An individually randomized controlled trial of a mother-daughter HIV/STI prevention program for adolescent girls and young women in South Africa: IMARA-SA study protocol

Geri R Donenberg, Millicent Atujuna, Katherine G Merrill, Erin Emerson, Sheily Ndwayana, Dara Blachman-Demner, Linda Gail Bekker, Geri R Donenberg, Millicent Atujuna, Katherine G Merrill, Erin Emerson, Sheily Ndwayana, Dara Blachman-Demner, Linda Gail Bekker

Abstract

Background: South Africa has the world's largest HIV epidemic, but South African adolescent girls and young women (AGYW) acquire HIV at twice the rate of and seroconvert on average 5-7 years earlier than their male peers. Female caregivers (FC) are an untapped resource for HIV/STI prevention in South Africa and offer a novel opportunity to strengthen AGYW prevention efforts. This study will evaluate the effectiveness and cost-effectiveness of an evidence-based mother-daughter HIV/STI prevention program tested in the United States and adapted for South Africa, Informed Motivated Aware and Responsible Adolescents and Adults (IMARA), to decrease STI incident infections and increase HIV testing and counseling (HTC) and PrEP uptake in AGYW.

Methods: This is a 2-arm individually randomized controlled trial comparing IMARA to a family-based control program matched in time and intensity with 525 15-19-year-old Black South African AGYW and their FC-dyads in Cape Town's informal communities. AGYW will complete baseline, 6-, and 12-month assessments. Following randomization, AGYW-FC dyads will participate in a 2-day group workshop (total 10 h) that includes joint and separate mother and daughter activities. Primary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 6 months. Secondary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 12 months, sexual behavior (e.g., condom use, number of partners), HIV incidence, and ART/PrEP adherence and intervention cost-effectiveness. AGYW who test positive for a STI will receive free treatment at the study site. HIV positive participants will be referred to ART clinics.

Discussion: Primary prevention remains the most viable strategy to stem new STI and HIV transmissions. HIV and STI disparities go beyond individual level factors, and prevention packages that include supportive relationships (e.g., FC) may produce greater reductions in HIV-risk, improve HTC and PrEP uptake, and increase linkage, retention, and adherence to care. Reducing new HIV and STI infections among South African AGYW is global public health priority.

Trial registration: ClinicalTrials.gov Number NCT04758390 , accepted 02/16/2021.

Keywords: Adolescent girls and women; HIV prevention; Mother-daughter intervention; South Africa.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Schema for an individually-randomized controlled trial of the IMARA-SA intervention

References

    1. Joint United Nations Programme on HIV/AIDS (UNAIDS) Ending AIDS: Progress Towards the 90–90-90 Targets. Geneva: Joint United Nations Programme on HIV/AIDS (UNAIDS); 2017.
    1. Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S, Zungu N, Labadarios D, Onoya D. South African national HIV prevalence, incidence and behaviour survey, 2012. Cape Town: HSRC Press; 2014.
    1. Lancet: The global HIV/AIDS epidemic—progress and challenges. Lancet 2017, 390(10092):333.
    1. World Health Organization . Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Geneva: World Health Organization; 2014.
    1. . Young People, HIV and AIDS. 2020. . Accessed 10 Jan 2021.
    1. UNICEF . Towards an AIDS-free generation: children and AIDS sixth stocktaking report. In. UNICEF: New York; 2013.
    1. Adolescents: health risks and solutions. .
    1. Abdool Karim Q, Meyer-Weitz A, Harrison A. Interventions with youth in high prevalence areas. In: Mayer KH, Pizer HF, editors. HIV prevention: A comprehensive approach. London: Academic Press; 2009. p. 407–43.
    1. Blankenship KM, Smoyer AB. Between spaces: Understanding movement to and from prison as an HIV risk factor. In: Crime, HIV and health: Intersections of criminal justice and public health concerns: Springer; 2013. p. 207–21.
    1. Brawner BM. A multilevel understanding of HIV/AIDS disease burden among African American women. J Obstetr Gynecol Neonatal Nurs. 2014;43(5):633–E650. doi: 10.1111/1552-6909.12481.
    1. Coates TJ, Richter L, Caceres C. Behavioural strategies to reduce HIV transmission: how to make them work better. Lancet. 2008;372(9639):669–684. doi: 10.1016/S0140-6736(08)60886-7.
    1. Dietrich J, Sikkema K, Otwombe KN, Sanchez A, Nkala B, de Bruyn G, Van Der Watt M, Gray GE. Multiple levels of influence in predicting sexual activity and condom use among adolescents in Soweto, Johannesburg, South Africa. J HIV AIDS Soc Serv. 2013;12(3–4):404–423. doi: 10.1080/15381501.2013.819312.
    1. Jackson C, Geddes R, Haw S, Frank J. Interventions to prevent substance use and risky sexual behaviour in young people: a systematic review. Addiction. 2012;107(4):733–747. doi: 10.1111/j.1360-0443.2011.03751.x.
    1. Auerbach JD, Parkhurst JO, Caceres CF. Addressing social drivers of HIV/AIDS for the long-term response: conceptual and methodological considerations. Glob Public Health. 2011;6(Suppl 3):S293–S309. doi: 10.1080/17441692.2011.594451.
    1. Baird SJ, Garfein RS, McIntosh CT, Ozler B. Effect of a cash transfer programme for schooling on prevalence of HIV and herpes simplex type 2 in Malawi: a cluster randomised trial. Lancet. 2012;379(9823):1320–1329. doi: 10.1016/S0140-6736(11)61709-1.
    1. Chandra-Mouli V, Lane C, Wong S. What does not work in adolescent sexual and reproductive health: a review of evidence on interventions commonly accepted as best practices. Glob Health Sci Pract. 2015;3(3):333–340. doi: 10.9745/GHSP-D-15-00126.
    1. Folkers GK, Fauci AS. Controlling and ultimately ending the HIV/AIDS pandemic: a feasible goal. JAMA. 2010;304(3):350–351. doi: 10.1001/jama.2010.957.
    1. Hankins CA, de Zalduondo BO. Combination prevention: a deeper understanding of effective HIV prevention. AIDS. 2010;24(Suppl 4):S70–S80. doi: 10.1097/01.aids.0000390709.04255.fd.
    1. Kurth AE, Celum C, Baeten JM, Vermund SH, Wasserheit JN. Combination HIV prevention: significance, challenges, and opportunities. Curr HIV/AIDS Rep. 2011;8(1):62–72. doi: 10.1007/s11904-010-0063-3.
    1. Merson MH, O'Malley J, Serwadda D, Apisuk C. The history and challenge of HIV prevention. Lancet. 2008;372(9637):475–488. doi: 10.1016/S0140-6736(08)60884-3.
    1. Padian NS, McCoy SI, Karim SS, Hasen N, Kim J, Bartos M, Katabira E, Bertozzi SM, Schwartlander B, Cohen MS. HIV prevention transformed: the new prevention research agenda. Lancet. 2011;378(9787):269–278. doi: 10.1016/S0140-6736(11)60877-5.
    1. Cellum C, Delany-Moretlwe S. HPTN 082: evaluation of daily oral PrEP as a primary prevention strategy for young African women. Paris: International AIDS Society Conference on HIV Science; 2017.
    1. Wilson KS, Beima-Sofie KM, Moraa H, Wagner AD, Mugo C, Mutiti PM, Wamalwa D, Bukusi D, John-Stewart GC, Slyker JA, Kohler PK, O’Malley G. "At our age, we would like to do things the way we want: " a qualitative study of adolescent HIV testing services in Kenya. AIDS. 2017;31(Suppl 3):S213–s220. doi: 10.1097/QAD.0000000000001513.
    1. Venter WD, Cowan F, Black V, Rebe K, Bekker L-G. Pre-exposure prophylaxis in southern Africa: feasible or not? J Int AIDS Soc. 2015;18(4 Suppl 3):19979. doi: 10.7448/IAS.18.4.19979.
    1. Aronowitz T, Rennells RE, Todd E. Heterosocial behaviors in early adolescent African American girls: the role of mother-daughter relationships. J Fam Nurs. 2005;11(2):122–139. doi: 10.1177/1074840705275466.
    1. Donenberg GR, Emerson E. Mackesy-Amiti: sexual risk among African American girls: psychopathology and mother-daughter relationships. J Consult Clin Psychol. 2011;79(2):153–158. doi: 10.1037/a0022837.
    1. Emerson E, Donenberg GR, Wilson HW. Health-protective effects of attachment among African American girls in psychiatric care. J Fam Psychol. 2012;26(1):124–132. doi: 10.1037/a0026352.
    1. Jaccard J, Dittus PJ, Gordon VV. Parent-adolescent congruency in reports of adolescents sexual behavior and in communications about sexual behavior. Child Dev. 1998;69(1):247–261. doi: 10.1111/j.1467-8624.1998.tb06146.x.
    1. O'Donnell L, Stueve A, Durnan R, Myint-U A, Agronick G, San Doval A, Wilson-Simmons R. Parenting practices, parents' underestimation of daughters' risks, and alcohol and sexual behaviors of urban girls. J Adolesc Health. 2008;42(5):496–502. doi: 10.1016/j.jadohealth.2007.10.008.
    1. Babalola S, Tambashe BO, Vondrasek C. Parental factors and sexual risk-taking among young people of cote d’Iviore. Afr J Reprod Health. 2005;9(1):49–65. doi: 10.2307/3583160.
    1. Donenberg G, Emerson E, Mackesy-Amiti M, Fletcher F. Sexual risk among African American girls seeking psychiatric care: a social-personal framework. J Consult Clin Psychol. 2018;86(1):24–38. doi: 10.1037/ccp0000270.
    1. Dutra R, Miller KS, Forehand R. The process and content of sexual communication with adolescents in two-parent families: associations with sexual risk-taking behavior. AIDS Behav. 1999;3(1):59–66. doi: 10.1023/A:1025419519668.
    1. Meschke LL, Bartholomae S, Zentall SR. Adolescent sexuality and parent-adolescent processes: promoting healthy teen choices. J Adolesc Health. 2002;31(6S):264–279. doi: 10.1016/S1054-139X(02)00499-8.
    1. Miller KS, Forehand R, Kotchick BA. Adolescent sexual behavior in two ethnic minority samples: the role of family variables. J Marriage Fam. 1999;61(2):85–98. doi: 10.2307/353885.
    1. Miller KS, Fasula A, Dittus P, Wiegand R, Wyckoff S, McNair L. Barriers and facilitators to maternal communication with preadolescents about age-relevant sexual topics. AIDS Behav. 2007;13(2):365–374. doi: 10.1007/s10461-007-9324-6.
    1. Poulsen M, Miller K, Lin C, Fasula A, Vandenhoudt H, Wyckoff S, Ochura J, Obong’o C, Forehand R. Factors associated with parent-child communication about HIV/AIDS in the United States and Kenya: a cross-cultural comparison. AIDS Behav. 2009;14(5):1083–1094. doi: 10.1007/s10461-009-9612-4.
    1. Whitaker DJ, Miller KS, May DC, Levin ML. Teenage partners’ communication about sexual risk and condom use: the importance of parent-teenager discussions. Fam Plan Perspect. 1999;31(3):117–121. doi: 10.2307/2991693.
    1. Adu-Mireku S. Family communication about HIV/AIDS and sexual behavior among senior secondary school students in Accra, Ghana. Afr Health Sci. 2003;3(1):7–14.
    1. Crichton J, Ibisomi L, Gyimah SO. Mother-daughter communication about sexual maturation, abstinence and unintended pregnancy: experiences from an informal settlement in Nairobi, Kenya. J Adolesc. 2012;35(1):21–30. doi: 10.1016/j.adolescence.2011.06.008.
    1. Dimbuene ZT, Defo BK. Risky sexual behaviour among unmarried young people in Cameroon: another look at family environment. J Biosoc Sci. 2011;43(2):129–153. doi: 10.1017/S0021932010000635.
    1. Juma M, Alaii J, Askew A, Bartholomew L, Borne B. Community Perspectives on parental/caregiver communication on reproductive health and HIV with adolescent orphans and non-orphans in Western Kenya. J Child Adolesc Behav. 2015;3(206).
    1. Puffer ES, Meade CS, Drabkin AS, Broverman SA, Ogwang-Odhiambo RA, Sikkema KJ. Individual- and family-level psychosocial correlates of HIV risk behavior among youth in rural Kenya. AIDS Behav. 2011;15(6):1264–1274. doi: 10.1007/s10461-010-9823-8.
    1. Soon CN, Kaida A, Nkala B, Dietrich J, Cescon A, Gray G, Miller CL. Adolescent experiences of HIV and sexual health communication with parents and caregivers in Soweto, South Africa. SAHARA J. 2013;10(3–4):163–169. doi: 10.1080/17290376.2014.902769.
    1. Peltzer K, Pengpid S. Sexuality of 16- to 17- years old south Africans in the context of HIV/AIDS. Soc Behav Pers. 2006;34(3):239–256. doi: 10.2224/sbp.2006.34.3.239.
    1. Stevens JW. Smart and sassy: the Strenghts of Inner-City Black girls. New York: Oxford University Press; 2002.
    1. Mbugua N. Factors inhibiting educated mothers in Kenya from giving meaningful sex-education to their daughters. Soc Sci Med. 2007;64(5):1079–1089. doi: 10.1016/j.socscimed.2006.10.008.
    1. Kuo C, Atujuna M, Mathews C, Stein DJ, Hoare J, Beardslee W, Operario D, Cluver L. L KB: developing family interventions for adolescent HIV prevention in South Africa. AIDS Care. 2016;28(Suppl 1):106–110. doi: 10.1080/09540121.2016.1146396.
    1. Donenberg GR, Pao M. Youths and HIV/AIDS: Psychiatry's role in a changing epidemic. J Am Acad Child Adolesc Psychiatry. 2005;44(8):728–747. doi: 10.1097/01.chi.0000166381.68392.02.
    1. HIV/AIDS among US women: Minority and young women at continuing risk. .
    1. Collins CE, Whiters DL, Braithwaite R. The saved SISTA project: a faith-based HIV prevention program for black woemn in addiction recovery. Am J Health Stud. 2007;22(2):76–82.
    1. Cornelius J, Moneyham L, LeGrand S. Adaptation of an HIV prevention curriculum for use with older African American women. J Assoc Nurses AIDS Care. 2008;19(1):16–27. doi: 10.1016/j.jana.2007.10.001.
    1. DiClemente RJ, Wingood GM. A randomized controlled trial of an HIV sexual risk-reduction intervention for young African-American women. J Am Med Assoc. 1995;274(16):1271–1276. doi: 10.1001/jama.1995.03530160023028.
    1. Wingood GM, DiClemente RJ. Enhancing adoption of evidence-based HIV interventions: Promotion of a suite of HIV prevention interventions for African American women. AIDS Educ Prev. 2006;18(Supplement A):161–170. doi: 10.1521/aeap.2006.18.supp.161.
    1. DiClemente RJ, Wingood GM, Harrington KF, Lang DL, Davies SL, Hook EW, Oh MK, Crosby RA. Efficacy of an HIV prevention intervention for African American adolescent girls: a randomized controlled trial. J Am Med Assoc. 2004;292(2):171–179. doi: 10.1001/jama.292.2.171.
    1. Brown LK, Hadley W, Donenberg GR, DiClemente RJ, Lescano C, Lang DM, Crosby R, Barker D, Oster D. Project STYLE: a multisite RCT for HIV prevention among youths in mental health treatment. Psychiatr Serv. 2014;65(3):338–344. doi: 10.1176/appi.ps.201300095.
    1. Beauclair R, Kassanjee R, Temmerman M, Welte A, Delva W. Age-disparate relationships and implications for STI transmission among young adults in Cape Town, South Africa. Eur J Contracept Reprod Health Care. 2012;17(1):30–39. doi: 10.3109/13625187.2011.644841.
    1. Cluver L, Boyes M, Orkin M, Pantelic M, Molwena T, Sherr L. Child-focused state cash transfers and adolescent risk of HIV infection in South Africa: a propensity-score-matched case-control study. Lancet Glob Health. 2013;1(6):e362–e370. doi: 10.1016/S2214-109X(13)70115-3.
    1. Shisana O, Rehle T, Simbayi L, et al. South African national HIV prevalence, HIV incidence, behavior and communication survey. Cape Town: HSRC Press; 2005.
    1. Decker MR, Peitzmeier S, Olumide A, Acharya R, Ojengbede O, Covarrubias L, Gao E, Cheng Y, Delany-Moretlwe S, Brahmbhatt H. Prevalence and health impact of intimate partner violence and non-partner sexual violence among female adolescents aged 15-19 years in vulnerable urban environments: a multi-country study. J Adolesc Health. 2014;55(6 Suppl):S58–S67. doi: 10.1016/j.jadohealth.2014.08.022.
    1. Wood K, Jewkes R. "Dangerous" love: Reflection on violence among Xhosa township youth. In: Morrell R, editor. Changing men in southern Africa. New York: Zed Books Ltd; 2001. pp. 317–336.
    1. O'Leary A, Jemmott JB, 3rd, Jemmott LS, Teitelman A, Heeren GA, Ngwane Z, Icard LD, Lewis DA. Associations between psychosocial factors and incidence of sexually transmitted disease among south African adolescents. Sex Transm Dis. 2015;42(3):135–139. doi: 10.1097/OLQ.0000000000000247.
    1. Dunkle KL, Jewkes RK, Brown HC, Gray GE, McIntryre JA, Harlow SD. Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa. Lancet. 2004;363(9419):1415–1421. doi: 10.1016/S0140-6736(04)16098-4.
    1. Jewkes R, Dunkle K, Nduna M, Levin J, Jama N, Khuzwayo N, Koss M, Puren A, Duvvury N. Factors associated with HIV sero-status in young rural south African women: connections between intimate partner violence and HIV. Int J Epidemiol. 2006;35(6):1461–1468. doi: 10.1093/ije/dyl218.
    1. Li Y, Marshall CM, Rees HC, Nunez A, Ezeanolue EE, Ehiri JE. Intimate partner violence and HIV infection among women: a systematic review and meta-analysis. J Int AIDS Soc. 2014;17(1):18845. doi: 10.7448/IAS.17.1.18845.
    1. Chacko L, Ford N, Sbaiti M, Siddiqui R. Adherence to HIV post-exposure prophylaxis in victims of sexual assault: a systematic review and meta-analysis. Sex Transm Infect. 2012;88(5):335–341. doi: 10.1136/sextrans-2011-050371.
    1. Hatcher AM, Smout EM, Turan JM, Christofides N, Stockl H. Intimate partner violence and engagement in HIV care and treatment among women: a systematic review and meta-analysis. AIDS. 2015;29(16):2183–2194. doi: 10.1097/QAD.0000000000000842.
    1. Roberts ST, Haberer J, Celum C, Mugo N, Ware NC, Cohen CR, Tappero JW, Kiarie J, Ronald A, Mujugira A, Tumwesigye E, Were E, Irungu E, Baeten JM, for the Partners PrEP Study Team Intimate partner violence and adherence to HIV pre-exposure prophylaxis (PrEP) in African women in HIV Serodiscordant relationships: a prospective cohort study. J Acquir Immune Defic Syndr. 2016;73(3):313–322. doi: 10.1097/QAI.0000000000001093.
    1. Donenberg G, Kendall A, Emerson E, Fletcher F, Bray B, McCabe K. IMARA: a mother-daughter group randomized controlled trial to reduce sexually transmitted infections in adolescent African American women. PLoS One. 2020;15(11):e0239650. doi: 10.1371/journal.pone.0239650.
    1. Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, Kharsany AB, Sibeko S, Mlisana KP, Omar Z, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168–1174. doi: 10.1126/science.1193748.
    1. Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, Tappero JW, Bukusi EA, Cohen CR, Katabira E, Ronald A, Tumwesigye E, Were E, Fife KH, Kiarie J, Farquhar C, John-Stewart G, Kakia A, Odoyo J, Mucunguzi A, Nakku-Joloba E, Twesigye R, Ngure K, Apaka C, Tamooh H, Gabona F, Mujugira A, Panteleeff D, Thomas KK, Kidoguchi L, Krows M, Revall J, Morrison S, Haugen H, Emmanuel-Ogier M, Ondrejcek L, Coombs RW, Frenkel L, Hendrix C, Bumpus NN, Bangsberg D, Haberer JE, Stevens WS, Lingappa JR, Celum C, Partners PrEP Study Team Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367(5):399–410. doi: 10.1056/NEJMoa1108524.
    1. Fonner VA, Dalglish SL, Kennedy CE, Baggaley R, O'Reilly KR, Koechlin FM, Rodolph M, Hodges-Mameletzis I, Grant RM. Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. 2016;30(12):1973–1983. doi: 10.1097/QAD.0000000000001145.
    1. Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, Segolodi TM, Henderson FL, Pathak SR, Soud FA, Chillag KL, Mutanhaurwa R, Chirwa LI, Kasonde M, Abebe D, Buliva E, Gvetadze RJ, Johnson S, Sukalac T, Thomas VT, Hart C, Johnson JA, Malotte CK, Hendrix CW, Brooks JT. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367(5):423–434. doi: 10.1056/NEJMoa1110711.
    1. HIV/AIDS. .
    1. PEPFAR: DREAMS innovation challenge fact sheet. In. Edited by PEPFAR; 2016.
    1. Auerbach JD, Hoppe TA. Beyond "getting drugs into bodies": social science perspectives on pre-exposure prophylaxis for HIV. J Int AIDS Soc. 2015;18(4 Suppl 3):19983. doi: 10.7448/IAS.18.4.19983.
    1. Rhodes SD, Foley KL, Zometa CS, Bloom FR. Lay health advisor interventions among Hispanics/Latinos: a qualitative systematic review. Am J Prev Med. 2007;33(5):418–427. doi: 10.1016/j.amepre.2007.07.023.
    1. Tolli MV. Effectiveness of peer education interventions for HIV prevention, adolescent pregnancy prevention and sexual health promotion for young people: a systematic review of European studies. Health Educ Res. 2012;27(5):904–913. doi: 10.1093/her/cys055.
    1. Hardee K, Gay J, Croce-Galis M, Afari-Dwamena NA. What HIV programs work for adolescent girls? J Acquir Immune Defic Syndr. 2014;66(Suppl 2):S176–S185. doi: 10.1097/QAI.0000000000000182.
    1. Dellar RC, Dlamini S, Karim QA. Adolescent girls and young women: key populations for HIV epidemic control. J Int AIDS Soc. 2015;18(2 Suppl 1):19408. doi: 10.7448/IAS.18.2.19408.
    1. Barnabas RV, Celum C. Bending the curve: maximising impact with focused HIV prevention. Lancet. 2014;384(9939):216–217. doi: 10.1016/S0140-6736(14)61182-X.
    1. Atujuna M, Merrill K, Ndwayana S, Emerson E, Fynn L, Bekker L-G, et al. Engaging female caregivers to improve south African girls' and young womens’ sexual and reproductive health outcomes: HIV Research for Prevention Virtual Conference; 2021.
    1. Donenberg G, Emerson E, Bryant F, Wilson H, Weber-Shifrin E. Understanding AIDS-risk behavior among adolescents in psychiatric care: links to psychopathology and peer relationships. J Am Acad Child Adolesc Psychiatry. 2001;40(6):642–53. 10.1097/00004583-200106000-00008.
    1. Wilson IB, Lee Y, Michaud J, Fowler FJ, Jr, Rogers WH. Validation of a new three-item self-report measure for medication adherence. AIDS Behav. 2016;20(11):2700–2708. doi: 10.1007/s10461-016-1406-x.
    1. Gorsky RD. A method to measure the costs of counseling for HIV prevention. Public Health Rep. 1996;111(supplement 1):115–122.
    1. Gorsky RD, Teutsch SM. Assessing the effectiveness of disease and injury prevention programs: costs and consequences. MMWR. 1995;RR-10:1–10.
    1. Boekhout BA, Hendrick SS, Hendrick C. Exploring infidelity: developing the relationship issues scale. J Loss Trauma. 2003;8(4):283–306. doi: 10.1080/15325020305882.
    1. Kalichman SC, Simbayi L. Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care. 2004;16(5):572–580. doi: 10.1080/09540120410001716360.
    1. Mukoma W, Flisher AJ, Helleve A, Aaro LE, Mathews C, Kaaya S, Klepp KI. Development and test-retest reliability of a research instrument designed to evaluate school-based HIV/AIDS interventions in South Africa and Tanzania. Scand J Public Health. 2009;37(Supplement 1):7–15. doi: 10.1177/1403494809103995.
    1. Kroenke K, Spitzer R, Williams J. The PHQ-9. Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613. doi: 10.1046/j.1525-1497.2001.016009606.x.
    1. Prins A, Ouimette P, Kimerling R, Cameron R, Hugelshofer D, Shaw-Hegwer J, Thrailkill A, Gusman F, Sheikh J. The primary care PTSD screen (PC-PTSD): development and operating characteristics. Prim Care Psychiatry. 2003;9(1):9–14. doi: 10.1185/135525703125002360.
    1. Spitzer R, Kroenke K, Williams J, Löwe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166(10):1092–1097. doi: 10.1001/archinte.166.10.1092.
    1. WHO: WHO multi-country study on women’s health and domestic violence against women: summary report of initial results on prevalence, health outcomes and women’s responses. 2005.
    1. Miller KS, Levin ML, Whitaker DJ, Xu X. Patterns of condom use among adolescents: the impact of mother-adolescent communication. Am J Public Health. 1998;88(10):1542–1544. doi: 10.2105/AJPH.88.10.1542.
    1. Miller KS, Kotchick BA, Dorsey S, Forehand R, Ham AY. Family communication about sex: What are parents saying and are their adolescents listening? Fam Plann Perspect. 1998;30(5):218–222. doi: 10.2307/2991607.
    1. Donenberg GR, Wilson H, Emerson E, Bryant FB. Holding the line with a watchful eye: the impact of perceived parental permissiveness and parental monitoring on risky sexual behavior among adolescents in psychiatric care. AIDS Educ Prev. 2002;14(2):138–157. doi: 10.1521/aeap.14.2.138.23899.
    1. Margolies PJ, Weintraub S. The revised 56-item CRPBI as a research instrument: reliability and factor structure. J Clin Psychol. 1977;33(2):473–476. doi: 10.1002/1097-4679(197704)33:2<472::AID-JCLP2270330230>;2-S.
    1. El-Bassel N, Ivanoff A, Schilling RF, Gilbert L, Bourne D, Chen D-R. Preventing HIV/AIDS in drug-abusing incarcerated women through skills-building and social support enhancement: preliminary outcomes. Soc Work Res. 1995;19(3):131–141.
    1. Pulerwitz J, Gortmaker SL, DeJong W. Measuring sexual relationship power in HIV/STD research. Sex Roles. 2000;42(7/8):637–660. doi: 10.1023/A:1007051506972.
    1. Wesson P, Lippman S, Neilands T, Twine R, Ahern J, Gomez-Olive X, Peacock D, MacPhail C, Kahn K, Pettifor A. Multilevel gender-equitable norms and risk of HIV and herpes simplex virus type 2 acquisition among young south African women: a longitudinal analysis of the HIV prevention trials network 068 cohort. J Adolesc Health. 2019;65(6):730–737. doi: 10.1016/j.jadohealth.2019.07.010.
    1. Stangl A, Lilleston P, Mathema H, Pilakas T, Krishnaratne S, Sievwright K, Bell-Mandla N, Vermaak R, Mainga T, Steinhaus M, et al. Development of parallel measures to assess HIV stigma and discrimination among people living with HIV, community members and health workers in the HPTN 071 (PopART) trial in Zambia and South Africa. J Int AIDS Soc. 2019;22:e25421. doi: 10.1002/jia2.25421.
    1. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51(6):1173–1182. doi: 10.1037/0022-3514.51.6.1173.
    1. Cohen J, Cohen P. Applied multiple regression/correlation analysis for the behavioral sciences, 2nd edition edn. New York: Erlbaum; 1983.
    1. Gill K, Johnson L, Dietrich J, Myer L, Marcus RF, Wallace M, Pidwell T, Mendel E, Fynn L, Jones K, Wiesner L, Slack C, Strode A, Spiegel H, Hosek S, Rooney J, Gray G, Bekker LG. Acceptability, safety, and patterns of use of oral tenofovir disoproxil fumarate and emtricitabine for HIV pre-exposure prophylaxis in south African adolescents: an open-label single-arm phase 2 trial. Lancet Child Adolesc Health. 2020;4(12):875–883. doi: 10.1016/S2352-4642(20)30248-0.

Source: PubMed

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