a sourcebook of hiv/aids prevention programs volume 2

Primary School Action for Better Health, Kenya 123• More girls believed that “no” means “no.”• More girls and boys felt they could have a boyfriend and girlfriend andnot have sex.• More boys and girls felt they could tell their boyfriend or girlfriend thatthe preferred to wait until marriage before having sex.Eighteen months after the introduction of the program, there was nosignificant increase in the likelihood of students receiving a passing gradeon the PSABH knowledge test, and there were no significant differencesover time between target and control schools on either teacher or studentknowledge (the odds ratios were 1.04 for students and 1.10 for teachers).In a subsequent evaluation, conducted 30 months postprogram, the differencewas highly significant. Program implementation was also higher butstudent participation was slightly lower. The decline in student participationresulted from reduced use of question boxes and school health clubs.This change occurred as a result of the loss of trained teachers and peersupporters and the inclusion of HIV/AIDS activities in the programs ofother school clubs.Qualitative findings back up the results of quantitative research. Focusgroup discussions indicated dramatic shifts in students’ abilities to describeconcrete methods they used to avoid or refuse sex. They also revealed anincrease in the accuracy and breadth of knowledge about HIV/AIDS.At all waves of data collection, teachers and community leaders presentedabstinence as the only truly effective method of preventing HIV infection.Changes in teachingInitially teachers taught:• ‘HIV/AIDS kills’• ‘It has no cure’• ‘You must abstain’With training they now teach:• ‘This is how you can abstain from early sex’• ‘There are many reasons why you should abstain’• ‘If you really can’t abstain, you should use a condom’ (for those whom the teacher thinksare sexually active)The messages teachers now give the children include:• ‘Sex is for married people’• ‘Sex is sacred’• ‘Early sex is harmful to your health’(c) The International Bank for Reconstruction and Development / The World Bank