AEGiS-15IAC: The role of culture-specific HIV intervention programmes in South African schools.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

The role of culture-specific HIV intervention programmes in South African schools.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrD1258)

Mendelson F, Mtshizana Y, Hani A, Flisher A, Mathews C, Bekker LG
The Desmond Tutu HIV Center, University of Cape Town, Cape Town, South Africa

BACKGROUND: Approximately 5.5 million South Africans are infected with HIV and over 60% of new infections occur in those aged 15-25y. Fifty per cent are sexually active by age 16, with sexual debut recorded as early as 13y. Attempts to alter sexual behaviour, attitudes and norms have been largely unsuccessful. Few of the national and local AIDS prevention programmes have been evaluated using comparison or control groups.

METHODS: A 10-week modular intervention programme comprised of Xhosa story-telling, discussions and interactive theatre was undertaken in Masiphumelele Township Cape Town, to address biomedical and psycho-social perspectives on HIV/AIDS. A self-administered questionnaire was undertaken prior, and at one- and three months post intervention. A "control" school was used for comparison, which did not receive the intervention.

RESULTS: 424 students aged 11-19y (mean 15y) were recruited. At baseline 38.5% were sexually active, with an average number of partners of 2.97. Of those, only 62% had ever used a condom. 88% knew that sex without a condom could cause HIV yet only 65% felt they could insist on condom use. 8/49 of the children under 13y were sexually active, the youngest being 11y old. 11.5% of the girls had non-consensual sex and 10% of the boys reported forcing sex on their partner. Preliminary results at follow-up show a 6% increase in sexual debut in the "intervention" school vs 18% increase in the control school. The full results of our intervention will be presented and we will discuss the factors that have contributed to the changes.

CONCLUSIONS: The survey shows the need for effective HIV prevention programmes aimed at pre-adolescents, identifying and addressing cultural issues that determine sexual practices. It also reflects the importance of rigorous evaluation employing a variety of techniques in order to assess the level of success, thus informing future interventions.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Sexual Behavior, Condoms, Culture, Schools, HIV Infections, Students, Safe Sex, Questionnaires, Attitude, Data Collection, Coitus, Adolescence, Humans, Male, Child, Female, ethnology

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