World Education, through its SHAPE 1 program, worked with a consortium of nine Civil Society Organizations (CSOs) to deliver HIV/AIDS education to in-school youth though a peer education program. The program had the goal of providing youth with the education they need to avoid or reduce risk-taking behavior, delay the onset of sexual activity, and if already sexually active, change behavior to reduce risk. This evaluation measured differences in HIV/AIDS and reproductive health knowledge, attitudes and behavior among youth with SHAPE peer educators and those in schools with no SHAPE-sponsored peer education program. An experimental-control posttest design with multi-stage clusters was used: SHAPE schools were intervention sites; comparable schools not exposed to the intervention were control sites. Ten intervention and 10 control schools were selected. Data collection was carried out during November 2004. Valid questionnaires were collected from 3223 students. The findings of this research support the hypothesis that students exposed to SHAPE 1 interventions will demonstrate more beneficial outcomes than students not exposed. ■ Knowledge of HIV/AIDS was very high. Most students rejected three or more misconceptions about HIV/AIDS. Students appear to be less well informed about other STIs, and this might be a topic to include in more detail in the SHAPE 2 curriculum. ■ Less than one-fourth of the students reported feeling ready for sex; boys in both groups were more than twice as likely to say they were ready as girls. Significantly fewer SHAPE 1 girls indicated they felt ready, compared with control girls. ■ Knowledge of protection from HIV/AIDS was nearly universal, and SHAPE 1 girls reported better knowledge than non-SHAPE girls. With more than 70 percent of students saying they are worried about risk, young people are applying extremely conservative calculations of personal risk. ■ Of the 1851 SSS students, 20 percent reported ever having sexual intercourse. Significantly fewer SHAPE 1 girls had had sex, and fewer SHAPE 1 students as a whole were sexually initiated. The average age at first sex was 15.5 among all students, slightly lower than that reported in other surveys of youth in Ghana. ■ Four in five students concurred that people infected with HIV/AIDS should be treated like everyone else; SHAPE 1 boys were more likely to hold this view than their non-SHAPE counterparts. Students held less accepting views of particular classes of individuals. Fifty to 60 percent agreed that an infected student should continue attending school, but 70 to 80 percent would worry if a classmate had HIV/AIDS. ■ A number of key HIV/AIDS topics were mentioned by only a small proportion of students. A strong, comprehensive program needs to devote considerable support and monitoring to ensure that peer educators convey information regularly on all topics included in their curriculum. ■ Peer educators were viewed as knowledgeable about pregnancy, sexually transmitted diseases and HIV/AIDS, with similar percentages of students mentioning peers and health personnel as equally credible. The SHAPE 1 program appears to have successfully improved a number of important indicators of knowledge, attitudes and behaviors among students attending schools in which the program operated. World Education and SHAPE 2 CSOs should determine what program elements did not show differences between the intervention and comparison schools, and develop strategies to address these gaps in the future.
Family Health International, FHI
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