Participation in a life skills-based HIV prevention programme and its association with safer sexual behaviour among youth: A cross-sectional study from South Africa

Abstract

Background: Life skills-based approaches are broadly used in HIV prevention programmes world-wide. However, evaluations of such programmes have found mixed evidence for their effects on indicators of safer sexual behaviour.
Methods: Questionnaires of 4,381 participants of the Star for Life (SFL) life skills-based prevention programme in South African schools were analysed using binary logistic regression. Odds ratios (OR) with 95% confidence intervals (CI) were calculated to assess the associations between the level of participation and HIV literacy as well as the level of self-esteem, and the associations between the level of participation, HIV literacy, and the level of self-esteem and several indicators of safer sexual behaviour.
Results: Associations were found between a higher level of participation and condom use in general (OR 1.84, 95% CI 1.51-2.24) and at last sexual encounter (OR 1.59, 95% CI 1.29-1.96). For female participants a higher level of participation in the programme was associated with sexual abstinence (OR 1.27, 95% CI 1.05-1.55) and fewer sexual partners (OR 1.50, 95% CI 1.03-2.20). HIV literacy was associated with sexual activity (OR 0.81, 95% CI 0.69-0.95 for sexual abstinence). Among male participants, associations were found between HIV literacy and being 15 years or older at first sexual intercourse (OR 1.50, 95% CI 1.12-2.00) and fewer sexual partners (OR 1.76, 95% CI 1.30-2.40). Higher self-esteem was associated with being 15 years or older at first sexual intercourse (OR 1.37, 95% CI 1.09-1.71), condom use at last sexual intercourse (OR 1.53, 95% CI 1.25-1.86) and the number of sexual partners (OR 1.65, 95% CI 1.33-2.05). Among male participants higher self-esteem was associated with sexual activity (OR 0.74, 95% CI 0.59-0.93). For female participants an association between higher self-esteem and consistent condom use was found (OR 1.72, 95% CI 1.25-2.37).
Conclusion: This study identified associations between all three exposures to indicators of safer sexual behaviour, which partially differed by gender. The results stress the importance to motivate participants to engage with a programme.

Popular Abstract

New evidence supports life skills-based approaches in the prevention of HIV/AIDS
A study with 4,381 pupils aged 14-18 years at 35 South African high schools found varying but overall positive associations between the level of participation in the programme by Star for Life (SFL), knowledge of HIV/AIDS, the level of self-esteem and indicators of safer sexual behaviour such as condom use, number of sex partners and age at first sexual encounter.
The Malmö-based organisation SFL holds workshops with a so-called life skills-based approach in high schools in South Africa, Namibia, Sri Lanka and Sweden. Contrary to the standard knowledge-focused teaching, life skills-based education enables the pupils to acquire knowledge and skills that are important throughout life such as communication and negotiation skills, and aims at changing attitudes towards a more positive understanding of safer sexual behaviour.
The study found that male and female participants who were highly engaged with the SFL programme were more likely to use condoms when they had sex. Girls who participated actively were less often sexually active and if they were sexually active, they had fewer sexual partners. Independent of their gender, participants with relevant knowledge of HIV/AIDS were less often sexually active. Boys who had sufficient knowledge of HIV/AIDS were older when they first had sex and had fewer sexual partners. Participants with high self-esteem were more likely to be older when they first had sex, to use condoms at last sexual encounter and to have fewer sexual partners. Boys with strong self-esteem were more often sexually abstinent, whereas girls with strong self-esteem were more likely to use condoms in general.
All three examined attributes were positively related to the different safer sexual behaviours. Consequently, programmes aiming at preventing HIV/AIDS need to motivate participants to engage, strengthen their self-esteem, and improve their knowledge.

• author: Oppelt, Katja Anita
• supervisor: Anette Agardh
• organization: Social Medicine and Global Health
• course: MPHN40 20161
• year: 2016
• type: H2 - Master's Degree (Two Years)
• subject: Medicine and Health Sciences
• keywords: Life skills-based programme, HIV prevention, safer sexual behaviour, South Africa, self-esteem, participation, youth, high schools
• language: English
• id: 8896498
• date added to LUP: 2017-01-16 14:42:16
• date last changed: 2017-01-16 14:42:16