OBJECTIVE: To test the efficacy of a school-based human immunodeficiency virus/sexually transmitted disease (HIV/STD) risk-reduction intervention for South African adolescents. DESIGN: A cluster-randomized, controlled design with assessments of self-reported sexual behavior collected before intervention and 3, 6, and 12 months after intervention. SETTING:Primary schools in a large, black township and a neighboring rural settlement in Eastern Cape Province, South Africa. PARTICIPANTS: Nine of 17 matched pairs of schools were randomly selected. Sixth-grade students with parent or guardian consent were eligible. INTERVENTIONS: Two 6-session interventions based on behavior-change theories and qualitative research. The HIV/STD risk-reduction intervention targeted sexual risk behaviors; the attention-matched health promotion control intervention targeted health issues unrelated to sexual behavior. OUTCOME MEASURES: The primary outcome was self report of unprotected vaginal intercourse in the previous 3 months averaged over the 3 follow-ups. Secondary outcomes were other sexual behaviors. RESULTS:A total of 1057 (94.5%) of 1118 eligible students (mean age, 12.4 years) participated, with 96.7% retained at the 12-month follow-up. Generalized estimating equation analyses adjusted for clustering from 18 schools revealed that, averaged over the 3 follow-ups, a significantly smaller percentage of HIV/STD risk-reduction intervention participants reported having unprotected vaginal intercourse (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.30-0.85), vaginal intercourse (OR, 0.62; 95% CI, 0.42-0.94), and multiple sexual partners (OR, 0.50; 95% CI, 0.28-0.89), when adjusted for baseline prevalences, compared with health-promotion control participants. CONCLUSION: This is the first large-scale, community-level, randomized intervention trial to show significant effects on the HIV/STD sexual risk behavior of South African adolescents in the earliest stages of entry into sexual activity.
RCT Entities:
OBJECTIVE: To test the efficacy of a school-based human immunodeficiency virus/sexually transmitted disease (HIV/STD) risk-reduction intervention for South African adolescents. DESIGN: A cluster-randomized, controlled design with assessments of self-reported sexual behavior collected before intervention and 3, 6, and 12 months after intervention. SETTING: Primary schools in a large, black township and a neighboring rural settlement in Eastern Cape Province, South Africa. PARTICIPANTS: Nine of 17 matched pairs of schools were randomly selected. Sixth-grade students with parent or guardian consent were eligible. INTERVENTIONS: Two 6-session interventions based on behavior-change theories and qualitative research. The HIV/STD risk-reduction intervention targeted sexual risk behaviors; the attention-matched health promotion control intervention targeted health issues unrelated to sexual behavior. OUTCOME MEASURES: The primary outcome was self report of unprotected vaginal intercourse in the previous 3 months averaged over the 3 follow-ups. Secondary outcomes were other sexual behaviors. RESULTS: A total of 1057 (94.5%) of 1118 eligible students (mean age, 12.4 years) participated, with 96.7% retained at the 12-month follow-up. Generalized estimating equation analyses adjusted for clustering from 18 schools revealed that, averaged over the 3 follow-ups, a significantly smaller percentage of HIV/STD risk-reduction intervention participants reported having unprotected vaginal intercourse (odds ratio [OR], 0.51; 95% confidence interval [CI], 0.30-0.85), vaginal intercourse (OR, 0.62; 95% CI, 0.42-0.94), and multiple sexual partners (OR, 0.50; 95% CI, 0.28-0.89), when adjusted for baseline prevalences, compared with health-promotion control participants. CONCLUSION: This is the first large-scale, community-level, randomized intervention trial to show significant effects on the HIV/STD sexual risk behavior of South African adolescents in the earliest stages of entry into sexual activity.
Authors: Shamagonam James; Priscilla S Reddy; Robert A C Ruiter; Myra Taylor; Champaklal C Jinabhai; Pepijn Van Empelen; Bart Van den Borne Journal: Health Promot Int Date: 2005-03-11 Impact factor: 2.483
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Authors: Ann O'Leary; John B Jemmott; Loretta S Jemmott; Anne Teitelman; G Anita Heeren; Zolani Ngwane; Larry D Icard; David A Lewis Journal: Sex Transm Dis Date: 2015-03 Impact factor: 2.830
Authors: Larry D Icard; John B Jemmott; Craig Carty; Ann O'Leary; Lulama Sidloyi; Janet Hsu; JoAnn Tyler; Omar Martinez Journal: Prev Sci Date: 2017-07
Authors: Jesca Mercy Batidzirai; G Anita Heeren; C Show Marange; Arnold Rumosa Gwaze; Andrew Mandeya; Zolani Ngwane; John B Jemmott; Joanne C Tyler Journal: Mediterr J Soc Sci Date: 2014
Authors: Bridgette M Brawner; Jillian Lucas Baker; Jennifer Stewart; Zupenda M Davis; Julie Cederbaum; Loretta Sweet Jemmott Journal: Fam Community Health Date: 2013 Apr-Jun