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Adolescent HIV prevention trial in South Africa and Tanzania

Date: Article published 17 May 2012
Creator: Katie Gannett
Source: Elsevier
Source Type: Literature
Link: http://download.journals.elsevierhealth.com/pdfs/journals/1876-3413/PIIS1876341312000162.pdf

Summary:
This study examines the effects of teacher-led school HIV-prevention programmes on young adolescent sexual risk behavior in two sites in South Africa (Cape Town and Mankweng) and one site in Tanzania (Dar es Salaam). The intervention consisted of 11-17 hrs of classroom sessions—combining teacher presentations, group discussions, and role-plays—documented in a teacher’s manual for each site. A cluster randomized controlled trial (RCT) was conducted in each site (30 schools in each CT and Mankweng and 24 schools in Dar es Salaam) among adolescents aged 12-14 years. A standard questionnaire was used across sites to measure reports of sexual behavior and the hypothesized mediators (knowledge, attitudes, social norms and self-efficacy).

In Dar es Salaam, the intervention was effective at delaying reported sexual debut, but in South Africa the intervention had no significant effects on the primary outcomes. The authors theorize that the great variety of school based HIV prevention programmes in South Africa—particularly the South African Department of Education’s Life Orientation curriculum—in contrast with a dearth in Tanzania may have limited the potential of this curriculum to make an impact in SA. Authors also note that the school environment in South Africa may have been less safe than in Tanzania, limiting participants’ ability to take individual action in response to the intervention.

Authors conclude that, “in South Africa, curriculum-based programmes need to be supplemented with interventions to change the environment in which adolescents make decisions about their sexuality.”

Implications:
The SATZ curriculum can be a terrific resource for GRS’ curriculum development and M&E teams. The study has high relevance to the GOAL trial in raising some of the challenges facing programs seeking to reduce sexual risk behavior in South Africa.

Action Steps:
The article includes a link to the SATZ teacher manuals, student workbooks, questionnaires used, theoretical frameworks, etc. Check it out!