Promising short-term outcomes among adolescent girls and young women participating in Zambia DREAMS


BACKGROUND: USAID/Zambia Community HIV Prevention Project (Z-CHPP) is a PEPFAR-funded project implementing Determined Resilient Empowered Aids-Free Mentored and Safe (DREAMS) programming for adolescent girls and young women (AGYW) in Zambia. While DREAMS is built on evidence-based interventions, gaps in the ways in which AGYW benefit from DREAMS activities remain. Pact conducted an outcomes assessment survey to determine the extent to which the core DREAMS activity- a 13-week HIV education curriculum (Stepping-Stones)-has led to positive immediate outcomes.
METHODS: Using single-stage cluster sampling, 2,392 AGYW aged 10-24 were recruited into the study between November 2019 and March 2021. Using a quantitative survey tool, data were collected by 11 randomly selected DREAMS mentors who administered the survey to AGYW at enrollment and at graduation. The tool included measures on resilience, HIV knowledge, and stigma. Frequency analysis was used to compare distribution of categorical variables among the same cohort of AGYW before and after completion of the Stepping-Stones curriculum.
RESULTS: Results demonstrate an increase in AGYW who reported resilience (i.e., social support and connectedness) from 51% (2,388) pre-intervention to 85% (3,964) post-intervention. Findings also showed an increase in HIV knowledge: 82% of AGYW post-intervention who believed that having multiple sexual partners increases the likelihood of contracting HIV compared to 60% pre-intervention and 94% (2,103) at post-intervention believed that HIV cannot be cured by ARVs compared to 63% (1,424) pre-intervention. Results also showed a decrease in perceived stigma of testing HIV positive from 39% (815) pre-intervention to 24% (509) post-intervention.
CONCLUSIONS: DREAMS, particularly the Stepping-Stones curriculum, resulted in positive short-term outcomes among AGYW. Further research will be conducted to assess the extent to which these gains are retained after completing the Stepping-Stones intervention. Findings from both studies will be used to inform future HIV prevention programming for AGYW aged 10 ' 24 years in Zambia.