The Development and Evaluation of a National School-based HIV Prevention Intervention for Primary School Children in Kenya.

Harper Gw,Suleta K,Ruto J,Neubauer Lc,Muthiani P,Muthigani A,Murphy Ag,Simiyu D

doi:10.16966/2380-5536.150

Abstract

Primary schools in Kenya provide a promising venue for widespread delivery of HIV prevention interventions. This article describes the development and evaluation of Making Life's Responsible Choices (MLRC), a school-based HIV prevention intervention for primary school children developed through a collaborative global partnership involving multiple community stakeholders. Intervention development was informed by extensive reviews of youth-focused evidence-based HIV prevention interventions, and was rooted in both the Theory of Planned Behavior and Social Cognitive Theory. MLRC includes six modules: 1) self-awareness, 2) human sexuality, 3) healthy relationships, 4) drug/alcohol abuse, 5) HIV/AIDS and other sexually transmitted infections, and 6) behavior change. Class 5 pupils (N=1846; 52.1% girls, 47.9% boys; mean age = 12) attending 46 different Catholic-sponsored public and private primary schools throughout Kenya participated in the evaluation of the intervention program which was delivered in the classroom and occurred over the course of 40 weeks (one academic term). Changes in knowledge and behavioral intentions were assessed using a one-group pre-test post-test experimental design. Pupils completed module-specific assessment measures, and paired samples t-tests were used to compare changes in knowledge and behavioral intentions at the classroom level. Gender-specific analyses were also conducted. All six modules displayed statistically significant positive changes in the mean percentage of knowledge items answered correctly for the full sample, with marginal gender differences revealed. Statistically significant health-promoting changes were seen in 11 of the 18 behavioral intention items (3 per module), with gender differences also revealed. Findings suggest that implementing interventions such as MLRC has the potential to thwart the spread of HIV among youth in Kenya, and equip youth with health-promoting skills. In addition, school-based programs have the potential to become institutionalized in school settings in order to maintain their long-term sustainability.

Highlights

Kenya is one of the countries in Sub-Saharan Africa that has been most impacted by the HIV/AIDS pandemic
Given that Kenya is one of the countries in Sub-Saharan Africa that has been most impacted by the HIV/AIDS pandemic, it is important to develop HIV prevention interventions to thwart the spread of HIV
Making Life’s Responsible Choices (MLRC) is a theory-informed school-based HIV prevention intervention for primary school pupils in Kenya implemented by local school teachers

Summary

Introduction

Kenya is one of the countries in Sub-Saharan Africa that has been most impacted by the HIV/AIDS pandemic. Data from the 2013 Kenya AIDS Indicator Survey (KAIS) demonstrated that national HIV prevalence rates among adults (ages 15–64) decreased from 7.2% in the 2007 KAIS to 6.0% in the 2013 KAIS (NASCOP, 2014). The 2013 KAIS documented continued regional variations in HIV infection rates, as well as higher prevalence rates among women than men (NASCOP, 2014). These declines in HIV prevalence rates are encouraging, the 6.0% national prevalence rate still equates to 1.6 million persons living with HIV in Kenya in 2013, representing a major public health concern (NASCOP, 2014). Implementing an HIV prevention intervention in Kenyan primary schools would be one way to ensure that the prevention intervention is delivered in a safe and supportive learning environment for pupils from all regions of the country

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