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UNESCO HIV and Health Education Clearinghouse

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  1. Cost-effectiveness analysis: educational interventions that reduce the incidence of HIV/AIDS infection in Kenyan teenagers

    This paper demonstrates a comprehensive and thorough application of an education cost-effectiveness analysis. Two interventions implemented in Western Kenya aimed to reduce the incidence of HIV/AIDS contraction in middle school girls. The cost-effectiveness of each intervention is assessed, ex post facto, by combining the results of the two programs’ evaluations with their costs. As few education evaluations consider cost, this article highlights a sound and disciplined method to use when detailed cost information is both readily available and unavailable. …

  2. Experimental evaluation of school-based HIV programs in sub-Saharan Africa

    School-based adolescent health education programs represent a durable strategy in reducing the spread of HIV because they can leverage pre-existing social and organizational structures to reach large fractions of students at critical life stages. Many evaluations of school-based HIV programs draw on multilevel study designs that assign schools to treatment conditions or assign students to treatment conditions within blocks defined by school membership. …

  3. Education, HIV, and early fertility: experimental evidence from Kenya

    A seven-year randomized evaluation suggests education subsidies reduce adolescent girls’ dropout, pregnancy, and marriage but not sexually transmitted infection (STI). The government’s HIV curriculum, which stresses abstinence until marriage, does not reduce pregnancy or STI. Both programs combined reduce STI more, but cut dropout and pregnancy less, than education subsidies alone. …

  4. Accessing the ‘right’ kinds of material and symbolic capital: the role of cash transfers in reducing adolescent school absence and risky behaviour in South Africa

    This article investigates how well South Africa’s Child Support Grant (CSG) responds to the material and psychosocial needs of adolescents, and the resultant effects on schooling and risky behaviour. One driver of schooling decisions is shame related to poverty and the ‘social cost’ of school, where a premium must often be paid for fashionable clothes or accessories. The other driver relates to symbolic and consumptive capital gained through engaging in sexual exchange relationships. The anticipated impacts from the CSG are partial because of these non-material drivers of adolescent choices. …

  5. Engaging school personnel in making schools safe for girls in Botswana, Malawi, and Mozambique

    Girls are vulnerable to HIV in part because the social systems in which they live have failed to protect them. This study evaluates a program aimed at making schools safe for girl learners in order to reduce girls’ vulnerability to HIV in Botswana, Malawi, and Mozambique. In addition to an extensive process evaluation with school personnel program participants, program facilitators, and community members, a cross-sectional post-intervention survey was conducted among adolescent girls in the three countries. The total sample size was 1249 adolescent girls (ages 11–18). …

  6. A case study of school support and the psychological, emotional and behavioural consequences of HIV and AIDS on adolescents

    Various studies have reported a huge increase in the numbers of orphaned adolescents in Sub-Saharan Africa and its effects on their psychological, emotional and behavioural development. Yet, their needs are seldom recognised or adequately addressed in policy and programmes.This article uses a qualitative study to report the experiences of 11 orphaned adolescents (5 boys and 6 girls aged between 15 and 18 years) affected by HIV and AIDS in a secondary school (in Atteridgeville, Pretoria, South Africa) and the school support provided by them. …

  7. Rising school enrollment and declining HIV and pregnancy risk among adolescents in Rakai district, Uganda, 1994–2013

    Background: Poverty, family stability, and social policies influence the ability of adolescents to attend school. Likewise, being enrolled in school may shape an adolescent’s risk for HIV and pregnancy. We identified trends in school enrollment, factors predicting school enrollment (antecedents), and health risks associated with staying in or leaving school (consequences). Methods: Data from the Rakai Community Cohort Study (RCCS) were examined for adolescents 15–19 years (n = 21,735 person-rounds) from 1994 to 2013. …

  8. Application of the information, motivation and behavioural skills model for targeting HIV risk behaviour amongst adolescent learners in South Africa

    This paper discusses the application of an information, motivation and behavioural skills (IMB) model in a school-based programme for the reduction of HIV risk behaviour among 259 Grade 11 learners in two high schools in Alexandra township, Johannesburg. School 1 was the Experimental group, while School 2 was the Control group. After a baseline study (Time 1) at both schools, a 3-week intervention programme was conducted at School 1. A post-test (Time 2) was conducted at both schools. The intervention was repeated at School 2, followed by another post-test (Time 3) at both schools. …

  9. Teacher training and HIV/AIDS prevention in West Africa: regression discontinuity design evidence from the Cameroon

    The authors assess the impact on teenage childbearing as well as student knowledge, attitudes, and behavior of a typical HIV/AIDS teacher training program in the Cameroon. Applying a regression discontinuity design identification strategy based on the key administrative criterion that determined program deployment, they find that 15–17 year old girls in teacher training schools are between 7 and 10 percentage points less likely to have started childbearing, an objective proxy for the incidence of unprotected sex. …

  10. An HIV/AIDS knowledge scale for adolescents: item response theory analyses based on data from a study in South Africa and Tanzania

    A 14-item human immunodeficiency virus/acquired immunodeficiency syndrome knowledge scale was used among school students in 80 schools in 3 sites in Sub-Saharan Africa (Cape Town and Mankweng, South Africa, and Dar es Salaam, Tanzania). For each item, an incorrect or don't know response was coded as 0 and correct response as 1. Exploratory factor analyses based on polychoric correlations showed two separate factors for all sites. …

  11. Gender, peer and partner influences on adolescent HIV risk in rural South Africa

    In preparation for a school-based intervention in KwaZulu-Natal, South Africa, the authors conducted a cross-sectional survey of potential HIV risk factors in youth ages 14–17 (n=983). Boys were significantly more likely than girls to report lifetime sexual activity (37.7% v. 13.8%, P<0.01). Among boys and girls, 46.1% reported condom use at last sex. Discussion of condom use with a partner was the strongest predictor of condom use (boys, odds ratio (OR)=7.39; girls, OR=5.58, P<0.0001). …

  12. Out-of-school and at risk? Socio-demographic characteristics, AIDS knowledge and risk perception among young people in Northern Tanzania

    This paper investigates the reasons why young people in urban and rural Kilimanjaro, Tanzania do not attend school, their socio-demographic characteristics, AIDS knowledge and risk perception. A structured face-to-face interview was conducted with 1007 young people between the ages of 13 and 18. Findings suggest that non-attendance is the product of a complex interaction of economic, individual, family and school-related factors. Boys have more AIDS knowledge than girls, and those from urban areas are more knowledgeable than their rural counterparts. …

  13. Multiple sexual partners and condom use among 10-19 year-olds in four districts in Tanzania: What do we learn?

    This study tested a hypothesis that sexual relationships with multiple partners in the 10- to 19-year age group spurs condom use during sex. The authors performed secondary analysis using data from the adolescent module of the cross-sectional household survey on Maternal, Newborn and Child Health (MNCH) that was done in Kigoma, Kilombero, Rufiji and Ulanga districts, Tanzania in 2008. A total of 612 adolescents from a random sample of 1,200 households participated in this study. Pearson Chi-Square was used as a test of association between multiple sexual partners and condom use. …

  14. HIV/AIDS related knowledge and perceived risk associated with condom use among adolescents in Uganda

    While considerable attention has been paid to sexual behaviors among HIV high-risk populations in Africa, few studies have looked at the adolescent population. Using data from the 2004 National Survey of Adolescents in Uganda, logistic regression models were fitted to examine the odds that HIV/AIDS related knowledge and perceived risk of HIV infection are associated with condom use among adolescents. …

  15. Young people's understanding of HIV: a qualitative study among school students in Mankweng, South Africa

    This article describes young people's interpretation of HIV, AIDS and sexually transmitted illness in a rural South African community in Mankweng, Limpopo Province. Method: The study was based on 19 focus group discussions with adolescents aged 12-14 years. Results: Our participants had limited knowledge about HIV from a biomedical perspective. Their understanding and interpretations of HIV and other sexually transmitted diseases were largely informed by traditional and religious belief systems that explain how and why people contract an illness via sexual intercourse. …

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