SHAZ! Expands to Reach HIV+ Young Women in Zimbabwe

Pangaea researchers Nancy Padian, PhD, MPH and Megan Dunbar, DrPH, MPH recently secured a grant from the National Institutes of Health (NIH) that will allow them to leverage their ongoing HIV prevention work with vulnerable young women in Zimbabwe by expanding their focus to include female adolescents who are HIV+.

Zimbabwe is confronting the synergistic plagues of a generalized HIV epidemic and rapid economic decline. Both have contributed to the large number of orphans and vulnerable children estimated at 1.5 million in 2007. Young women in this population have limited access to educational and economic opportunities, are twice as likely to be HIV infected than their male counterparts, and are more likely to engage in high risk sexual behavior. Among those that are HIV infected, economic vulnerability, and the psychological consequences of being poor and HIV+, increase the risk of secondary transmission.

Padian and Dunbar have led the development of SHAZ! (Shaping the Health of Adolescents in Zimbabwe) – an HIV prevention intervention and research study in Zimbabwe that empowers adolescent female orphans to avoid sexual risk behaviors by improving economic opportunities and linking them to life skills-based HIV education and clinical care. The new grant will allow the SHAZ! team to add 650 HIV+ young women to the program, to be called “SHAZ! For Positives”, all of whom will be linked to clinical care and then randomly assigned to the combined economic (vocational training, guidance counseling and a micro-grant) and life skills intervention compared to the life skills intervention alone.

“We’re tremendously excited to have the opportunity to expand our focus to include HIV+ young women with the hope that we can help them control their disease, reduce the chance that they’ll infect others, and put them on the road to economic independence,” said Dunbar. “Our goal is to find a formula that works for these young women that can inform program and policy decisions throughout Africa.”

Through the expanded program – which brings together the Women’s Global Health Imperative at RTI International, the University of Zimbabwe-UCSF Research Programme, the Pangaea Global AIDS Foundation and the HIV/AIDS clinic at the Chitungwiza Hospital – the research team will evaluate the effect of SHAZ! for Positives on: 1) indicators of economic livelihoods and social resources; 2) adherence to care and treatment, and subsequent health outcomes; 3) psychosocial morbidity, disclosure and coping skills; 4) behaviors associated with the secondary transmission of HIV, and 4.a) whether secondary transmission risk behavior is mediated by treatment outcomes or psycho-social factors.