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UNESCO HIV and Health Education Clearinghouse

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  1. Gender and sexual vulnerability of young women in Africa: experiences of young girls in secondary schools in Uganda

    Sexuality is part and parcel of students' experiences of schooling manifested in personal friendships, relations and social interaction. These encounters constitute sites within which sexual identities are developed, practiced and actively produced through processes of negotiation. Drawing on qualitative research conducted in 14 selected secondary schools in Central and Western Uganda, the study illuminates gendered sexual vulnerability within patterns of social interaction and young girls gendered experiences and negotiation of their sexuality. …

  2. 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. …

  3. The World Starts With Me: using intervention mapping for the systematic adaptation and transfer of schoolbased sexuality education from Uganda to Indonesia

    Evidence-based health promotion programmes, including HIV/AIDS prevention and sexuality education programmes, are often transferred to other cultures, priority groups and implementation settings. Challenges in this process include the identification of retaining core elements that relate to the programme’s effectiveness while making changes that enhances acceptance in the new context and for the new priority group. This paper describes the use of a systematic approach to programme adaptation using a case study as an example. …

  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. Sexuality education in South Africa: Three essential questions

    Sex education is the cornerstone on which most HIV/AIDS prevention programmes rest and since the adoption of Outcomes-Based Education (OBE), has become a compulsory part of the South African school curriculum through the Life Orientation learning area. However, while much focus has been on providing young people with accurate and frank information about safe sex, this paper questions whether school based programmes sufficiently support the needs of young people. …

  6. 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. …

  7. Sexual behaviour and knowledge regarding sexually transmitted infections among undergraduate students in Durban, South Africa

    The objective of this cross-sectional study was to identify the sexual behavior and knowledge of sexually transmitted infections (STIs) amongst 752 undergraduate university students in South Africa, using self-administered questionnaires. More than half reported presently being sexually active, the majority used contraceptives and especially used condoms. Almost a third of the sample, had multiple sexual partners, and more than a quarter of them reported to have sex under the influence of alcohol. …

  8. Sexual coercion among in-school adolescents in Rwanda: prevalence and correlates of victimization and normative acceptance

    Adolescents are particularly vulnerable to sexual coercion, as victim as well as perpetrator. This paper aims to adapt sexual and reproductive health interventions to the reality of young people’s sexuality and relationships. This study assesses the prevalence of forced sex, characteristics of victims and norms regarding sexual coercion among Rwandan adolescents. A survey was completed by 285 senior secondary school students and four focus groups were conducted. Of sexually active respondents, 15.5% reported forced sexual intercourse. …

  9. Nothing as practical as good theory? The theoretical basis of HIV prevention interventions for young people in sub-Saharan Africa: A systematic review

    This paper assesses the extent to which HIV prevention interventions for young people in sub-Saharan Africa are grounded in theory and if theory-based interventions are more effective. Three databases were searched for evaluation studies of HIV prevention interventions for youth. Additional articles were identified on websites of international organisations and through searching references. 34 interventions were included; 25 mentioned the use of theory. …

  10. The ABC's of HIV prevention: education in Uganda and Côte d'Ivoire

    Abstince-only education programs in the United States have been controversial since their inception in 1981 because of their lack of efficacy and because of the sexualities and behaviors that they promulgate. Barack Obama's 2010 budget eliminates federal funding for abstinence-only education programs in the US; however, the outline of his five-year strategy for the President's Emergency Plan for AIDS Relief (PEPFAR) does not indicate whether the US government will continue to mandate abstinence-only education in so-called "focus countries", primarily in sub-Saharan Africa. …

  11. Condom Use Increases Among Namibian Youths Following HIV Training

    Namibian adolescents who received an HIV training curriculum experienced significant changes in attitudes, knowledge, intentions and behaviors concerning sexual activity and HIV. Adolescents who received training were more likely than their peers to know how pregnancy occurs and how to use a condom correctly. They also were more likely to believe that they could be intimate with a partner without having sex and that they could have a girlfriend or boyfriend for a long time without having sex. …

  12. 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. …

  13. Do teenagers respond to HIV risk information? Evidence from a field experiment in Kenya

    We use a randomized experiment to test whether and what information changes teenagers' sexual behavior in Kenya. Providing information on the relative risk of HIV infection by partner's age led to a 28 percent decrease in teen pregnancy, an objective proxy for the incidence of unprotected sex. Self-reported sexual behavior data suggests substitution away from older (riskier) partners and toward same-age partners. In contrast, the official abstinence-only HIV curriculum had no impact on teen pregnancy. …

  14. HIV prevention for South African youth: which interventions work? A systematic review of current evidence

    South Africa's HIV prevalence among 15-24 year olds is one of the highest in the world. This systematic review looks at the evidence for youth HIV prevention in the country since 2000 and critically assesses interventions across four domains: study design and outcomes; intervention design; thematic focus and HIV causal pathways; and intervention delivery. Eight interventions were included in the review, all similar regarding content and objectives, but with variouis thematic foci, causal pathways, theoretical bases, delivery methods, intensity and duration. …

  15. Evaluation of an HIV/AIDS peer education programme in a South African workplace

    This paper describes an evaluation of a workplace HIV/AIDS peer-educational program. A cross-sectional study of 900 employees was conducted in 2001 across three areas in South Africa and measured the impact of a peer-education program on knowledge, attitudes towards people living with HIV/AIDS, perceptions of risk and condom use. Peer-education had no impact on any outcome. Some 59% of subjects had good knowledge, 62% positive attitude towards people living with HIV/AIDS, 34% reported frequently using condoms, 73% perceived themselves at low risk for infection. …

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