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UNESCO HIV and Health Education Clearinghouse

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  1. 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. …

  2. Efficacy of a theory-based abstinence-only intervention over 24 months: A randomized controlled trial with young adolescents

    Objective: To evaluate the efficacy of an abstinence-only intervention in preventing sexual involvement in young adolescents. Design:Randomized controlled trial. Setting: Urban public schools. Participants:A total of 662 African American students in grades 6 and 7. …

  3. 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. …

  4. Education and risky sex in Africa: Unraveling the link between women’s education and reproductive health behaviors in Kenya

    Much research attention has been devoted to understanding the relationship between education and riskier sex-related behaviors and HIV/AIDS in sub-Saharan Africa. While in the early 1990s researchers found that increases in education were associated with a higher incidence of HIV/AIDS, this relationship appears to have reversed and better educated people, especially women, appear less likely to engage in riskier sex-related behaviors and have a lower incidence rate of HIV/AIDS. …

  5. 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. …

  6. 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. …

  7. 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. …

  8. Condom access in South African schools: law, policy, and practice

    South Africa’s recently adopted Children’s Act provides children the right to access reproductive health services as a way of addressing the HIV pandemic, but there remains confusion about how socially divisive rights provided for by the Act, such as condom access for youth, will be achieved. The Children’s Act, together with South African government policies, allows individual schools to decide whether to distribute condoms, but most school staff are unaware of South African policy and regulations governing condom provision in schools. …

  9. Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household surevy

    Objectives: To determine the prevalence of HIV infection, HIV risk factors, and exposure to national HIV prevention programs, and to identify factors associated with HIV infection among South African youth, aged 15–24 years. Design: A cross-sectional, nationally representative, household survey. Methods: From March to August 2003 we conducted a national survey of HIV prevalence and sexual behavior among 11 904 15–24 year olds. Multivariable models for HIV infection were restricted to sexually experienced youth. …

  10. Economic status, education and risky sexual behavior for urban Botswana women

    This study investigated the relationship between economic status, education and risky sexual behavior for urban Botswana women. The data used are a nationally representative sample from the Botswana AIDS Impact Survey conducted in 2004. An un-weighted sample of 2215 women aged 15-49, who have had sexual intercourse was considered for analysis. Both bivariate and multivariate analyses are used to gain insights into the potential linkages between economic status, education and risky sexual behavior. …

  11. 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). …

  12. Masculinities and condom use patterns among young rural South Africa men: a cross-sectional baseline survey

    Notions of ideal manhood in South Africa are potentially prescriptive of male sexuality thus accounting for the behaviors which may lead to men being at greater HIV risk. We tested the hypothesis that gender and relationship constructs are associated with condom use among young men living in rural South Africa. 1219 men aged 15–26 years completed a cross-sectional baseline survey from an IsiXhosa questionnaire asking about sexual behaviour and relationships. …

  13. The sexual behaviour of adolescents in sub-Saharan Africa: patterns and trends from national surveys

    Objectives: To describe the sexual and reproductive behaviour of adolescents in sub-Saharan Africa, particularly 15- to 19-year-olds. Methods: Using DHS/AIS data (2000–2010), nine indicators of adolescent behaviour and one of adult attitudes towards condom education for adolescents were described for 24 countries. Indicators were disaggregated by gender, urban/rural residency and educational status, and time trends were described. Results: Up to 25% of 15- to 19-year-olds reported sex before age 15; this proportion shrank over time in many countries. …

  14. 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). …

  15. HIV, syphilis infection, and risky sexual behaviors among male university students who have sex with men in Beijing, China: a cross-sectional study

    Young male university students who have sex with men are at high risk of HIV and sexually transmitted infections (STIs). The authors conducted a cross-sectional survey to assess the prevalence of risky sexual behaviors, HIV, and syphilis among male university students who have sex with men in Beijing, China; and to identify risk factors for unprotected anal intercourse (UAI). Among 157 study participants, HIV and syphilis prevalence were 2.5% and 7.0%, respectively. The authors found a high prevalence of UAI in the study population. …

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