Evaluation of a Culturally-Situated, Research-Based HIV-prevention Program in South African Schools

Background: This study evaluated the effects of a school-based intervention on cognitions and self-reported behaviours related to increased HIV risk amongst South African adolescents. Methods: The (“PREPARE”) intervention was based on the Information, Motivation, Behavioural skills model and incorporated 12 key messages into pre-existing health promotion in schools. The intervention was delivered by teachers in five 3-hour units over 5 weeks. A cluster-randomised trial involving 24 schools and 2588 adolescents aged 13-14 years in Limpopo, South Africa was employed to evaluate the intervention. Targeted beliefs, attitudes, norms, culture-specific beliefs and self-reported behaviours (e.g. condom use) were assessed via researcher-administered questionnaires at baseline and two months follow up. Findings: A series of targeted cognitions (e.g. condom use attitudes and self-efficacy) and self-reported condom use showed significant differences (p<.05) in favour of intervention participants. However, effect sizes were generally small (Cohen’s ds<.25). Discussion: A theory- and evidence- based intervention improved HIV-preventive education among South African adolescents.