a sourcebook of hiv/aids prevention programs volume 2

Primary School Action for Better Health, Kenya 127interest (typically by a boy). Research highlighted the importance of providinggender-specific education about sexuality and HIV/AIDS. In responsethe program began to deliver education to girls- and boys-only groups.Sexual activityAs the program was implemented, it became apparent that a large percentageof upper-primary school students were already sexually active. In response tothis realization, the program introduced a broader range of preventionmessages and strategies, not only targeting the needs of students yet tobecome sexual active but also trying to change the behaviors of those alreadyhaving sex. Program materials were modified to provide more objectiveinformation about prevention and concrete strategies for abstinence.Teachers’ ability to deliver educationOperational research conducted for the program revealed differences in theway that trained personnel were interpreting and delivering the programmaterials. It became apparent that adults’ belief systems made them uncomfortablein delivering some areas of knowledge and skills to younger children.Training was modified to enable teachers to overcome their discomfort.Kenya’s changing cultureResearch demonstrated the ways in which poverty drives some young peoplein Kenya to engage in prostitution or to exchange sex for goods provided by“sugar daddies.” Cultural factors such as wife inheritance and early marriagecan also act to increase the risks of transmission. Gender expectations canlead many young people, especially girls, to feel that they are forced intosex. In response to these findings, the program was modified to strengthenits ability to enable students to make healthy choices in the difficult environmentsin which many live. Changes included enabling guidance andcounseling teachers to assist with peer support training, encouraging theparticipation of church leaders in training, and helping college lecturers todisseminate AIDS information to college students.Cost-effectivenessSeveral changes are recommended based on the cost-effectiveness assessmentof the program:• The number of teachers trained per school should be increased by two,(c) The International Bank for Reconstruction and Development / The World Bank