The SHAZ! Project: Results from a Pilot Randomized Trial of a Structural Intervention to Prevent HIV among Adolescent Women in Zimbabwe

January 2015 - Structural Prevention

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Dunbar, M. S., Kang Dufour, M. S., Lambdin, B, et al. PLoS ONE (November 2014), doi: 10.1371/journal.pone.0113621.

Shaping the Health of Adolescents in Zimbabwe (SHAZ!) is a randomized controlled trial comparing the HIV prevention impact of a combined intervention package (including life-skills and health education, vocational training, micro-grants, and social supports) to the impact of life skills and health education alone. This study assessed the impact of adding a livelihoods intervention (financial literacy education and a choice of vocational training); and integrated social support (guidance counseling to help participants navigate challenges, along with self-selected adult mentors) to the combined SHAZ! intervention package. The study included 315 eligible female adolescents aged 16–19 years who were randomly assigned to the intervention or control group. Intervention participants received the livelihood and integrated social support interventions, in addition to the other SHAZ! interventions that all participants received. The study found that intervention participants had lower risk of transactional sex [IOR = 0.64, 95% CI (0.50, 0.83)], and a higher likelihood of using a condom with their current partner [IOR = 1.79, 95% CI (1.23, 2.62)] over time compared to baseline. There was also evidence of fewer unintended pregnancies among intervention participants [HR = 0.61, 95% CI (0.37, 1.01)], although this relationship achieved only marginal statistical significance. The authors concluded that future HIV prevention packages for adolescent females should include interventions for vocational training and micro-grants along with other interventions.

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