204985 Assessing the impact of youth peer education programs on HIV prevention: Results from a multi-component study in Zambia

Tuesday, November 10, 2009: 8:45 AM

Holly McClain Burke, MPH , Behavioral and Biomedical Research, Family Health International, Research Triangle Park, NC
Karah I. Fazekas, MPH , Applied Research Department, Family Health International, Research Triangle Park, NC
Laura M. Johnson, MA , Behavioral and Biomedical Research, Family Health International, Research Triangle Park, NC
  
BACKGROUND: Youth peer education (YPE) is a widely used approach to HIV prevention in developing countries. Currently, there is no standardized way of conducting YPE nor have the effects of YPE programs been evaluated in a systematic way.

METHODS: Five community-based YPE programs in Zambia were assessed using tools to measure program inputs, processes, and outputs. These tools included eight checklists measuring core programmatic components. To link the quality of YPE programming to HIV prevention behaviors in Zambia, exposure to YPE and outcomes (HIV prevention behaviors and referrals for services, including VCT) were examined using survey data from seven reproductive health clinics and the 2005 Zambia Sexual Behavior Survey.

RESULTS: The highest quality programs were also the most expensive per peer educator trained. Higher scores on checklists were positively associated with more peer educator activities, more youth exposure to YPE, and more referrals of youth to clinics. Population-based survey data found that YPE exposure in Zambia was high (74%) among youth ages 15-24 and associated with higher HIV knowledge, increased intention to use condoms, lower stigma towards people living with HIV/AIDS, and increased likelihood of using a condom. Among 10,300 15-24 year old clients attending study clinics, over half (53%) were referred to the clinic by a peer educator.

CONCLUSIONS: This study found a chain of associations indicating YPE in Zambia was a successful approach to promoting HIV prevention. The core components of YPE programming, as measured by the standardized study tools, are useful for assessing and comparing YPE programs.

Learning Objectives:
1. Describe a set of tools which can be used to systematically evaluate and compare Youth Peer Education (YPE) programs. 2. Describe the impact of Youth Peer Education (YPE) programs on HIV prevention in Zambia.

Keywords: HIV Interventions, Adolescents, International

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I served as the project assistant/manager and data analyst on the study which generated the data for this presentation. Specific roles I held on this study include: designing the data collection instruments, training field staff, analyzing the data, interpreting the results, and writing the final report. I have worked as a researcher at Family Health International for seven years conducting reproductive health (HIV/AIDS and family planning) research in developing countries. I hold a Master of Public Health degree from the University of North Carolina at Chapel Hill (UNC-CH), Department of Health Behavior and Health Education. I am currently working on my PhD dissertation in the Department of Maternal and Child Health at UNC-CH.
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.

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