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UNESCO HIV and Health Education Clearinghouse

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  1. Is the sexual behaviour of young people in sub-Saharan Africa influenced by their peers? A systematic review

    Adolescents in sub-Saharan Africa are highly vulnerable to HIV, other sexually transmitted infections (STIs) and unintended pregnancies. Evidence for the effectiveness of individual behaviour change interventions in reducing incidence of HIV and other biological outcomes is limited, and the need to address the social conditions in which young people become sexually active is clear. Adolescents' peers are a key aspect of this social environment and could have important influences on sexual behaviour. There has not yet been a systematic review on the topic in sub-Saharan Africa. …

  2. Designing an effective sexuality education curriculum for schools: lessons gleaned from the South(ern) African literature

    Sexuality education forms part of the national school curricula of most sub-Saharan African countries, yet risk-related sexual behaviour among young people continues to fuel the HIV pandemic in this part of the world. One of the arguments put forward to explain why sexuality education seems to have had little impact on sexual risk-taking is that existing curricula have neglected to take into account the complexity of the social, cultural and gender norms that influence the behaviour of school-going young people in sub-Saharan Africa. …

  3. 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. …

  4. Condoms in sub-Saharan Africa

    Sub-Saharan Africa (SSA) is the region with the world’s highest rates of HIV and other sexually transmissible infections (STIs), yet numerous studies show that condom use is generally rare. This suggests a need for a better understanding of how condoms fit within sexual practices and relationships in SSA. This paper seeks to address this need by reviewing research published between the late 1980s and 2011 on use and factors influencing use of male condoms in SSA. …

  5. 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. …

  6. 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. …

  7. 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. …

  8. HIV/AIDS and its impact on education in sub-Saharan Africa: policy initiatives and challenges

    Impact mitigation strategies in sub-Saharan Africa on HIV/AIDS in the education sector involved initially the development of education sector policies. This study traces the policy development initiatives, level of implementation, progress made and existing challenges. The study is based on a close (textual) reading of authoritative literature from United Nations Programme on HIV/AIDS (UNAIDS), World Bank, UNESCO and UNICEF for the last decade on global monitoring of HIV/AIDS and statistical data. …

  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 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. …

  11. A tale of two countries: rethinking sexual risk for HIV among young people in South Africa and the United States

    This paper compares the sexual behaviors of young people in South Africa (SA) and the United States (US) with the aim of better understanding the potential role of sexual behavior in HIV transmission in these two countries that have strikingly different HIV epidemics. Nationally representative, population-based surveys of young people ages 18-24 years from SA (n = 7,548) and the US (n = 13,451) were used. The prevalence of HIV was 10.2% in SA and 1% in the US. …

  12. 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). …

  13. 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. …

  14. AIDS: conceptual and methodological issues in researching sexual behaviour in sub-Saharan Africa

    This paper describes some of the conceptual and methodological issues encountered in the course of a study of mainly anthropological secondary source materials on sexual behaviour in sub-Saharan Africa. Its aim was to survey and review existing literature and other secondary sources available both outside and within Anglophone sub-Saharan Africa and to evaluate their usefulness to AIDS research and prevention. The review cautioned against the uncritical use of anthropological sources without due regard for their conceptual and methodological status. …

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