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We adapted a U.S. HIV prevention program to address knowledge gaps and cultural pressures that increase the risk of infection in adolescent Ghanaian girls. The theory-based nine-module HIV prevention program combines didactics and games, an interactive computer program about sugar daddies, and tie-and-dye training to demonstrate an economic alternative to transactional sex. The abstinence-based study was conducted in a church-affiliated junior secondary school in Nsawam, Ghana. Of 61 subjects aged 10-14 in the prevention program, over two thirds were very worried about becoming HIV infected. …
We provide experimental evidence on the relationships between education, HIV/AIDS education, risky behavior and early fertility in Kenya. We exploit randomly assigned variation in the cost of schooling and in exposure to the national HIV/AIDS prevention curriculum for a cohort of over 19,000 adolescents in Western Kenya, originally aged 13.5 on average. We collected data on the schooling, marriage, and fertility out-comes of these students over 7 years, and tested them for HIV and Herpes (HSV2) after 7 years. …
The disappearance of traditional sex education during rites of passage in African societies has left many youth uncertain of where to look for information. Against this backcloth, the objectives of this study were to identify knowledge gaps amongst adolescents in Kenya regarding sexuality, HIV/AIDS and reproductive health. A thematic analysis was conducted of questions posed by 735 school youth aged 12–18 years from Meru and Kajiado Districts. Results show that many questions showed curiosity and anxiousness. …
We explored constraints of implementing AIDS education in public schools in Kenya. Sixty interviews with teachers and 60 focus group discussions with students were conducted in 21 primary and nine secondary schools. System/school-level constraints included lack of time in the curriculum, limited reach of secondary-school students (because AIDS education is embedded in biology, which is not compulsory), and disapproval of openness about sex and condoms by the Ministry of Education and parents. Alternative strategies to teach about AIDS had their own constraints. …
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. …
Uganda’s HIV success story has become increasingly focused around the idea of ‘ABC’ (Abstain, Be faithful or use Condoms). During the George W. Bush administration, the US Government has promoted one specific ABC model for its development agencies, with a particular emphasis on abstinence. Yet other actors have contested this view. To understand Uganda’s success, it is imperative to look at what ABC was in Uganda when critical changes in behaviour were occurring. …
The aim of the study was to explore young people's understanding and knowledge about why protective measures against HIV/AIDS, malaria and unplanned pregnancy are not taken by those at risk in Uganda. The study results were that the participants (all from secondary school in Kanungu Uganda) could identify reasons why preventive action was not taken. These reasons included misconceptions, the inpracticability of abstinence, and fear of side effects of several key interventions. The article argues that there is an apportunity to improve preventive measures by tackling these issues. …
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. …
In an effort to reduce unintended pregnancy and sexually transmitted disease (STD) in adolescents, both abstinence and comprehensive sex and STD/HIV education programs have been proffered. Based on specified criteria, the author searched for and reviewed 56 studies that assessed the impact of such curricula (8 that evaluated 9 abstinence programs and 48 that evaluated comprehensive programs) on adolescents’ sexual behavior. Study results indicated that most abstinence programs did not delay initiation of sex and only 3 of 9 had any significant positive effects on any sexual behavior. …
There is no vaccine to prevent HIV/AIDS, and the best treatment does not constitute a cure. U.S. government institutions responsible for setting public health standards have therefore repeatedly and strongly urged that providing complete and accurate information to adolescents about HIV/AIDS prevention, including the proper use of condoms as a means to reduce the risk of HIV transmission, be an important part of the government's prevention efforts. …
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. …
A health education program conducted in primary schools in Soroti district, Uganda promoted increased access to information, better peer interactions and better quality of the health education system. A cross-sectional survey was conducted among students in their final year of primary school (average age 14 years) at baseline and two years after introduction of the intervention. The percentage of sexually active students decreased from 42.9% (123 out of 287) to 11.1% (31 out of 280) in the intervention arm, while no changes were observed in the control arm. …
In the majority of states, sex education is mandatory or strongly recommended in public schools. Forty-eight states and most of the large school districts across the country support sex education, including about STIs and abstinence. Fewer districts and states make education on pregnancy prevention mandatory. Larger school districts cover a broader range of sex-related topics, especially related to preventing pregnancy, than state curricula. Such districts also provide greater support to instructors through curricula provision, training and other activities, than do states. …
A study in four districts of Rhode Island (USA) of 1,379 junior high school students (average age 13.2 years) found that sexually active boys were less knowledgeable about HIV, less tolerant of people living with AIDS, less fearful of contraction of HIV and more likely to undertake risky behavior, than those who were not sexually active. The same pattern, although less extreme, is found among girls in the sample. …
Educators within the school system are well placed to facilitate the dissemination of knowledge and skills in order for adolescents to be equipped for appropriate sexual decision-making. The aim of this research was to provide an understanding of educators' beliefs, attitudes and behaviours with regard to sexual and reproductive health promotion. Methods: Individual interviews were conducted with 15 educators from demographically diverse high schools in the Western Cape. One-off interviews were conducted with Grade 8 Life Orientation educators and principals. …
