Gender-focused HIV and pregnancy prevention for school-going adolescents: The Mpondombili pilot intervention in KwaZulu-Natal, South Africa

ABSTRACT

This pilot study evaluated a 15-session classroom intervention for HIV and pregnancy prevention among grade 8–10 boys and girls (aged 14–17 years) in rural South Africa, guided by gender-empowerment theory and implemented by teachers, nurses, and youth peer educators. Pre- and post-intervention surveys included 933 male and female students in two intervention and two comparison schools. The main outcome was condom use at last sex; secondary outcomes were partner communication, gender beliefs and values, perceived peer behaviors, and self-efficacy for safer sex. At 5 months post-intervention, change in condom use did not differ between intervention and comparison schools. Intervention school youth had greater increases in self-efficacy for unsafe sex refusal (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.01–2.57) and condom use (OR 1.76, 95% CI 1.07–2.89), partner communication (OR 2.42, 95% CI 1.27–4.23), and knowledge of HIV testing opportunities (OR 1.76, 95% CI 1.08–2.87). This gender-focused pilot intervention increased adolescents’ self-efficacy and partner communication and has potential to improve preventive behaviors.

KEYWORDS:

• adolescents
• gender
• HIV prevention
• pregnancy
• school-based intervention
• South Africa