Nelson, Kate Andrews; Magut, Faith; Mulwa, Sarah; Osindo, Jane; Kamire, Vivienne; Khagayi, Sammy; Pulerwitz, Julie; Cook, Sarah; Gourlay, Annabelle; Ziraba, Abdhalah; +3 more... Kwaro, Daniel; Floyd, Sian; Birdthistle, Isolde; (2024) Impact of DREAMS interventions on attitudes towards gender norms among adolescent girls and young women: Findings from a prospective cohort in Kenya. PLOS global public health, 4 (3). e0002929-. ISSN 2767-3375 DOI: https://doi.org/10.1371/journal.pgph.0002929
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
The DREAMS partnership aims to deliver a comprehensive package to reduce HIV incidence among adolescent girls and young women (AGYW), including through shifting gender norms. We evaluate DREAMS' effect on attitudes towards gender norms in two Kenyan settings. AGYW aged 15-22 in Nairobi (n = 852) and Gem (n = 761) were randomly selected for cohort enrolment in 2017-18 and followed-up to 2019. We described the proportion of AGYW and their male peers with equitable attitudes towards gender norms, using an adapted version of the GEM scale. We estimated the association between self-reported invitation to DREAMS (in 2017-18) and AGYW's attitudes towards two dimensions of gender norms, and then applied a causal inference framework to estimate the difference in the proportion of AGYW with equitable attitudes under the counterfactual scenarios that all versus none were DREAMS beneficiaries. We estimated that overall, 90.2% versus 87.1% of AGYW would have equitable norms around sexual and reproductive health decision-making in Nairobi if all versus none were DREAMS beneficiaries (+3.1; 95%CI:-2.5, +9.0). In Gem, we estimated a risk difference of +1.0 (89.6% vs 88.6%, 95%CI: -3.6,+5.6). There was no evidence for an effect of DREAMS on attitudes towards violence-related norms (Nairobi: 82.7% vs 82.2%, +0.5; 95%CI: -5.3,+6.5; Gem: 44.3% vs 48.2%, -3.9; 95%CI: -11.7,+3.0). We found no evidence of an impact of DREAMS invitation on individual attitudes towards gender norms. In some cases, equitable attitudes at enrolment left limited scope for improvement, and additional effort may be required to shift inequitable violence attitudes among both AGYW and their male peers.
Item Type | Article |
---|---|
Faculty and Department |
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) Faculty of Public Health and Policy > Dept of Health Services Research and Policy Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & International Health (2023-) |
Research Centre |
Centre for Maternal, Reproductive and Child Health (MARCH) ?? 226579 ?? |
PubMed ID | 38446820 |
Elements ID | 216645 |
Official URL | http://dx.doi.org/10.1371/journal.pgph.0002929 |
Download
Filename: journal.pgph.0002929.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Download