Results of a model AIDS prevention program for high school students in the Philippines

Research Institute for Tropical Medicine, Department of Health, Alabang, Muntinlupa, Metro Manila, Philippines.
AIDS (Impact Factor: 5.55). 08/1995; 9 Suppl 1:S7-13.
Source: PubMed


To describe the sexual practices of high school students; to describe the process of development of a school-based AIDS prevention program; and to evaluate the effect of this program on students' AIDS-related knowledge, attitudes and AIDS-preventive behaviors.
A cluster-randomized, controlled trial with pretest/post-test evaluation was conducted in four demographically similar public high schools in a semi-urban district of Metro Manila, the Philippines. Of 845 high school students who participated in the baseline survey, 804 (95%) completed a postintervention questionnaire.
An AIDS prevention program was developed by public high school teachers together with local AIDS experts, social scientists and health educators. The teacher-led AIDS program was designed to provide students with accurate information about AIDS, particularly in dispelling misconceptions about casual contagion, to foster positive attitudes towards people with AIDS and to develop skills aimed at clarifying values and assessing intended behavior.
At baseline, 11% of students (20% of males and 4% of females) reported ever having had sexual intercourse (mean age 14 years). Among these, condom use was low (24%). After implementation of the AIDS prevention program, statistically significant effects favoring the intervention group were observed in knowledge and attitudes towards people with AIDS. While there was no statistically significant overall effect on intended preventive behavior, the program appeared to delay the students' intended onset of sexual activity.
A sizable number of Filipino high school students are sexually active but condom use is low. School-based AIDS prevention programs can be developed and implemented in developing countries with the assistance of school personnel to address sexual issues. Our program was successful in increasing AIDS-related knowledge and improving attitudes towards people with AIDS. Supplementation with other preventive activities may be needed to achieve lasting changes in students' risk-taking behavior.

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    • "Studies have shown that these pupils become sexually active as young as age 12 (Smart, 1999; Coombe, 2002). Various programs exist for pupil-training in HIV/AIDS both in developed and developing countries (Aplasca et al., 1995). In South Africa, HIV/AIDS is addressed extensively in the formal school curriculum as part of the subject Life Orientation. "
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    • "No other impacts were found in the study by James, Reddy, and Ruiter (2006) colleagues. Other studies have reported impacts on the following: intention to abstain from sex (Aplasca et al., 1995; Reddy, James, McCauley, 2003); approval of abstinence among men (Reddy et al., 2003); accepting attitudes toward people living with HIV (Aplasca et al., 1995; Caceres et al., 1996; Chacko, Banu, & Mathew, 2005; Klepp, Ndeki, Leshabari, Hannan, & Lyimo, 1997) accepting attitudes toward condoms (Kinsler, Sneed, Morisky, & Ang, 2004; Martinez-Donate et al., 2004), accepting attitudes toward delayed sexual debut (Aplasca et al., 1995); increased acceptance of contraception, increased self-efficacy and increased prevention-oriented behavior (Caceres et al., 1996); and intention to use condoms (Reddy et al., 2003; Kinsler et al., 2004). Two studies measured increased communication with parents (Kinsler et al., 2004; Klepp et al., 1997); and another measured decreased acceptance of machismo (Caceres et al., 1996). "
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    ABSTRACT: For 20 years, "life skills" education has been advocated as a key component of HIV and AIDS education for young people. But what do terms such as life skills imply, and what evidence is there that a life skills-based approach really works? This article reviews the literature on the effects and effectiveness of life skills-based education for HIV prevention. Evaluated interventions were identified by using three search strategies. The review identified a surprising number of rigorously designed and evaluated interventions from Africa, Latin America, Asia, and the Pacific. Most interventions used life skills training as a component of the overall education strategy. Programs worked best to positively influence knowledge, attitudes, intentions, skills, and abilities. Programs rarely produced consistent effects on sexual behavior. Also, life skills, training had little effect on biological outcomes. The narrow focus on achieving behavioral outcomes may be at the loss of documenting other positive impacts.
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    • "Most awareness programmes address relationship and communication issues between partners and encourage abstinence. Results are sketchy: although the average age of first sexual intercourse was delayed in the Philippines (Aplasca et al., 1995), education did not manage to incite teenagers to systematically use condoms. Furthermore, certain aspects of prevention are not accepted in the school setting (Tsering and Paldon, 1996). "
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