Preventing HIV and HSV-2 through improving knowledge and attitudes: a replication study of a multicomponent intervention in Zimbabwe

Yu and colleagues conducted a replication study of an influential paper “The Regai Dzive Shiri Project: results of a randomised trial of an HIV prevention intervention for Zimbabwean youth” by Frances Cowan and colleagues. The original study investigated a community-based, multicomponent HIV and reproductive health intervention aimed at young people in rural Zimbabwe. Despite some changes in knowledge, attitudes, and reduced prevalence of pregnancy, the original publication found that community-based interventions did not affect the prevalence of HIV or HSV-2 in this context.

The replication authors performed a push button replication and a pure replication that generally replicated the original results with few minor discrepancies. They also conducted a theory of change analysis to supplement the original analyses by assessing whether an increase in knowledge or attitudes or a combination of both is associated with a decrease in the prevalence of HIV or HSV-2. They further examined the robustness of the original results using measurement and estimation analyses. The results showed that the demographics of the study population changed over time and participants received different amounts of exposure to the intervention. The amount of exposure to the intervention affected knowledge and attitude outcomes and a few risky sexual behaviors. The replication authors concluded that it could be useful to design an intervention that maximizes the amount of intervention exposure received by the participants, and explore additional and/or complementary interventions with a focus on reducing risky sexual behaviors for HIV or HSV-2 prevention.