{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:23:09Z","timestamp":1793125389385,"version":"4.5.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Global Fund to fight AIDS, TB and Malaria","award":["202100857"],"award-info":[{"award-number":["202100857"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Adolescent girls and young women (AGYW) remain highly vulnerable to the risk of acquiring HIV (Human immunodeficiency virus). This study was conducted to measure behavioral, biomedical and structural outcomes for the Global Fund funded AGYW programmes in five African countries with high burden of HIV including Botswana, Cameroon. Lesotho, Malawi and Namibia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The study used a mixed methods approach to collect behavioral, structural and biomedical outcome data. Quantitative data were collected through 418 Polling Booth Survey (PBS) sessions from 4,581 AGYWs. Participants were recruited through a community-based multistage sampling technique using sampling weights for urban and rural communities. 23 Focus Group Discussions (FGD) were conducted to understand barriers to use of HIV prevention programme and community recommendations for improved coverage. Ethical approvals were obtained from the ethics review board in all five countries.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>More than 50% of the respondents from all five countries reported to be sexually active, and at least 30% or more of those who were sexually active had multiple sex partners. There were wide variations between the countries in condom use with a non-marital sexual partner which ranged between 66% in Namibia to 42% in Cameroon. Cameroon (44%) had high percentage of AGYWs with independent income source while school drop-outs were higher in Malawi (55.5%) and Lesotho (46.6%). Nearly 1\/4th of AGYWs in all countries, except Namibia, reported experiencing intimate partner violence. Nineteen percent of the respondents were pregnant in the last 12 months, and 50% of those pregnancies were unplanned. Lesotho had the highest proportion of AGYW (90.5%) ever tested for HIV, followed by Malawi (87.5%), Botswana (75%), Cameroon (69%) and Namibia (62.6%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>There is diversity across the countries, with country-wise and age-wise variations in results. In all countries, the AGYW programme will benefit from a more targeted approach to reach out to the most vulnerable AGYW, strengthening structural interventions, strengthening linkage to PrEP (Pre-Exposure Prophylaxis) and ART (Antiretroviral Therapy) for those who are living with HIV and a strong linkage with reproductive health services. The assessment helped countries to understand the gaps and opportunities to improve the HIV prevention programme with AGYW.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0307198","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T17:31:13Z","timestamp":1721669473000},"page":"e0307198","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Measuring HIV outcomes for adolescent girls and young women programs in Africa: Using the polling booth survey technique"],"prefix":"10.1371","volume":"19","author":[{"given":"Faran","family":"Emmanuel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lize","family":"Aloo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0582-2472","authenticated-orcid":true,"given":"Amna","family":"Mahfooz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathato","family":"Nkuatsana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nametsego","family":"Tswetla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolus","family":"Mutenda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biziwick","family":"Mwale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zounkanyi","family":"Bissek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parinita","family":"Bhattacharjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"key":"pone.0307198.ref001","unstructured":"UNAIDS, \u201cYoung people and HIV,\u201d 2021. [Online]. Available: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/young-people-and-hiv_en.pdf."},{"key":"pone.0307198.ref002","unstructured":"UNICEF, \u201cAdolescent HIV prevention\u2014UNICEF DATA.\u201d Accessed: Dec. 18, 2023. [Online]. Available: https:\/\/data.unicef.org\/topic\/hivaids\/adolescents-young-people\/."},{"key":"pone.0307198.ref003","unstructured":"UNAIDS, \u201c2022-global-aids-update_en,\u201d 2022."},{"key":"pone.0307198.ref004","unstructured":"UNAIDS, \u201cCOMMUNITIES AT THE CENTRE DEFENDING RIGHTS BREAKING BARRIERS REACHING PEOPLE WITH HIV SERVICES,\u201d 2019."},{"key":"pone.0307198.ref005","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.ijregi.2022.08.009","article-title":"Perspective HIV and adolescent girls and young women in sub-Saharan Africa: A call for expedited action to reduce new infections","volume":"5","author":"G. Murewanhema","year":"2022","journal-title":"IJID Regions"},{"issue":"SUPPL.1","key":"pone.0307198.ref006","first-page":"74","article-title":"Genital immunology and HIV susceptibility in young women","volume":"69","author":"T. J. Yi","year":"2013","journal-title":"American Journal of Reproductive Immunology"},{"issue":"Suppl 1","key":"pone.0307198.ref007","first-page":"64","article-title":"Adolescent girls and young women: key populations for HIV epidemic control","volume":"18","author":"R. C. Dellar","year":"2015","journal-title":"J Int AIDS Soc"},{"issue":"2","key":"pone.0307198.ref008","first-page":"118","article-title":"Early age of sexual debut: a risky experience","volume":"35","author":"M. Stanley","year":"2009","journal-title":"BMJ Sex Reprod Health"},{"key":"pone.0307198.ref009","unstructured":"Canadian Paediatric Society, \u201cCPS Practice Point,\u201d 2014. [Online]. Available: www.phac-aspc.gc.ca\/std-mts\/sti-its\/guide-lignesdir-eng.php"},{"key":"pone.0307198.ref010","doi-asserted-by":"crossref","DOI":"10.1590\/1518-8345.6264.3696","article-title":"Risk factors for HIV infection among adolescents and the youth: a systematic review","volume":"30","author":"P. A. Bossonario","year":"2022","journal-title":"Rev Lat Am Enfermagem"},{"key":"pone.0307198.ref011","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0178106","article-title":"Sex in the shadow of HIV: A systematic review of prevalence, risk factors, and interventions to reduce sexual risk-taking among HIV-positive adolescents and youth in sub-Saharan Africa","author":"E. Toska","year":"2017"},{"issue":"1","key":"pone.0307198.ref012","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-018-5051-3","article-title":"Determinants of HIV infection among adolescent girls and young women aged 15\u201324 years in South Africa: A 2012 population-based national household survey","volume":"18","author":"M. Mabaso","year":"2018","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0307198.ref013","first-page":"1","article-title":"Impact of social environment on sexual behaviors of adolescent girls in 12 sub-Saharan African countries: a cross-sectional study","volume":"19","author":"S. A. Darfour-Oduro","year":"2022","journal-title":"Reprod Health"},{"key":"pone.0307198.ref014","unstructured":"AVAC Global Advocacy for HIV prevention, \u201cUnderstanding the Results of the ECHO Study,\u201d 2020. Accessed: Jun. 05, 2024. [Online]. Available: https:\/\/avac.org\/wp-content\/uploads\/2023\/03\/UnderstandingResultsECHO_feb2020.pdf."},{"key":"pone.0307198.ref015","unstructured":"UNAIDS, \u201cglobal-AIDS-strategy-2021-2026_en,\u201d 2021."},{"key":"pone.0307198.ref016","unstructured":"The Global fund strategy, \u201cInvesting to end epidemics,\u201d 2017, Accessed: Nov. 29, 2023. [Online]. Available: https:\/\/archive.theglobalfund.org\/media\/2531\/archive_global-fund-strategy-2017-2022_strategy_en.pdf."},{"key":"pone.0307198.ref017","unstructured":"UNICEF, \u201cAssessing the Vulnerability and Risks of Adolescent Girls and Young Women in Eastern and Southern Africa: A Review of the Tools in Use,\u201d 2021."},{"key":"pone.0307198.ref018","unstructured":"The Global Fund, \u201c40 th Board Meeting Report of the Executive Director Introduction and Overview,\u201d 2018."},{"issue":"4","key":"pone.0307198.ref019","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1007\/s10461-011-0004-1","article-title":"Polling booth surveys: A novel approach for reducing social desirability bias in HIV-related behavioural surveys in resource-poor settings","volume":"16","author":"C. M. Lowndes","year":"2012","journal-title":"AIDS Behav"},{"key":"pone.0307198.ref020","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/7375831","article-title":"Health Risk Behaviour among Adolescents Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-Analysis","volume":"2018","author":"D. Ssewanyana","year":"2018","journal-title":"Biomed Res Int"},{"issue":"7","key":"pone.0307198.ref021","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1111\/j.1365-3156.2012.03005.x","article-title":"The sexual behaviour of adolescents in sub-Saharan Africa: Patterns and trends from national surveys","volume":"17","author":"A. M. Doyle","year":"2012","journal-title":"Tropical Medicine and International Health"},{"key":"pone.0307198.ref022","doi-asserted-by":"crossref","first-page":"3238","DOI":"10.1007\/s10461-021-03291-z","article-title":"From Survival to Glamour: Motivations for Engaging in Transactional Sex and Relationships Among Adolescent Girls and Young Women in South Africa","volume":"25","author":"Z. Duby","journal-title":"AIDS Behav"},{"issue":"1","key":"pone.0307198.ref023","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-13394-4","article-title":"Determining HIV risk for Adolescent Girls and Young Women (AGYW) in relationships with \u2018Blessers\u2019 and age-disparate partners: a cross-sectional survey in four districts in South Africa","volume":"22","author":"G. George","year":"2022","journal-title":"BMC Public Health"},{"issue":"2","key":"pone.0307198.ref024","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1080\/21528586.2020.1813194","article-title":"Laying Claim to a Name: Towards a Sociology of \u2018Gender-Based Violence,\u2019","volume":"51","author":"D. Buiten","year":"2020","journal-title":"South African Review of Sociology"},{"issue":"SUPPL. 4","key":"pone.0307198.ref025","article-title":"Age-disparate and intergenerational sex in southern Africa: The dynamics of hypervulnerability","volume":"22","author":"S. Leclerc-Madlala","year":"2008","journal-title":"AIDS"},{"key":"pone.0307198.ref026","doi-asserted-by":"crossref","first-page":"53","DOI":"10.2174\/1874613601812010053","article-title":"Send Orders for Reprints to reprints@benthamscience.ae The Open AIDS Journal HIV Prevention in Adolescents and Young People in the Eastern and Southern African Region: A Review of Key Challenges Impeding Actions for an Effective Response","volume":"12","author":"K. Govender","year":"2018","journal-title":"Open AIDS J"},{"key":"pone.0307198.ref027","doi-asserted-by":"crossref","DOI":"10.21203\/rs.3.rs-2164051\/v1","article-title":"The role of structural factors for preventing HIV risk practices among adolescents in South Africa: A three-wave analysis of caregiving, education, food security, and social protection","author":"W. E. Rudgard","year":"2023"},{"key":"pone.0307198.ref028","article-title":"The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries","author":"P. Mee","year":"2018"},{"issue":"1","key":"pone.0307198.ref029","first-page":"2020","article-title":"Is it time to RE-AIM? A systematic review of economic empowerment as HIV prevention intervention for adolescent girls and young women in sub-Saharan Africa using the RE-AIM framework","volume":"1","author":"Dec","journal-title":"Implementation Science Communications"},{"key":"pone.0307198.ref030","unstructured":"UNAIDS, \u201cMILES TO GO CLOSING GAPS BREAKING BARRIERS RIGHTING INJUSTICES,\u201d 2018."},{"key":"pone.0307198.ref031","doi-asserted-by":"crossref","DOI":"10.7448\/IAS.15.3.17397","article-title":"Addressing the structural drivers of HIV: a luxury or necessity for programmes?","author":"J. Seeley","year":"2012"},{"key":"pone.0307198.ref032","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-019-0709-6","article-title":"Effective integration of sexual reproductive health and HIV prevention, treatment, and care services across sub-Saharan Africa: Where is the evidence for program implementation?","volume":"16","author":"D. M. Kangudie","year":"2019","journal-title":"Reproductive Health"},{"key":"pone.0307198.ref033","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0140-6736(10)60548-X","article-title":"Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study","volume":"376","author":"R. K. Jewkes","year":"2010","journal-title":"The Lancet"},{"key":"pone.0307198.ref034","article-title":"Intimate partner violence and HIV infection among women: a systematic review and meta-analysis","author":"Y. Li","year":"2014"},{"key":"pone.0307198.ref035","doi-asserted-by":"crossref","DOI":"10.1007\/s10461-012-0361-4","article-title":"Forced sexual initiation, sexual intimate partner violence and HIV risk in women: A global review of the literature","author":"J. K. Stockman","year":"2013"},{"issue":"10","key":"pone.0307198.ref036","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0258542","article-title":"Adolescent girls and young women\u2019s PrEP-user journey during an implementation science study in South Africa and Kenya","volume":"16","author":"E. Rousseau","year":"2021","journal-title":"PLoS One"},{"issue":"8","key":"pone.0307198.ref037","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1089\/apc.2020.0037","article-title":"High Awareness, Yet Low Uptake, of Pre-Exposure Prophylaxis Among Adolescent Girls and Young Women Within Family Planning Clinics in Kenya","volume":"34","author":"J. Sila","year":"2020","journal-title":"AIDS Patient Care STDS"},{"key":"pone.0307198.ref038","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25588","article-title":"Uptake and retention on HIV pre-exposure prophylaxis among key and priority populations in South-Central Uganda","author":"J. Kagaayi","year":"2020"},{"key":"pone.0307198.ref039","doi-asserted-by":"crossref","first-page":"9474","DOI":"10.1136\/bmjgh-2022-009474","article-title":"Interventions to increase the uptake and continuation of pre-exposure prophylaxis (PrEP) by adolescent girls and young women at high risk of HIV in low-income and middle-income countries: a scoping review","volume":"7","author":"O. I. Ekwunife","year":"2022","journal-title":"BMJ Glob Health"},{"key":"pone.0307198.ref040","article-title":"Enhancing oral PrEP uptake among adolescent girls and young women in Africa","volume":"2022","author":"C. J. Heck","year":"2022","journal-title":"J Int AIDS Soc"},{"key":"pone.0307198.ref041","unstructured":"WHO, \u201cImproving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa,\u201d 2021."},{"key":"pone.0307198.ref042","doi-asserted-by":"crossref","first-page":"e475","DOI":"10.1016\/S2352-3018(17)30183-2","article-title":"U = U taking off in 2017","volume":"4","author":"T. Lancet HIV","year":"2017","journal-title":"Lancet HIV"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0307198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T17:31:40Z","timestamp":1721669500000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0307198"}},"subtitle":[],"editor":[{"given":"Moses","family":"Katbi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,7,22]]},"references-count":42,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0307198","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,22]]}}}