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UNESCO HIV and Health Education Clearinghouse

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  1. School-based sexual health education interventions to prevent STI/HIV in sub-Saharan Africa: a systematic review and meta-analysis

    The authors reviewed evaluations of school-based sexual health education interventions in sub-Saharan Africa to assess effectiveness in reducing sexually transmitted infections and promoting condom use.

  2. An examination of knowledge, attitudes and practices related to HIV/AIDS prevention in Zimbabwean university students: Comparing intervention program participants and non-participants

    OBJECTIVES: This study represents a comprehensive assessment of differences between participants in an HIV/AIDS prevention program (SHAPE: Sustainability, Hope, Action, Prevention, Education) and non-participants in knowledge, attitudes and practices with a focus on cultural, sociological and economic variables. METHODS: We developed an eight-page questionnaire that was administered to 933 randomly selected students at the University of Zimbabwe. Survey items addressed sexual decision-making, condom use, limiting sexual partners, cultural power dynamics and access to HIV testing. …

  3. Emma says: A case study of the use of comics for health education among women in the AIDS heartland

    The purpose of this paper is to examine one mass media AIDS education project, the Emma Says comic series. Created by an international health research organization based in the USA, the series was designed to educate women in rural Africa about the need to protect themselves from AIDS. The Emma Says series aimed to deliver powerful messages about AIDS in an easy-to-understand format using the caricature of an African woman working as a health educator in her community. …

  4. Evaluation of HIV/AIDS prevention through peer education, counselling, health care, training and urban refuges in Ghana

    Since 1996, Ireland Aid has supported UNICEF Ghana in the implementation of five activities that promote behaviour change to limit the spread of HIV/AIDS and STIs. The interventions are run by different local organisations, and have provided over 75,000 in and out-of-school youth and commercial sex workers with preventive education. People retained the information given, are knowledgeable about how HIV is transmitted, and can name key preventive methods. They pass on the information to their friends. Commercial sex workers were empowered to support one another in negotiating for safer sex. …

  5. 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. …

  6. Youth in a void: sexuality, HIV/AIDS and communication in Kenyan public schools

    The disappearance of traditional sex education during rites of passage in African societies has left many youth uncertain of where to look for information. Against this backcloth, the objectives of this study were to identify knowledge gaps amongst adolescents in Kenya regarding sexuality, HIV/AIDS and reproductive health. A thematic analysis was conducted of questions posed by 735 school youth aged 12–18 years from Meru and Kajiado Districts. Results show that many questions showed curiosity and anxiousness. …

  7. If you don't abstain, you will die of AIDS: AIDS education in Kenyan public schools

    We explored constraints of implementing AIDS education in public schools in Kenya. Sixty interviews with teachers and 60 focus group discussions with students were conducted in 21 primary and nine secondary schools. System/school-level constraints included lack of time in the curriculum, limited reach of secondary-school students (because AIDS education is embedded in biology, which is not compulsory), and disapproval of openness about sex and condoms by the Ministry of Education and parents. Alternative strategies to teach about AIDS had their own constraints. …

  8. Effectiveness of HIV prevention for youth in sub-Saharan Africa: systematic review and meta-analysis of randomized and nonrandomized trials

    Objective: Systematically assess the effectiveness of HIV-prevention interventions in changing sexual behaviour of young people (10–25 years) in sub-Saharan Africa. Methods: Three online databases were searched using prespecified terms. Additional articles were identified on websites of international organizations and by searching bibliographies. Randomized and nonrandomized trials of interventions aiming to reduce risk behaviour were included as well as single-arm studies reporting effects of differential exposure to an intervention. …

  9. A surprising prevention success: Why did the HIV epidemic decline in Zimbabwe?

    There is growing recognition that primary prevention, including behavior change, must be central in the fight against HIV/AIDS. The earlier successes in Thailand and Uganda may not be fully relevant to the severely affected countries of southern Africa. We conducted an extensive multi-disciplinary synthesis of the available data on the causes of the remarkable HIV decline that has occurred in Zimbabwe (29% estimated adult prevalence in 1997 to 16% in 2007), in the context of severe social, political, and economic disruption. …

  10. Long-Term Biological and Behavioural Impact of an Adolescent Sexual Health Intervention in Tanzania: Follow-up Survey of the Community-Based MEMA kwa Vijana Trial

    The ability of specific behaviour-change interventions to reduce HIV infection in young people remains questionable. Since January 1999, an adolescent sexual and reproductive health (SRH) intervention has been implemented in ten randomly chosen intervention communities in rural Tanzania, within a community randomised trial (see below; NCT00248469). The intervention consisted of teacher-led, peer-assisted in-school education, youth-friendly health services, community activities, and youth condom promotion and distribution. …

  11. Does Education Affect HIV Status? Evidence from five African Countries

    Data from the first five Demographic and Health Surveys to include HIV testing for a representative sample of the adult population are used to analyze the socioeconomic correlates of HIV infection and associated sexual behavior. Emerging from a wealth of country relevant results, some important findings can be generalized. First, successive marriages are a significant risk factor. Second, contrary to prima facie evidence, education is not positively associated with HIV status. …

  12. An innovative online HIV/STI prevention programme in higher education: preliminary results NMMU

    The objectives were to determine risky sexual behavioural trends and health promotion needs among students, to develop an online HIV/STI prevention programme utilising the NMMU intranet portal. Descriptive data regarding demographics, sexual behaviour, internet usage and the relevance of various health promotion messages were included in an online questionnaire. Participants' attitude towards risk behaviour was also assessed using ten outcome questions rated on a five-point Likert scale. …

  13. Evidence, politics and Uganda's HIV success: moving forward with ABC and HIV prevention

    Uganda’s HIV success story has become increasingly focused around the idea of ‘ABC’ (Abstain, Be faithful or use Condoms). During the George W. Bush administration, the US Government has promoted one specific ABC model for its development agencies, with a particular emphasis on abstinence. Yet other actors have contested this view. To understand Uganda’s success, it is imperative to look at what ABC was in Uganda when critical changes in behaviour were occurring. …

  14. Effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda: results from a non-randomized controlled trial

    While the HIV epidemic is levelling off in sub-Saharan Africa, it remains at an unacceptably high level. Young people aged 15-24 years remain particularly vulnerable, resulting in a regional HIV prevalence of 1.4% in young men and 3.3% in young women. This study assesses the effectiveness of a peer-led HIV prevention intervention in secondary schools in Rwanda on young people’s sexual behavior, HIV knowledge and attitudes. In a non-randomized longitudinal controlled trial, fourteen schools were selected in two neighboring districts in Rwanda Bugesera (intervention) and Rwamagana (control). …

  15. 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). …

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