Completion of Primary Package Sessions by Adolescent Girls and Young Women Before and During COVID-19 Period: Case of DREAMS Program in Zimbabwe

Abstract

Rapid increase in Coronavirus disease 2019 (COVID-19) cases in Zimbabwe resulted in lockdown measures to curb further transmission. Participation of Adolescent Girls and Young Women (AGYW) in HIV prevention programs was erratic during lockdown periods due to movement restrictions. We assessed completion of primary package sessions among AGYW aged 10-24 years enrolled in the Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS) program before and during COVID-19 periods, in Bulawayo, Gweru and Mazowe districts. Secondary analysis of routine program data for AGYW aged 10-24 years enrolled in the DREAMS program in Bulawayo, Gweru, and Mazowe districts was conducted. Data for the period 1 April 2019 to the 31 March 2020 (period before COVID-19) and 1 April 2020 to the 31 March 2021 (COVID-19 period) were extracted from the DREAMS District Heath information Systems (DHIS 2) database and analysed using SPSS generating descriptive statistics. Completion was defined as AGYW who went through and finished the HIV prevention, gender norms and financial literacy sessions after enrolment in DREAMS. Chi-square test was used to assess differences in completion rates between different categories of AGYW. Data for 52,300 AGYW enrolled in the DREAMS program were analysed and the median age was 15 years (IR, 7). Overall completion rate of primary package sessions in DREAMS program was 96.0% (50,184/52,300), with the completion rate before COVID-19 period being 96.8% (25,460/26,299) and 95.1% (24,724/26,001) during the COVID-19 period. Session completion before COVID-19 period was high among those in-school, out of school, age groups 15-19, 20-24, among young mothers, as well as Bulawayo and Gweru districts (p<0.001). Also, the 10-14 years old, people Living with HIV (PLHIV), and young women selling sex (YWSS) showed higher completion of primary package sessions before than during COVID-19 period. However, session completion for young mothers dropped from 97.5% before COVID-19 to 86.1% during COVID-19 period. Completion of DREAMS primary package sessions remained high during the COVID-19 period although it dropped by 1.7%. Despite travel and meeting restrictions during the COVID-19 period, session completion remained high, and this can be attributed to the use of virtual platforms and effective community follow-up mechanisms for AGYW invested by the DREAMS program. We recommend scaling up the DREAMS HIV prevention primary package sessions delivery models employed during COVID-19 period and improve session delivery strategies for young mothers to match the other categories of AGYW.