Educating Cameroonian girls to increase behavior skills and intentions to postpone sexual activity

Introduction: Acquired Immune Deficiency Syndrome (AIDS) is an escalating problem in sub-Saharan Africa. According to the World Health Organization, the disease constitutes a threat to the health of adolescents in this region. One of the countries in this region with a growing prevalence of AIDS is Cameroon, where an estimated one in four adolescents is at risk for contracting this disease. Little is known, however, about effective strategies that can assist adolescents in this country to reduce their vulnerability. Purpose: The purpose this study was to test the appropriateness and effectiveness of a school-based intervention delivered to pre-adolescent Cameroonian girls to: 1) increase intentions to postpone sexual activity and 2) increase sexual-abstinence behavior skills. A pretest/posttest quasi-experimental design was used. Method: Participants included 60 female students from a primary school in Buea, Cameroon. The students received a pretest measuring intentions to postpone sexual activity and sexual-abstinence behavior skills followed by an educational intervention based on the Theory of Planned Behavior. A posttest was then administered to measure the same variables as in the pretest and a questionnaire evaluating the appropriateness of the study. Descriptive statistical analyses were performed on all variables. Exact paired t-tests were used to compare pretest and posttest scores. Effect sizes and confidence intervals were also estimated for each of the two dependent variables. The alpha level was set a priori at 0.05. Findings: Post intervention scores on both variables were higher than pre-intervention scores; intentions to postpone sexual activity (t=3.40; p<.05) and sexual-abstinence behavior skills (t=4.51; p<.05). Effect sizes were moderate, with narrow 95% confidence intervals (.66; CI= .59-.73 and .75; CI=.67-.83 respectively) Seventy five percent of the participants found all aspects of the study appropriate. Conclusions: The findings provide a basis for a large randomized community trial using these instruments and intervention. If these findings are replicated with larger random samples the intervention could be used by policy makers, public health planners, and community health nurses to reverse the rapidly escalating HIV infection rates in Cameroon.