Abstract
BackgroundThis article describes an evaluation of a school-based peer education intervention for HIV prevention among students in twenty seven high schools in Aden, Yemen. The intervention was developed after a survey among the same population in 2005, which revealed a high level of stigma towards people living with HIV (PLWH) and a low level of HIV knowledge.MethodsIn a quasi-experimental design students who received the peer education intervention (78.6%) were compared with students who did not receive the intervention (21.4%). No systematic procedure was applied in selecting students for the intervention condition. Data were collected using a self-administered questionnaire from a sample of 2510 students from all 27 high-schools in Aden governorate. To increase internal validity, students were also compared with a cohort control sample surveyed in 2005, which was a random sample of 2274 students from the same schools.ResultsSixty eight percent of students targeted by peer education had good knowledge scores, compared with 43.3% of students not targeted by peer education (χ2 = (df = 1) = 111.15, p < .01). Multi-level regression analysis revealed that, although there was a significant difference among schools, the intervention effect of peer education at the individual level was significant; students who received peer education had a statistically higher knowledge score(9.24 out of 12.0) compared with those not targeted (7.89 out of 12.0), OR = 2.11, 95% CI = 1.04-4.27, p < .05). Compared with the 2005 cohort control sample, students targeted by peer education had better knowledge on the modes of transmission and prevention and fewer misconceptions; and knowledge on the use of condoms increased from 49.4% to 67.8%. In addition, students who received the peer education interventions suggested significantly more actions to provide care and support for PLWH. Also, the levels of stigma and discrimination were much higher among the 2005 cohort control group, compared with those who received the peer education intervention.ConclusionThe school-based peer education intervention has succeeded in improving levels of knowledge on modes of transmission and prevention, and in decreasing levels of stigma and discrimination in a culturally conservative setting.
Highlights
This article describes an evaluation of a school-based peer education intervention for HIV prevention among students in twenty seven high schools in Aden, Yemen
General HIV/AIDS awareness Of all students 99.5% (2498 out of 2510) reported that they have heard about AIDS prior to this survey, and among them, 87.7% thought that HIV/AIDS was a disease that existed in Yemen; a lower proportion (61.0%) perceived its existence in Aden
Suggested actions to deal with People living with HIV/ AIDS We looked at the suggestions of students for actions to be taken towards people living with HIV by the government, society, and individuals
Summary
This article describes an evaluation of a school-based peer education intervention for HIV prevention among students in twenty seven high schools in Aden, Yemen. The intervention was developed after a survey among the same population in 2005, which revealed a high level of stigma towards people living with HIV (PLWH) and a low level of HIV knowledge. Yemen is one of the poorest countries in the Middle East and North Africa (MENA) region [1], and one of the poorest countries in the world, where more than 45% of the population lives in poverty [2]. High rates of poverty, unemployment, mobility, and gender disparities could place the predominantly young Yemeni population vulnerable to HIV infection. Yemeni youth, just like other youth in MENA, are experiencing increased premarital sex, peer pressure to engage in risky behaviour, and changing lifestyle norms[7]
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