Uptake of community-based integrated HIV and sexual and reproductive health services for young people in Zimbabwe: the CHIEDZA study

作者：Victoria Simms, Ethel Dauya, Chido Dziva Chikwari, Tsitsi Bandason, Katharina Kranzer, Mandikudza Tembo, Constancia Mavodza, Aoife M. Doyle, Leyla Larsson, Owen Mugurungi, Tsitsi Apollo, Richard Hayes, Rashida A. Ferrand, CHIEDZA trial team · 发表于：BMC Health Services Research · 年份：2025 · DOI：10.1186/s12913-025-13635-3 · 被引用次数：2 · 研究领域：Adolescent Sexual and Reproductive Health、HIV/AIDS Research and Interventions、HIV/AIDS Impact and Responses

INTRODUCTION: Limited engagement with health services contributes to the poorer HIV care outcomes observed in young people. We conducted a cluster-randomised trial to investigate the impact of community-based integrated HIV and sexual and reproductive health (SRH) service (CHIEDZA) for young people on HIV outcomes in three provinces in Zimbabwe. Here we examine the uptake of services. METHODS: In the 12 intervention arm clusters, weekly integrated HIV and SRH services were delivered from community centres to cluster residents aged 16-24 years over 30 months. Service components included HIV testing, treatment and adherence support, management of sexually transmitted infections (STIs), menstrual health management, provision of condoms and contraception, counselling, and a tailored package of educational text messages on SRH topics. All components were optional. Fingerprint scanning was used to register clients and track their attendances and service uptake over time. RESULTS: From April 2019-March 2022 36,991 clients attended CHIEDZA services, for a total of 78,810 visits; each centre had a median of 55 clients per day; 40.6% of clients returned for more than one visit. Overall, 75.0% of clients were female and 53.0% were aged < 20 years. Clients accessed a median 3 (IQR 2-4) service components/visit. The most popular service components for women were menstrual health products (taken up at least once by 96.5% of eligible clients), HIV testing (83.7%) and period pain management ...