Zambian Informed Motivated Aware Responsible Adolescent Girls and Adults
The proposed hybrid effectiveness-implementation study will systematically adapt the Informed, Motivated, Aware, Responsible Adolescent Girls and Adults (IMARA) curriculum that was previously adapted for South Africa (IMARA-SA) to use in Zambia (will be renamed Zambian Informed, Motivated, Aware, Responsible Adolescent Girls and Adults (ZAIMARA) and evaluate the impact of ZAIMARA on improving adolescent girls and young women HIV testing, HIV and STI incidence, PrEP uptake and sexual risk behaviour. The study will also assess the impact of monthly mental health screening with referral versus a monthly nutrition and exercise screening on peer leaders job retention. We will also examine implementation factors and outcomes associated with ZAIMARA across five sites.
⁃ Adolescent girls and young women (AGYW)
• 15-19 years-old females (sex assigned at birth)
• Unmarried
• Residing outside the five study catchment areas
• Speak Nyanja, Bemba, or English or a combination (the primary regional languages)
• Willing and able to provide consent (\> 18 years old) and/or assent (\< 18 years old)
• Not known to be living with HIV (i.e., no positive test and not on ART)
⁃ Mother Figures (MF)
• selected to participate by the AGYW
• if not the guardian/mother, agreed upon by the guardian/mother
• \> 24 years-old
• living with or in daily contact with the AGYW
• speak Nyanja, Bemba, or English or a combination
• Willing and able to provide consent
⁃ Peer leaders (ZAIMARA \& Health Promotion)
• live in the community where they will be working
• have prior experience working with young people
• have a minimum grade 12 education
• be proficient in reading and writing English and/or Nyanja or Bemba
• are 22-29 years old for AGYW sessions
• are \>30 years-old for MF sessions