School‐based sexual health interventions in sub‐Saharan Africa: A review

Abstract

The vulnerability to HIV/AIDS of adolescents and youths raises the need for cost‐effective, school‐based AIDS prevention programmes that encourage safe sexual behaviour. This article reviews school‐based programmes in sub‐Saharan Africa through a critical examination of published evaluations. Our major finding is that there is a paucity of such studies that evaluate school‐based programmes. Furthermore, variations in the content, duration and intensity of the interventions, together with differences in the design of evaluations and of evaluation instruments, makes it difficult to conduct comparisons. The better designed studies do demonstrate that school‐based programmes have some effect. Most of the studies revealed expected effects on knowledge, attitudes and communication about sexuality and sexual health. Programmes also had demonstrable effects on behaviour in terms of the onset of sexual intercourse, the incidence of sexual intercourse and the number of sexual partners. Programmes less consistently affected awareness of personal susceptibility, and self‐efficacy in abstaining from risky sexual behaviours and engaging in protective behaviours (including condom use).

Notes

The authors would like to acknowledge the European Community for funding the Concerted Action Project: The Adolescent Reproductive Health Network (Contract no. ERBICI8CT970232), which facilitated this collaborative work.