Effects of PREPARE, a Multi-component, School-Based HIV and Intimate Partner Violence (IPV) Prevention Programme on Adolescent Sexual Risk Behaviour and IPV: Cluster Randomised Controlled Trial.

Catherine Mathews,Yolisa Mtshizana,Leif E Aarø,Sander M Eggers,Petrus J De Vries,Loraine Townsend,Hein De Vries,Annegreet Wubs,Joy Koech,Petra De Koker,Amanda J Mason-Jones,Tracy Mcclinton Appollis

doi:10.1007/s10461-016-1410-1

Abstract

Young South Africans, especially women, are at high risk of HIV. We evaluated the effects of PREPARE, a multi-component, school-based HIV prevention intervention to delay sexual debut, increase condom use and decrease intimate partner violence (IPV) among young adolescents. We conducted a cluster RCT among Grade eights in 42 high schools. The intervention comprised education sessions, a school health service and a school sexual violence prevention programme. Participants completed questionnaires at baseline, 6 and 12 months. Regression was undertaken to provide ORs or coefficients adjusted for clustering. Of 6244 sampled adolescents, 55.3 % participated. At 12 months there were no differences between intervention and control arms in sexual risk behaviours. Participants in the intervention arm were less likely to report IPV victimisation (35.1 vs. 40.9 %; OR 0.77, 95 % CI 0.61–0.99; t(40) = 2.14) suggesting the intervention shaped intimate partnerships into safer ones, potentially lowering the risk for HIV.

Highlights

HIV is ranked second among the leading causes of death among adolescents [1]
We evaluated the effects of PREPARE, a multi-component, school-based HIV prevention intervention to delay sexual debut, increase condom use and decrease intimate partner violence (IPV) among young adolescents
In our cluster randomised controlled trial, PREPARE, conducted among young adolescents in the Western Cape, we evaluated an HIV prevention programme that included a focus on IPV and sexual violence reduction

Summary

Introduction

HIV is ranked second among the leading causes of death among adolescents [1]. In the Western Cape, South Africa, the setting of this study, HIV is still the leading cause of premature mortality (http://www.mrc.ac.za/bod/WC2010Re port.pdf), and adolescents commonly report an early sexual debut and unprotected sex [5]. These behaviours increase the risk of sexually transmitted infections (STI) including HIV. In the Western Cape and Limpopo provinces of South Africa, cluster RCTs of school-based HIV prevention interventions without a focus on IPV, failed to demonstrate an impact on the timing of sexual debut or condom use among the AIDS Behav (2016) 20:1821–1840 younger adolescent participants (average age 13 years) and failed to impact on IPV [5]. In the Eastern Cape, a community-based HIV and IPV prevention programme for adolescents 16 years and older, which included a substantial focus on IPV, showed a beneficial impact on STI incidence and male IPV perpetration [8]

Objectives

Methods

Results

Discussion

Conclusion