202314 Evaluating an HIV peer education program in Zambian Schools: Do youth peer educators make a difference?

Tuesday, November 10, 2009

Julie Anne Denison, PhD , Behavioral and Biomedical Research Department, Family Health International, Arlington, VA
Sharon Tsui, MPH , Behavioral and Biomedical Research Department, Family Health International, Durham, NC
Mark Weaver, PhD , Quantitative Sciences, Family Health International, Durham, NC
Kwasi Torpey , Family Health International, Lusaka, Zambia
Mushota Kabaso , Family Health International, Lusaka, Zambia
Lameck Nyirenda , Family Health International, Lusaka, Zambia
Jonathan Mukundu , Family Health International, Lusaka, Zambia
Kennedy Sichinsambwe , Students Partnership Worlwide, Kabwe, Zambia
Background: Students Partnership Worldwide (SPW)/Zambia teaches 5th -12th graders HIV prevention and reproductive health (RH) by placing youth who have completed their secondary education as peer educators in schools.

Purpose: To evaluate the associations between SPW program exposure and HIV and RH knowledge, attitudes and behaviors.

Significance: SPW deployment of youth peer educators to teach in schools is an innovative approach. Objective evidence regarding the effectiveness of novel school-based HIV interventions is needed.

Methods: A non-randomized quasi-experimental design was used to assess outcomes for a cross-sectional sample of 8/9th grade students in 13 SPW intervention schools compared to 13 matched non-SPW schools. The analysis controlled for socio-demographics, and adjusted for clustering using GEE.

Results: Out of 2,133 respondents, 53% were 16 or older (range 11-28). Official school age for 8/9th grade is 14-15. Adjusted analyses found that intervention students had statistically significant higher levels of knowledge about HIV (52% vs. 42%) and reproductive health (40% vs. 29% with all responses correct); and reported low levels of stigma towards HIV+ people (64% vs. 51%). No differences in ever having had sex (~28%), were found between study arms, however, fewer sexually active respondents from intervention schools compared to comparison schools had sex in the past year (37% vs. 44%).

Conclusions: The SPW/PE program has associations with increased HIV and RH knowledge, low levels of stigma, and having had less sex in the past year. Grade specific curriculum may need to be reconsidered given the wide age range of 8th and 9th graders.

Learning Objectives:
Describe the five components of the SPW school-based peer education program being conducted in Central Province, Zambia; Assess the programs association with desired HIV and Reproductive Health outcomes among 8th and 9th graders, including higher levels of HIV knowledge and less HIV-related stigma; Discuss associations between exposure to specific program elements and HIV and Reproductive Health outcomes

Keywords: Adolescent Health, School-Based Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: PhD and MHS in International Health from Johns Hopkins Bloomberg School of Public Health (2005 and 1999 respectively); Over 10 years of behavioral research experience (with organizations such as Johns Hopkins University, Family Health International and Population Council); Published articles, including an article on adolescent health and HIV counseling and testing (Denison JA, McCauley AP, Dunnett-Dagg WA, Lungu N, & Sweat MD (2008) The HIV testing experiences of adolescents in Ndola, Zambia: do families and friends matter? AIDS Care, 20(1):101-105)
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.