How effective are HIV behaviour change interventions? Experimental evidence from Zimbabwe

Abstract

ABSTRACTThere is growing evidence that HIV behaviour change interventions can increase knowledge but have little effect on behaviour. We revisit this conclusion by evaluating a popular educational tool for teaching young people about HIV – the ‘Join-In Circuit on AIDS, Love, and Sexuality’. The tool has been implemented in over 20 countries, reaching out to more than 230,000 people. We present evidence from a randomised controlled trial in Zimbabwe that randomly assigned 3661 individuals to the intervention. Using survey evidence, we find that the intervention increased knowledge both for assigned participants and nearby residents. While most behavioural outcomes are unaffected, individuals assigned to theJIC also report 0.5 fewer sex partners and are more likely to utilise social networks to talk about sexually transmitted infections. Problematically, the intervention also decreased confidence to practice safe sex. Using focus group discussions, we attribute the negative outcome to two unintended side effects. First, the intervention contradicted sociocultural norms, creating uncertainty about correct behaviour. Second, by being exposed to information about the many risks of sexual intercourse, participants felt overwhelmed and less confident to practice safe sex.