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Elshiekh HF, Hoving C, de Vries H. Psychosocial determinants of consistent condom use among university students in Sudan: findings from a study using the Integrated Change Model. BMC Public Health 2023; 23:578. [PMID: 36978037 PMCID: PMC10045195 DOI: 10.1186/s12889-023-15466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Unprotected sex is common among university students in Sudan, thus increasing risks for sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV). As little is known about the psychosocial determinants of consistent condom use among this population, this study was designed to identify them. The Integrated Change Model (ICM) was applied in a cross-sectional design to identify in 218 students (aged 18-25 years) from Khartoum which items distinguish condom users from non-condom users. Condom users differed significantly from non-condom users in having more HIV and condom use-related knowledge, higher perception of susceptibility to HIV, reporting more exposure to condom use cues, having a less negative attitude towards condom use (attitude cons), experiencing social support and norms favouring condom use and having higher condom use self-efficacy. Binary logistic regression showed that peer norms favouring condom use in addition to HIV-related knowledge, condom use cues, negative attitude and self-efficacy were the factors uniquely associated with consistent condom use among university students in Sudan. Interventions seeking to promote consistent condom use among sexually active students could benefit from increasing knowledge about HIV transmission and prevention, raising HIV-risk perception, using condom use cues, addressing perceived condom disadvantages and enhancing students` self-efficacy to avoid unprotected sex. Moreover, such interventions should raise students` perceptions of their peers` beliefs and behaviours favouring condom use and seek health care professionals` and religious scholars` support for condom use.
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Affiliation(s)
- Husameddin Farouk Elshiekh
- CAPHRI School for Public Health and Primary Care, Department of Health Promotion, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands.
| | - Ciska Hoving
- CAPHRI School for Public Health and Primary Care, Department of Health Promotion, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands
| | - Hein de Vries
- CAPHRI School for Public Health and Primary Care, Department of Health Promotion, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands
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Koletić G, Landripet I, Tafro A, Jurković L, Milas G, Štulhofer A. Religious faith and sexual risk taking among adolescents and emerging adults: A meta-analytic review. Soc Sci Med 2021; 291:114488. [PMID: 34662764 DOI: 10.1016/j.socscimed.2021.114488] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
RATIONALE Although there is some evidence that religious faith may offer protection against sexual risk taking in adolescence and emerging adulthood, no attempts have been made to systematically quantify the association. OBJECTIVE Using data from studies conducted in the 2000-2020 period, this meta-analysis aimed to estimate the link between religious faith and four sexual risk-taking behaviors in samples of adolescents and emerging adults. METHODS Five different search systems were used to conduct a systematic literature search in April 2020. Studies that contained quantitative data on religious faith and at least one indicator of sexual risk taking (age at sexual debut, number of sexual partners, condom use at most recent sexual intercourse, and consistent condom use) were searched for. In total, 35 articles published in peer-reviewed journals, in English, were identified. Random-effects meta-analytic approach was used to assess target associations among 41,758 adolescents and emerging adults (Mage = 18.9 years, 37% male). To estimate the effect across the four risk indicators, we employed robust variance estimation (RVE) method. RESULTS We found small associations between religious faith on the one hand and age at sexual debut (r = 0.08, 95% CI = 0.03, 0.12) and the number of sexual partners on the other hand (r = -0.15, 95% CI = -0.21, -0.09). No association with condom use was observed. With all studies included, the overall effect size was 0.11 (95% CI = 0.06, 0.16), indicating a small (protective) role of religious faith in young people's sexual risk taking. CONCLUSIONS Considering the limited role of religious faith in young people's sexual and reproductive health, comprehensive sexuality education remains essential for risk-reduction, even among more religious young people.
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Affiliation(s)
- Goran Koletić
- Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.
| | - Ivan Landripet
- Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Azra Tafro
- Faculty of Forestry and Wood Technology, University of Zagreb, Zagreb, Croatia
| | - Luka Jurković
- Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Goran Milas
- Institute of Social Sciences Ivo Pilar, Zagreb, Croatia
| | - Aleksandar Štulhofer
- Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
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Haffejee F, Maksudi K. Understanding the risk factors for HIV acquisition among refugee women in South Africa. AIDS Care 2019; 32:37-42. [PMID: 31701772 DOI: 10.1080/09540121.2019.1687833] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The prevalence of HIV in South Africa is among the highest in the world. This study provides an in-depth understanding of the risks for HIV transmission among refugee women residing in Durban, KwaZulu-Natal, South Africa. Qualitative interviews were conducted among refugee women originally from Sub-Saharan African countries. They reported sexual abuse by their intimate partners who were also having extramarital affairs with the local women. Condom use was low, with the women unable to negotiate use, due to fear of violence and religious beliefs, making them vulnerable to contracting HIV. Women were unable to leave their relationship due to financial constraints and dependence on their spouses. These dire circumstances also led to transactional sex. Uptake of HIV testing was high among the women. They were, however, uncertain of their partners' HIV status. We conclude that the higher risk for HIV transmission among refugee women is associated with increased engagement in sexual risk behavior. Behavioral change is required within this population and we recommend counselling in line with the religious and cultural beliefs of the population. The acceptability of condom use requires promotion. Increasing employment opportunities will empower women and decrease the social and structural determinants of sexual risk behavior.
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Affiliation(s)
- Firoza Haffejee
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
| | - Kassa Maksudi
- Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
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Idemudia ES, Olasupo MO, Modibo MW. Stigma and chronic illness: A comparative study of people living with HIV and/or AIDS and people living with hypertension in Limpopo Province, South Africa. Curationis 2018; 41:e1-e5. [PMID: 30456983 PMCID: PMC6244151 DOI: 10.4102/curationis.v41i1.1879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 07/27/2018] [Accepted: 08/02/2018] [Indexed: 01/15/2023] Open
Abstract
Background Stigma among people with chronic illnesses exists, preventing many sufferers from presenting for treatment especially in South Africa. Objectives This study compared stigma experiences of people living with human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV and/or AIDS) (PLWHA) and people living with hypertension (PLWHPT) in Limpopo Province of South Africa. Method Using a cross-sectional design, 600 participants (300 PLWHA with mean age of 31 years, standard deviation of 8.2; and 300 PLWHPT with age of 55 years, standard deviation of 8.1) were purposefully sampled at HIV and/or AIDS and hypertension outpatient clinics. The perceived stigma of AIDS scale was used to assess stigma in the HIV and/or AIDS sample while the adapted version was used to assess stigma in PLWHPT. Data were analysed using independent t-test. Results Results indicated that PLWHA experienced significantly higher enacted stigma (t(598) = −11.79, p < 0.001) as compared to PLWHPT. However, PLWHPT experienced significantly higher internalised stigma (t(598) = 37.56, p < 0.001) and perceived stigma (t(598) = 41.71, p < 0.001) than PLWHA. Conclusion Stigma among people with chronic illnesses is existent. The stigma type is, however, dependent on the nature of the illness. Stigma reduction interventions among these populations are indicated.
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Affiliation(s)
- Erhabor S Idemudia
- Population and Health Research Entity, Faculty of Humanities, North-West University.
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Sano Y, Antabe R, Atuoye KN, Hussey LK, Bayne J, Galaa SZ, Mkandawire P, Luginaah I. Persistent misconceptions about HIV transmission among males and females in Malawi. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2016; 16:16. [PMID: 27267906 PMCID: PMC4896031 DOI: 10.1186/s12914-016-0089-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 05/18/2016] [Indexed: 11/14/2022]
Abstract
Background The prevalence of HIV in Malawi is one of the highest in sub-Saharan Africa, and misconceptions about its mode of transmission are considered a major contributor to the continued spread of the virus. Methods Using the 2010 Malawi Demographic and Health Survey, the current study explored factors associated with misconceptions about HIV transmission among males and females. Results We found that higher levels of ABC prevention knowledge were associated with lower likelihood of endorsing misconceptions among females and males (OR = 0.85, p < 0.001; OR = 0.85, p < 0.001, respectively). Compared to those in the Northern region, both females and males in the Central (OR = 0.54, p < 0.001; OR = 0.53, p < 0.001, respectively) and Southern regions (OR = 0.49, p < 0.001; OR = 0.43, p < 0.001, respectively) were less likely to endorse misconceptions about HIV transmission. Moreover, marital status and ethnicity were significant predictors of HIV transmission misconceptions among females but not among males. Also, household wealth quintiles, education, religion, and urban–rural residence were significantly associated with endorsing misconceptions about HIV transmission. Conclusion Based on our findings, we recommend that education on HIV transmission in Malawi should integrate cultural and ethnic considerations of HIV/AIDS.
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Affiliation(s)
- Yujiro Sano
- Department of Sociology, University of Western Ontario, 1151 Richmond Street, London, ON, Canada
| | - Roger Antabe
- Environmental Health and Hazards Lab, Department of Geography, University of Western Ontario, 1151 Richmond Street, London, ON, Canada
| | - Kilian Nasung Atuoye
- Environmental Health and Hazards Lab, Department of Geography, University of Western Ontario, 1151 Richmond Street, London, ON, Canada
| | - Lucia Kafui Hussey
- Environmental Health and Hazards Lab, Department of Geography, University of Western Ontario, 1151 Richmond Street, London, ON, Canada
| | - Jason Bayne
- Environmental Health and Hazards Lab, Department of Geography, University of Western Ontario, 1151 Richmond Street, London, ON, Canada
| | - Sylvester Zackaria Galaa
- Faculty of Integrated Development Studies, University for Development Studies, Wa Campus, Wa, Ghana.
| | - Paul Mkandawire
- Institute of Interdisciplinary Studies, Human Rights Program, Carleton University, Ottawa, Canada
| | - Isaac Luginaah
- Department of Geography, University of Western Ontario, 1151 Richmond Street, London, ON, Canada
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Lugova H, Mon AA, Daher AM, Suleiman A. HIV-Related Stigma and Discriminatory Attitudes among a Semi-Urban Population. Malays J Med Sci 2015; 22:64-69. [PMID: 28239270 PMCID: PMC5295737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 07/02/2015] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Stigma and discriminatory attitudes (SDAs) have a negative impact on human immunodeficiency virus (HIV) prevention, testing, and treatment as well as on family and social networks. There is a lack of understanding about HIV-related SDAs among people living outside large cities. This study is aimed to determine the level of HIV-related SDAs among a semi-urban population in Malaysia and to compare the SDA results among people with different sociodemographic characteristics. METHODS A sample of 106 respondents was generated by convenience sampling during the screening campaign in Alor Gajah, Malaysia. Data collection was carried out based on a pre-tested questionnaire via face-to-face interviews. RESULTS More than half of the respondents (62.3%) thought that an HIV-positive teacher should not be allowed to continue teaching at school; 81.1% were unsure or were unwilling to care for their family member with AIDS at home; 81.2% thought children with HIV/AIDS should not continue to be raised in families; and 77.3% thought they would not reveal if a family member had HIV/AIDS. CONCLUSION Priority should be given to evidence-based interventions to reduce HIV-related SDAs. This study did not reveal any significant relationship between sociodemographic profiles and HIV-related SDAs. Therefore, further research with a larger sample size is needed to investigate the underlying causes of HIV-related SDAs.
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Affiliation(s)
- Halyna Lugova
- Community Medicine Unit, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi Prime Camp, 57000 Kuala Lumpur, Malaysia
| | - Aye Aye Mon
- Microbiology Unit, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi Prime Camp, 57000 Kuala Lumpur, Malaysia
| | - Aqil Mohammad Daher
- Community Medicine Unit, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi Prime Camp, 57000 Kuala Lumpur, Malaysia
| | - Adlina Suleiman
- Community Medicine Unit, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Sungai Besi Prime Camp, 57000 Kuala Lumpur, Malaysia
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Endeshaw M, Alemu S, Andrews N, Dessie A, Frey S, Rawlins S, Walson JL, Rao D. Involving religious leaders in HIV care and treatment at a university-affiliated hospital in Ethiopia: Application of formative inquiry. Glob Public Health 2015; 12:416-431. [PMID: 26256618 DOI: 10.1080/17441692.2015.1069868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In sub-Saharan Africa, religious views strongly influence how people relate to illness, health, and healing. Belief in the curative power of religion, including for HIV, persists in many communities. As such, many funding agencies and organisations working in the field of HIV have incorporated religious institutions into their programmes in various capacities. Yet, debate continues regarding the benefits and drawbacks of including sectarian organisations in the fight against HIV. In the current study, we sought to explore whether patients with HIV would be amenable to receiving HIV-related psychosocial support from religious leaders. We interviewed 48 Ethiopian Orthodox Church followers who presented for routine HIV care at Gondar University Hospital ART (antiretroviral treatment) clinic. Although almost half (46%) of participants self-identified as 'very religious', the majority of them (73%) had not disclosed their HIV status to a religious leader. Study participants highlighted multiple factors that could potentially affect their willingness to involve religious leaders in their HIV care. We discuss these findings in relation to religion and HIV in the African context. Our findings support the use of formative qualitative work prior to developing and implementing programmes that integrate faith and medical communities.
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Affiliation(s)
- Meheret Endeshaw
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Shitaye Alemu
- b Internal Medicine , University of Gondar , Gondar , Ethiopia
| | - Nancy Andrews
- c Care Opportunities through Partnership in Ethiopia (SCOPE) , Seattle , WA , USA
| | - Abere Dessie
- b Internal Medicine , University of Gondar , Gondar , Ethiopia
| | - Sarah Frey
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Sarah Rawlins
- d Harborview Medical Center , University of Washington , Seattle , WA , USA
| | - Judd L Walson
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Deepa Rao
- a Department of Global Health , University of Washington , Seattle , WA , USA
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Syed IA, Syed Sulaiman SA, Hassali MA, Thiruchelvum K, Lee CK. A qualitative insight of HIV/AIDS patients' perspective on disease and disclosure. Health Expect 2014; 18:2841-52. [DOI: 10.1111/hex.12268] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Imran Ahmed Syed
- School of Pharmaceutical Sciences; Universiti Sains Malaysia (USM); Penang Malaysia
- School of Pharmacy; International Medical University; Kuala Lumpur Malaysia
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9
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Wong LP. Multi-ethnic perspective of uptake of HIV testing and HIV-related stigma: A cross-sectional population-based study. AIDS Care 2013; 25:1356-69. [DOI: 10.1080/09540121.2013.766302] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Wong LP. Prevalence and factors associated with HIV/AIDS-related stigma and discriminatory attitudes: a cross-sectional nationwide study. Prev Med 2013; 57 Suppl:S60-3. [PMID: 23583477 DOI: 10.1016/j.ypmed.2013.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 03/26/2013] [Accepted: 03/27/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The prime purpose of this study is to assess HIV/AIDS-related self-stigma and discrimination (S&D) attitudes and associated factors using multivariate analysis of data from the 2010-11 National Survey of Understanding the Root of HIV/AIDS Related Stigma and Discrimination. METHOD A national telephone survey was carried out with 2271 of the Malaysian public aged 18-60 years. The sample was contacted by random digit dialing covering the whole of Peninsular Malaysia from December 2010 to May 2011. The HIV-transmission knowledge, HIV-related self-stigma, and public stigma were investigated. RESULTS Despite high level of HIV-transmission knowledge [mean (SD)=10.56 (2.42), mean score at 70th percentile] the respondents in this study had moderate levels (mean scores near midpoints) of self-stigma and public stigma attitudes. HIV-transmission knowledge score was not significantly correlated with self-stigma score, but showed a significantly small positive effect (r<0.2) for public stigma scores. Ethnicity is the strongest correlate of HIV-transmission knowledge, self-stigma, and public stigma attitudes in the multivariate analyses. Other significant correlates were age, socioeconomic group, and urban-rural setting. CONCLUSIONS The root causes of HIV stigma and discriminatory attitudes were not associated with knowledge deficiency. Interventions should be oriented towards promoting de-stigmatization of HIV/AIDS, and tailored socio-culturally.
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Affiliation(s)
- Li Ping Wong
- Epidemiology and Biostatistics Unit, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Mantell JE, Correale J, Adams-Skinner J, Stein ZA. Conflicts between conservative Christian institutions and secular groups in sub-Saharan Africa: ideological discourses on sexualities, reproduction and HIV/AIDS. Glob Public Health 2011; 6 Suppl 2:S192-209. [PMID: 21834733 PMCID: PMC3178341 DOI: 10.1080/17441692.2011.604039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Religious and secular institutions advocate strategies that represent all points on the continuum to reduce the spread of HIV/AIDS. Drawing on an extensive literature review of studies conducted in sub-Saharan Africa, we focus on those secular institutions that support all effective methods of reducing HIV/AIDS transmission and those conservative religious institutions that support a limited set of prevention methods. We conclude by identifying topics for dialogue between these viewpoints that should facilitate cooperation by expanding the generally acceptable HIV/AIDS prevention methods, especially the use of condoms.
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Affiliation(s)
- Joanne E Mantell
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA.
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Massari V, Lapostolle A, Cadot E, Parizot I, Dray-Spira R, Chauvin P. Gender, socio-economic status, migration origin and neighbourhood of residence are barriers to HIV testing in the Paris metropolitan area. AIDS Care 2011; 23:1609-18. [DOI: 10.1080/09540121.2011.579940] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
| | | | | | | | | | - Pierre Chauvin
- a INSERM , Paris , France
- b UPMC Université , Paris , France
- e AP-HP, Hôpital Saint-Antoine , Paris , France
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Al-Iryani B, Basaleem H, Al-Sakkaf K, Crutzen R, Kok G, van den Borne B. Evaluation of a school-based HIV prevention intervention among Yemeni adolescents. BMC Public Health 2011; 11:279. [PMID: 21548968 PMCID: PMC3112119 DOI: 10.1186/1471-2458-11-279] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2010] [Accepted: 05/07/2011] [Indexed: 11/30/2022] Open
Abstract
Background This article describes an evaluation of a school-based peer education intervention for HIV prevention among students in twenty seven high schools in Aden, Yemen. The intervention was developed after a survey among the same population in 2005, which revealed a high level of stigma towards people living with HIV (PLWH) and a low level of HIV knowledge. Methods In a quasi-experimental design students who received the peer education intervention (78.6%) were compared with students who did not receive the intervention (21.4%). No systematic procedure was applied in selecting students for the intervention condition. Data were collected using a self-administered questionnaire from a sample of 2510 students from all 27 high-schools in Aden governorate. To increase internal validity, students were also compared with a cohort control sample surveyed in 2005, which was a random sample of 2274 students from the same schools. Results Sixty eight percent of students targeted by peer education had good knowledge scores, compared with 43.3% of students not targeted by peer education (χ2 = (df = 1) = 111.15, p < .01). Multi-level regression analysis revealed that, although there was a significant difference among schools, the intervention effect of peer education at the individual level was significant; students who received peer education had a statistically higher knowledge score(9.24 out of 12.0) compared with those not targeted (7.89 out of 12.0), OR = 2.11, 95% CI = 1.04-4.27, p < .05). Compared with the 2005 cohort control sample, students targeted by peer education had better knowledge on the modes of transmission and prevention and fewer misconceptions; and knowledge on the use of condoms increased from 49.4% to 67.8%. In addition, students who received the peer education interventions suggested significantly more actions to provide care and support for PLWH. Also, the levels of stigma and discrimination were much higher among the 2005 cohort control group, compared with those who received the peer education intervention. Conclusion The school-based peer education intervention has succeeded in improving levels of knowledge on modes of transmission and prevention, and in decreasing levels of stigma and discrimination in a culturally conservative setting.
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Affiliation(s)
- Buthaina Al-Iryani
- Department of Health Promotion, Faculty of Medicine, Health, and Life-Sciences, Maastricht University, the Netherlands.
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