Picture of Kate MerrillKate Merrill, PhD and colleagues published preliminary outcomes from the IMARA South Africa pilot. The authors examined the preliminary effectiveness and implementation outcomes of InformedMotivatedAwareand Responsible Adolescents and Adults—South Africa (IMARA-SA), an evidence-based intervention for South African AGYW (15–19 years) and their female caregivers.  Primary outcomes were HIV Testing and Counselling (HTC) uptake, STI incidence (gonorrhea, chlamydia), and pre-exposure prophylaxis (PrEP) uptake. Secondary outcomes were self-reported sexual risk behavior (condom use at last sex, consistency of condom use, substance use during sex, and number of sexual partners) and PrEP adherence. We examined four implementation outcomes: reach, feasibility, acceptability, and fidelity. While the diffreneces did not reach statistical significance, IMARA-SA is a promising strategy for reducing HIV/STI risk among South African AGYW. We found strong evidence of reach, feasibility, acceptability, and fidelity. A fully powered randomized controlled trial is warranted.


Merrill KG, Atujuna M, Emerson E, Blachman-Demner D, Bray BC, Bekker, LG, Donenberg, GR. (2023) Preliminary effectiveness and implementation outcomes of the IMARA-South Africa sexual health intervention on adolescent girls and young women: A pilot randomized trial. PLOS Global Public Health 3(2): e0001092.