AEGiS-15IAC: Another blow to school-based prevention curricula. Interactive intervention fails to reduce risk behavior.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Another blow to school-based prevention curricula. Interactive intervention fails to reduce risk behavior.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1155)

Torres MP, Walker DM, Gutierrez JP, Bertozzi SM
Division of Reproductive Health, National Institute of Public Health (INSP), Cuernavaca, Mexico

BACKGROUND: There is growing skepticism among experts as to the impact of school-based education interventions on reducing sexual risk taking and unplanned pregnancy. We aimed to measure the impact of a high school-based HIV/AIDS prevention intervention on knowledge, attitudes and sexual risk behavior in Morelos, Mexico.

METHODS: This cluster-randomized intervention compared the impact of (i) an HIV prevention curriculum (HPC) with (ii) the same curriculum plus emergency contraception education (HPC+EC) and (iii) the standard government sexuality curriculum. After 40 hrs of teacher training, 106 teachers presented the 32 hr curriculum in 40 high schools. We administered three rounds of anonymous questionnaires, pre (n=11,177), 4 months post (n= 9,542), and one year post (June 2003, n=7629).

RESULTS: At baseline, reported sexual experience was 17.6% among HPC, 16% for HPC+EC and 15.6% in the comparison group. At one year, 22% in both intervention groups and 22.4% of comparison reported sexual intercourse. At 4 months we saw a significant and positive impact on condom use at last sex that was lost at one year (HPC+EC 1.50 CI 1.14-1.97 (first FU), 1.16 CI 0.88 - 1.55 (1 yr). The intervention had no effect on the number of sexual partners nor on age of sexual debut. It had a positive impact in the self-reported willingness to negotiate condom use (p<0.01), HIV prevention knowledge (p< 0.01), self-esteem (p<0.01) and attitudes towards HIV positive people (p< 0.05).

CONCLUSIONS: The intervention did not promote earlier sexual initiation and had a positive effect on safe sex attitudes, yet there was no sustained impact on condom use. Condom access may be a factor. It may also be that we are effectively teaching adolescents how to gauge risk and that they are not increasing condom use but using condoms with riskier partners. The change in association of condom use with level of risk will be explored in subsequent analyses.

Keywords: AEGIS, Risk-Taking, Sexual Behavior, Condoms, Safe Sex, Curriculum, Acquired Immunodeficiency Syndrome, Health Education, Sex Education, Questionnaires, Coitus, Mexico, Adolescence, Female, Pregnancy, prevention & control, education

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