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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. …
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. …
Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. We conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of searching and data abstraction were utilized. Merged effect sizes were calculated using random effects models. Thirty studies were identified. …
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. …
Background: The international community agrees that the Millennium Development Goals will not be achieved without ensuring universal access to both sexual and reproductive health (SRH) services and HIV/AIDS prevention, treatment, care and support. Recently, there has been increasing awareness and discussion of the possible benefits of linkages between SRH and HIV programmes at the policy, systems and service delivery levels. However, the evidence for the efficacy of these linkages has not been systematically assessed. …
Objective: To evaluate the efficacy of an abstinence-only intervention in preventing sexual involvement in young adolescents. Design:Randomized controlled trial. Setting: Urban public schools. Participants:A total of 662 African American students in grades 6 and 7. …
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. …
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. …
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. …
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. …
The objectives were to determine risky sexual behavioural trends and health promotion needs among students, to develop an online HIV/STI prevention programme utilising the NMMU intranet portal. Descriptive data regarding demographics, sexual behaviour, internet usage and the relevance of various health promotion messages were included in an online questionnaire. Participants' attitude towards risk behaviour was also assessed using ten outcome questions rated on a five-point Likert scale. …
This publication describes three German-supported initiatives in Africa (specifically in Guinea, Mozambique and Tanzania) and one in Latin America (a six-country regional initiative). All integrate sexual health and HIV prevention within school systems. The three African initiatives operate within generalized epidemics driven largely by unprotected sex between men and women. In Latin America general prevalence in the countries described here is well below one percent, and much less among young people. …
Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. Results: We located 26 studies, including seven randomized trials. …
South Africa’s recently adopted Children’s Act provides children the right to access reproductive health services as a way of addressing the HIV pandemic, but there remains confusion about how socially divisive rights provided for by the Act, such as condom access for youth, will be achieved. The Children’s Act, together with South African government policies, allows individual schools to decide whether to distribute condoms, but most school staff are unaware of South African policy and regulations governing condom provision in schools. …
