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Abstract
We conducted a quasi-experiment to investigate whether a peer education intervention could result in positive sexual behavioral change outcomes in selected schools in Northern Malawi. The experimental participants (n = 158) were exposed to an HIV risk reduction intervention. The control participants (n = 147) were exposed to a Health Promotion Package. At 8 months, there were significant improvements in the intervention arm on several outcomes. The experimental group was 96% less likely to have sex than the control (OR = 0.04, CI = 0.01–0.20). Intervention participants were also 3.49 times likely to report condom use when they had sex (OR = 3.49, 95% CI = 0.96 to 12.65) and had lower odds of having multiple sexual partners. There were no significant differences on abstinence and the desire to have medical male circumcision (MMC). We suggest the intervention has potential efficacy to improve HIV risk reduction among adolescents in Malawi and perhaps in other similar settings.
Trial registration: Pan African Clinical Trial Registry identifier: PACTR201612001889209.
Acknowledgments
The authors wish to acknowledge the contributions of all the participants involved in this study as well as the school authorities whose input is invaluable and will go a long way in improving health outcomes for HIV risk reduction among adolescents and young people in Malawi. We also thank Mzuzu University for sponsoring the PhD project and staff at the University of Malawi, College of Medicine for the support they offered. Special thanks to the Research Support Center at College of Medicine as well as the Malawi-Liverpool-Wellcome Trust Clinical Research Program for the advanced postgraduate research methods courses in quantitative research methods and data analysis.
Declarations
Ethics approval and consent to participate
Ethics approval for the study was granted by the University of Malawi College of Medicine [ref#: P.01/16/1847]. The quasi experiment was initially retrospectively registered as an RCT with PACTR on December 12, 2016. Informed consent for the study was obtained from all study participants including parental or guardian consent for respondents below the age of 18.
Consent to publish
Consent to publish has been obtained from participants. This was highlighted in the consent to participate form that each participant read and signed before recruitment.
Availability of data and materials
Data and materials for the study will be available from the corresponding author.
Competing interests
The authors declare that they have no competing interests.
Study status
The study has been completed. There were two main phases; a cross-sectional situation analysis phase that informed the model for the intervention and the intervention implementation through the quasi experiment whose findings we present in this paper.
Related articles
No publication containing the intervention results herewith documented in this manuscript have been published or sent to any other journal. We have however published findings for the preliminary cross-sectional situation analysis with Sahara Journal. Another article on the preliminary phase is under peer review with Afrika Focus. We also published a systematic review on literature that was mainly used in the study with BMC Public Health and the same journal is peer reviewing the study design for the intervention.
Authors' contributions
MM with supervision from ASM conceptualized, designed, and developed the protocol and wrote this paper. All the authors read and approved the final version of the manuscript.
Author information
Department of Education, Mzuzu University, Private Bag 201, Luwinga, Mzuzu 2, Malawi.
Department of Public Health and Family Medicine, University of Malawi College of Medicine, Chichiri, Blantyre 3, Malawi.