Combining and adapting American school-based alcohol and HIV prevention programmes in South Africa: The HAPS project

Abstract

Adolescents in South Africa are at particularly high risk for human immunodeficiency virus (HIV), as well as other sexually transmitted infections. Because rates are so high, using minimal time and resources to develop effective interventions is essential. One strategy to achieve this goal is to modify and adapt western school-based preventive interventions for application in South African schools. This study focuses on the adaptation and integration of two interventions with proven effectiveness in the United States in order to ensure cultural relevance in South Africa and its subsequent testing in eight high schools located in townships near Pietermaritzburg, KwaZulu-Natal province. The findings reported in this paper reflect data from the first cohort of students, which included 1095 9th grade learners. Participants were assessed both 4–6 months and 15–18 months following baseline data collection. Results indicated significant differences in change between students in the intervention and comparison conditions on sexual refusal self-efficacy, intentions to have sex, attitudes about sex, initiation of sex, intention to use alcohol with sex, alcohol refusal self-efficacy and attitudes about alcohol. These results suggest that, after careful adaptation for cultural differences, behavioural interventions developed in western countries may achieve effectiveness in other contexts including township schools in South Africa.

Keywords:

• HIV prevention
• adolescents
• South Africa
• school-based studies
• delay of sexual initiation

Acknowledgements

This project was funded by the National Institute on Alcohol Abuse and Alcoholism, R01AA13927, Rick Zimmerman, Principal Investigator. We also thank the students, administrators and teachers and peer leaders in the eight township schools participating in this study; without their help, this study would truly not have been possible.