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UNESCO HIV and Health Education Clearinghouse

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  1. How reliable are reports of early adolescent reproductive and sexual health events in demographic and health surveys?

    CONTEXT: Age at sexual debut, age at first marriage or first union and age at first birth are among the most widely used indicators of health and well-being for female adolescents. However, the accuracy of estimates for these indicators, particularly for younger adolescents, is poorly understood. METHODS: For each of nine countries in Africa and Latin America, Demographic and Health Survey (DHS) data from two surveys conducted five years apart were used to examine women’s reports of age at sexual debut, marriage or first union, and first birth. …

  2. Sexual behavior among persons living with HIV in Uganda: Implications for policy and practice

    Introduction: HIV epidemics are sustained and propagated by new cases of infection which result from transmission from infected persons to uninfected susceptible individuals. People living with HIV (PLHIV) play a critical role in prevention if they adopt safer sexual behaviors. This study estimated the prevalence of and factors associated with safer sexual behaviors among PLHIV seeking care from civil society organizations (CSOs). …

  3. Promoting sexual and reproductive health among adolescents in southern and eastern Africa (PREPARE): project design and conceptual framework

    Background: Young people in sub-Saharan Africa are affected by the HIV pandemic to a greater extent than young people elsewhere and effective HIV-preventive intervention programmes are urgently needed. The present article presents the rationale behind an EU-funded research project (PREPARE) examining effects of community-based (school delivered) interventions conducted in four sites in sub-Saharan Africa. One intervention focuses on changing beliefs and cognitions related to sexual practices (Mankweng, Limpopo, South Africa). …

  4. 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. …

  5. Having sex, becoming somebody: A qualitative study assessing (sexual) identity development of adolescents living with HIV/AIDS

    A growing number of adolescents are living with HIV/AIDS. For their well-being and for prevention, age- and culturally appropriate interventions become increasingly important. This qualitative study was conducted as the first step to develop a sexual and reproductive health (SRH) intervention. The study's objective was to assess the impact of HIV and related contextual conditions on identity formation of adolescents living with HIV/AIDS (ALH) in the domains of physical, cognitive, social, and sexual development. Data were collected using focus group discussions (FGDs). …

  6. 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. …

  7. HIV infection and sexual risk behaviour among youth who have experienced orphanhood: systematic review and meta-analysis

    Background: Previous research has suggested that orphaned children and adolescents might have elevated risk for HIV infection. We examined the state of evidence regarding the association between orphan status and HIV risk in studies of youth aged 24 years and younger. Methods: Using systematic review methodology, we identified 10 studies reporting data from 12 countries comparing orphaned and non-orphaned youth on HIV-related risk indicators, including HIV serostatus, other sexually transmitted infections, pregnancy and sexual behaviours. …

  8. Young people and sexual agency in rural Uganda

    Drawing on definitions of agency from within the international development literature, the author focuses on decision-making processes leading to young people's involvement in relationships; actions undertaken to maintain secret relationships in contexts where young people's sexual agency is generally prohibited; transactional and gendered negotiations between young people involved within a relationship; and a range of outcomes arising from young people's sexual activity. …

  9. Individual and community-level tolerance of spouse abuse and the association with the circumstances of first sex among youth from six sub-Saharan African countries

    Youth who engage in early and premarital sex are at risk of HIV and sexually transmitted infections. Most prevention programs ignore the mediating influence of the threat and experience of violence on these outcomes. Using nationally representative data from Lesotho, Malawi, Zimbabwe, Kenya, Tanzania, and Uganda, the autors used multivariate analyses to examine the association between individual- and community-level tolerance of spouse abuse on the age and circumstances of sexual debut among female youth. The youth sample sizes ranged from a high of 5007 in Malawi to a low of 3050 in Lesotho. …

  10. Self-reported sexual behaviour among adolescent girls in Uganda: reliability of data debated

    The objective of this study was to compare self-reported information about sexual behavior in a research interview to information retrieved during a clinical consultation. Social workers interviewed 595 sexually experienced women below 20 years about genital symptoms and sexual behavior. A midwife interviewed and examined the women and took vaginal samples for gonorrhea and chlamydia. Four questions were embedded in both the social workers' interviews and among the midwife's questions. …

  11. Adolescents' perceptions of sexual coercion in Uganda

    In Uganda, HIV prevalence remains high with young people at higher risk of infection than adults. Much is known about the sexual risk factors for HIV transmission among youths, including sexual encounters that are coerced. On the other hand, relatively little is known about the barriers to preventing sexual coercion and what strategies may overcome those barriers with adolescents. …

  12. Maisha Newsletter December 2011

    Maisha+ focuses on sharing experiences and lessons in reaching out to the hard-to-reach community populations in Sub Saharan African with HIV and AIDS interventions. In this issue: -Towards zero HIV infections, discrimination and AIDS deaths for hard to reach communities -Violence against women contributing to spread of HIV -Supporting Associations of people living with HIV in Uganda -Challenges in addressing traditional beliefs and practices in HIV and AIDS among the Maasai -Working with sexual minorities in Rwanda -Stop the discrimination! -testimony from a victim of assault

  13. 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. …

  14. Sexual, reproductive health needs and rights of young people with perinatally acquired HIV in Uganda

    The number of young people with perinatally acquired HIV is growing significantly. With antiretroviral drugs, children who get infected at birth with HIV have an opportunity to graduate into adolescence and adulthood. This achievement notwithstanding, new challenges have emerged in their care and support needs, the most dynamic being their sexual and reproductive health needs and rights (SRHR). …

  15. 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. …

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