined (behavioral and structural) interventions. All findings are based on 22 studies. HIV incidence was significantly reduced by one structural intervention. All three types of interventions improved condom use among AGYW. Evidence suggests that structural interventions can reduce HIV incidence, while behavioral and combined interventions require further investigation.

Resumen

Niñas adolescentes y las mujeres jóvenes (15–24 años) en África meridional y oriental representan casi 30% de las nuevas infecciones por VIH. Se realizó una revisión sistemática de estudios que examinan la efectividad de las intervenciones estructurales, de comportamiento, y combinadas (comportamiento + estructurales) sobre la incidencia de VIH y las conductas sexuales de alto riesgo entre niñas adolescentes y las mujeres jóvenes. Siguiendo las pautas de PRISMA, se buscaron estudios en PubMed, CINAHL, Web of Science, y Global Health. Veintidós estudios cumplieron con los criterios de inclusión realizados en África oriental y meridional, e incluyeron intervenciones de comportamiento, estructurales, o combinadas (comportamiento + estructurales). Todos los resultados y conclusiones están basados en los 22 estudios. La incidencia de VIH fue significativamente reducida por una intervención estructural. Los tres tipos de intervenciones mejoraron el uso de condones entre niñas adolescentes y las mujeres jóvenes. Evidencia sugiere que las intervenciones estructurales pueden reducir la incidencia de VIH mientras intervenciones de comportamiento e intervenciones combinadas requieren mayor investigación.

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Acknowledgements

The authors would like to thank Mark Toles, PhD, RN, FAAN, Suzanne Thoyre, PhD, RN, Jada L. Brooks, PhD, MSPH, RN, and all colleagues of CM for useful critiques, feedback, and discussions that helped shape this manuscript.

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Authors and Affiliations

  1. School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, S Columbia St, Chapel Hill, NC, 27599, USA

    Carolyne N. Muthoni & Jessica R. Williams

  2. School of Nursing, UNC-CH Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Shawn M. Kneipp

  3. Substance Use, Gender, and Applied Research (SUGAR) Program, RTI International, Durham, NC, USA

    Margaret W. Gichane

  4. College of Nursing, East Carolina University, Greenville, NC, USA

    Courtney E. Caiola

  5. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Audrey E. Pettifor

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  1. Carolyne N. Muthoni
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  4. Courtney E. Caiola
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Contributions

CM developed the idea, developed search terms, extracted data, and wrote the manuscript. SK provided critical feedback on the initial development of the idea, read all manuscripts and provided in depth feedback. MG reviewed articles, extracted data, and provided critical feedback. AP provided initial guidance on HIV intervention research and gaps reviewed and provided critical feedback on manuscript. JW provided feedback on manuscript helped shape the manuscript. All authors read and approved the final manuscript.

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Correspondence to Carolyne N. Muthoni.

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Muthoni, C.N., Kneipp, S.M., Gichane, M.W. et al. A Systematic Review of HIV Interventions for Young Women in Sub-Saharan Africa. AIDS Behav 24, 3395–3413 (2020). https://doi.org/10.1007/s10461-020-02914-1

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