Megan S. Dunbar|Mi?Suk Kang Dufour|Barrot H. Lambdin|Imelda Mudekunye-Mahaka|Definate Nhamo|Nancy Padian
The SHAZ! Project: Results from a Pilot Randomized Trial of a Structural Intervention to Prevent HIV among Adolescent Women in Zimbabwe
Pangaea Global AIDS Foundation|San Francisco AIDS Foundation|University of California, San Francisco|Pangaea Global AIDS Foundation|Zimbabwe AIDS Network|Zimbabwe AIDS Network
adolescent females zimbabwe high risk hiv acquisition shaping health adolescents zimbabwe shaz randomized controlled trial combined intervention package including lifeskills health education vocational training microgrants social supports compared lifeskills health education alone shaz originally envisioned larger effectiveness trial however intervention scaled back due contextual economic conditions country time shaz enrolled 315 participants randomly assigned study arm within blocks 50 participants 158 intervention 157 control intervention arm participants showed statistically significant differences control arm participants several outcomes two years follow including reduced food insecurity ior 083 vs cor 068 p002 income ior 205 vs cor 167 p 002 additionally within intervention arm lower risk transactional sex ior 064 95 ci 050 083 higher likelihood using condom current partner ior 179 95 ci 123 262 time compared baseline also evidence fewer unintended pregnancies among intervention participants hr 061 95 ci 037 101 although relationship achieved marginal statistical significance several important challenges study included coordination vocational training programs political economic instability area time study difficulty creating true standard care control arm overall results shaz study suggest important potential hiv prevention intervention packages include vocational training microgrants lessons economic livelihoods interventions adolescent females work needed refine intervention model test impact intervention scale biological outcomesclinicaltrialsgov nct02034214