Multisectoral, Combination HIV Prevention for Adolescent Girls and Young Women: A Qualitative Study of the DREAMS Implementation Trajectory in Zambia

Figures & Tables

TABLE 1.

Primary and Secondary Individual DREAMS Interventions for Adolescent Girls and Young Women in Zambia

	Individual Interventions	Description
Primary	Social-asset building	13 age-appropriate Safe Space sessions focused on HIV prevention–related topics (e.g., puberty, consent) delivered in community-based “hubs”
	Condom promotion and distribution	Education, promotion, and availability of condoms through Safe Spaces and adolescent health services
	HIV testing services	HIV testing and linkage to services (e.g., HIV care and treatment, other DREAMS services)
	Combination socioeconomic support	Cash transfers Village and loan savings groups Financial literacy education
	School-based HIV and violence prevention	Education on HIV and gender-based violence for in-school AGYW (ages 15–19 years only)
Secondary	Adolescent-friendly family planning services	Expanded access to contraception (i.e., long-acting reversible methods) and other reproductive health services
	PrEP	Education and linkage to PrEP for at-risk women
	Postviolence care	Screening and linkage to postviolence services, including PEP
	Education subsidies	Money to support educational expenses, including school fees, uniforms, and transportation
	Parenting and caregiver programs	Family strengthening programming, including HIV risk and violence prevention awareness for parents of AGYW (i.e., Families Matter!)

Abbreviations: AGYW, adolescent girls and young women; DREAMS, Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women; PEP, post-exposure prophylaxis; PrEP, preexposure prophylaxis.

TABLE 2.

Characteristics of Interviewed AGYW Who Completed or Withdrew From DREAMS Programming in Zambia, by District

Abbreviations: DREAMS, Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women; SD, standard deviation.

TABLE 3.

Characteristics of Interviewed DREAMS Implementing Partner Staff in Zambia, by District

	District, No.		Total (N=15)
	Lusaka (n=11)	Ndola (n=4)	Total (N=15)
Staff cadre
Management	7	—	7
Site level	4	4	8
Job function
Senior leadership	2	—	2
Technical advisor	1	—	1
Program manager	4	—	4
Site coordinator	1	—	1
Connector	1	1	2
Mentor	2	3	5
DREAMS program area
Social asset building	5	4	9
Combination socioeconomic support	1	—	1
School-based HIV and violence prevention	1	—	1
Preexposure prophylaxis	1	—	1
Postviolence care	1	—	1
Education subsidies	1	—	1
Parenting and caregiver programs	1	—	1