Effectiveness of HIV prevention and control strategies among school adolescents in Dodoma urban district

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Southern New Hampshire University
The study was conducted in Dodoma Municipal Council covering ten secondary schools. The aim of the study was to evaluate and analyze the HIV/AIDS interventions in secondary schools so as to determine effective HIV prevention strategies for behavior change among school adolescents. The specific objectives were also put forward. These were; to assess and analyze the level of HIV/AIDS knowledge among school adolescents, to find out why school adolescents are at risk of HIV infection, to analyze issues relating to sex, sexuality and HIV/AIDS among school adolescents, to assess and identify barriers to positive behavior change, to assess and analyze the roles of different individuals and social groups in influencing behavior change among the school adolescents, and to suggest effective methodology/strategies for behavior change among school adolescents. Self administered questionnaires were used to obtain important information about HIV/AIDS and related issues among youth, particularly school adolescents. The questionnaires were completed by secondary school students of form I to VI. Interview guide was used for teachers and parents. Observations and past experiences were also part of the methodology in this study. The data collected were systematically organized in a manner that facilitated analysis. Quantitative analysis was anticipated, therefore the responses in the questionnaires were analyzed using Statistical Package for Social Sciences (SPSS). Descriptive statistics such as percentages and frequencies were also determined. The majority of respondents were female (52.1%) while 47.9% were male.Most of the respondents had knowledge about safer sex (70.6%) and what causes AIDS (97.5%). However, there were some misconceptions as reflected by 50.4% of the respondents who did not know whether breast milk can transmit HIV. Knowledge about modes of HIV transmission and how HIV can be prevented was found to be very high (95.8%). The high level of HIV/AIDS knowledge could explain the relatively higher rate of condom use (73.5%) during their last sexual encounter. The study results reveal that 24.4% of the respondents had used condom consistently while 17.6% did use it inconsistently over the last one year. Despite the fact that school adolescents are now well informed about the risk of contracting HIV, they still practice unprotected sex. This was also revealed when asked whether they used condom in their last sexual encounter. Forty two percent of the total respondents had used it while 15.1% had not. It is obvious that the school adolescents are at risk though 97.5% know that one can contract HIV by having sex only once. Results from the study reveal that school adolescents engaged in risky behaviors by having more than one sexual partners despite the fact that 82.4% of the respondents had mentioned that abstinence and fidelity (88.2%) were among the preventive methods. The number of sexual partners was significantly associated with the number of times a respondent went out with a friend for a date or other social affairs (p<0.05). The study results also reveal that the school adolescents were aware that they are at risk of contracting HIV. When asked whether they can be infected, 36.1% indicated that they are likely while 6.7% said they are most likely to be infected. Though the study reveals that 74.8% feel close to their parents, more than half (58%) of the respondents do not talk freely about condom use. There is no effective communication about sexual matters between teachers and students and between parents and children. This was reflected by 20.2% of the respondents who could talk freely with teachers and 7.6% with parents . It was also revealed that the respondents confide in their peer group as it was discovered that 93.3% can talk openly with their peers about condoms. This means that even other issues related to sex or sexuality such as relationships and how to avoid pregnancy and STIs can be discussed freely. The study shows that sexual experience is part of adolescence development as it is shown in table 6 that 60.6% of the total respondents had one to more than three sexual partners over the last one year. Furthermore, the study reveals that 14.3% of the respondents are not confident to refuse sex if they do not want to. Also when asked whether they are confident enough to insist on condom use, only 35.3% male and 24.4 female agreed. It was also revealed that 26.1% of the female reported to have less confidence while their counterpart is only 10.1% . This raises concern over the gender differentials where girls are not in the position to say no over sexual matter. They need to be trained on assertive skills early enough to be able to take responsibility of their own life, to take care of themselves and break the cultural barriers which insist women should be submissive before men. There were wrong information /misconceptions that relationship between a girl and a boy should always involve sex. The study reveals that 7.6% believe that they have to try out their manhood once they reach puberty. It is important not to delay providing information to young people but to begin when they are young. Basic information provides the foundation on which more complex knowledge is built up over time. The responses also indicated that respondents are at risk and they are likely to contract HIV/AIDS. However, despite the fact that students know that unprotected sex is no longer safe, they continue to indulge in it, sometimes with multiple partners. These findings are consistent with a number of other reports in the literature. Relationships among the young people are inevitable. However, we need to enhance the quality of relationships. We need to develop young people's ability to make decisions over their entire lifetime. Sex education that works, should contribute to this overall aim. The proposed behavior change model based on social learning theories was put forward in this study. (Author abstract)