Do African adolescents know enough about AIDS to protect themselves against infection? What is the best way to educate them about the risks of HIV? A report from Population Services International evaluates a peer-led HIV prevention programme in a secondary school in Zambia.

During the programme, students discuss their beliefs and fears about AIDS with trained peers. As a result, they become more positive about virginity and condom use. The programme's success results from the dual strategy of promoting values and providing information.

Adolescents are important targets for HIV prevention strategies. In sub-Saharan Africa, where the majority of HIV-positive people live, young people are particularly vulnerable to infection. Awareness of AIDS among adolescents in Africa is generally quite high. But the information they receive is not always accurate or helpful.

Adolescents in Zambia hear conflicting messages about HIV. The media and entertainment industries often glorify the physical aspects of sex and adolescents tend to think of abstinence as boring and old-fashioned. On the other hand, girls are expected to remain naïve and inexperienced and they worry that suggesting condom use will make them seem like prostitutes. Political leaders who condemn condoms on moral grounds add to the confusion.

Peer intervention can play an important role by providing information in a setting that adolescents are comfortable with. In interactive sessions in schools, peers help students to acquire accurate knowledge and develop personal values.

The researchers evaluated the effectiveness of a peer intervention implemented in a secondary school by the Society for Family Health/Zambia (SFH). The researchers found that the 421 students in the programme are more likely to report positive attitudes towards abstinence and condom use than 338 students not included in the programme.

Students in the programme are more likely to believe that:

• people can avoid HIV by abstaining from sex
• it is common for both men and women to approve of and insist on abstinence
• condoms are effective in preventing HIV and other sexually-transmitted infections
• it is acceptable for a woman to suggest condom use
• they are at risk of catching HIV
• healthy-looking people can have HIV.

They are also more likely to approve of condom use and to know where to obtain them.

The researchers conclude that the programme was successful because it:

• took account of research on adolescent sexuality.
• exploited SFH's experience in marketing condoms to Zambian adolescents
• emphasised both values (virginity) and practical guidelines (condom use) - this may be particularly important in a social context where adolescents receive mixed messages about sexuality and interventions tend to be extremely moralistic.

However, more children attend primary school than secondary school in Zambia. Could this intervention be extended to the primary school setting?

Source(s):
'An evaluation of the effectiveness of a peer sexual health intervention among secondary school students in Zambia' by S. Agha, PSI Research Division Working Paper 41, Population Services International, Washington DC (2001)

Funded by: UK Department for International Development; USAID

id21 Research Highlight: 08 May 2002

Further Information:
Sohail Agha
Population Services International
1120 19th Street NW, Suite 600
Washington DC 20036
USA

Tel: +1 2020 785 0072
Fax: +1 202 785 0120
Contact the contributor: generalinfo@psieurope.org.uk

Population Services International

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