An Independent Outcome Evaluation of an AIDS/HIV Prevention Program in Kenyan Schools

Abstract

Background: The pervasive spread of HIV/AIDS in Africa necessitates development of social and behavioral interventions to impact sexual behaviors. The primary research objective was to determine if the Stay Alive program was effective in reducing sexual activity amongst the participants. The study’s secondary objective was to determine if students successfully learned target concepts taught by the Stay Alive program. 

Methods: Pregnancy rates were compared among 14,916 students from 52 Kenyan schools using a randomized, wait-list controlled, pre-post experimental design. Additionally, 957 children were randomly selected for more in-depth, mixed-methods, pre-post testing and interviewing to determine if students successfully learned Stay Alive program concepts. Data was collected during a year-long study that began in Fall of 2014. 

Results: The program was effective in reducing sexual activity as evidenced by a 67% reduction in pregnancy rates. The odds of a girl becoming pregnant after being taught the Stay Alive program was approximately one-third the odds of a girl becoming pregnant while on the waiting list (OR = 0.3549; 95%CI = 0.2712, 0.4644). After participating in the Stay Alive program, there was a 90% drop in the odds that a child believed he or she would die of HIV/AIDS, even though the level of belief that one would contract the disease did not change significantly. There was no significant shift in male students beliefs regarding the right of women to refuse male sexual advances (p = 0.066). Female students, on the other hand, significantly increased in their belief that their responses to advances would impact the future happiness of their families (OR = 2.08, p <0.001) and that, as a result, they had the right or need to reject those advances in order to protect their families (OR = 2.25, p <0.001).  

Conclusions: Social and behavioral interventions can play an important role in battling HIV/AIDS in Africa.