Ybarra Michele L, Bull Sheana S, Prescott Tonya L, Birungi Ruth
a Center for Innovative Public Health Research , 555 El Camino Real #A347, San Clemente , CA , USA.
AIDS Care. 2014 Apr;26(4):441-7. doi: 10.1080/09540121.2013.841837. Epub 2013 Oct 4.
Capitalizing on emerging data suggesting that HIV-preventive behaviors can be positively affected by Internet-based programs, we developed and tested CyberSenga, an Internet-based, comprehensive sexuality education program for adolescents in Mbarara, Uganda. Three hundred and sixty-six secondary school students were randomly assigned to either the five-lesson program (+ booster) or a treatment-as-usual control. At three-month follow-up, intervention participants provided feedback on the program acceptability. Six focus groups with intervention participants were additionally conducted after the final follow-up at 6 months. Data support a hypothesis of feasibility: despite schedule interruptions, 95% of intervention participants completed all the five modules; only 17% deviated from the once-a-week intended delivery schedule. Internet service was uninterrupted during the field period and, in general, the technology performed to specifications. The intervention also appears to be acceptable: 94% of intervention youth somewhat or strongly agreed that they learned a lot and 93% said they were somewhat or very likely to recommend the program. Although more than two in three youth somewhat or strongly agreed that the program talked too much about sex (70%) and condoms (75%), 89% somewhat or strongly disagreed that "I do not think kids like me should do the CyberSenga program." Feedback from focus group participants further suggested that the content was generally acceptable and did not contradict local norms in most cases. In fact, despite concerns from some local stakeholders to the contrary, information about condoms did not appear to be confusing or contradictory for youth who were abstinent. Nonetheless, some of the sexual topics seemed to be unfamiliar or uncomfortable for some participants - particularly brief references to oral and anal sex. Together, both qualitative and quantitative data suggest that the program is a feasible and acceptable way of delivering HIV preventive information to both sexually experienced and inexperienced adolescents in Mbarara, Uganda.
利用新出现的数据表明基于互联网的项目可以对艾滋病毒预防行为产生积极影响，我们开发并测试了CyberSenga，这是一个为乌干达姆巴拉拉的青少年提供的基于互联网的综合性性教育项目。366名中学生被随机分配到五节课的项目组（+强化课程）或常规治疗对照组。在三个月的随访中，干预参与者对项目的可接受性提供了反馈。在6个月的最终随访后，还与干预参与者进行了6个焦点小组讨论。数据支持了可行性假设：尽管日程安排中断，但95%的干预参与者完成了所有五个模块；只有17%的人偏离了每周一次的预定授课时间表。实地调查期间互联网服务未中断，总体而言，技术运行符合规格。该干预措施似乎也是可以接受的：94%的干预青少年有点或非常同意他们学到了很多，93%的人说他们有点或非常可能推荐这个项目。尽管超过三分之二的青少年有点或非常同意该项目过多地谈论了性（70%）和避孕套（75%），但89%的人有点或非常不同意“我认为像我这样的孩子不应该参加CyberSenga项目”。焦点小组参与者的反馈进一步表明，内容总体上是可以接受的，在大多数情况下与当地规范不矛盾。事实上，尽管一些当地利益相关者持相反观点，但对于禁欲的青少年来说，关于避孕套的信息似乎并不令人困惑或矛盾。尽管如此，一些性话题对一些参与者来说似乎不熟悉或不舒服——特别是对口交和肛交的简短提及。定性和定量数据共同表明，该项目是向乌干达姆巴拉拉有性经验和无性经验的青少年提供艾滋病毒预防信息的一种可行且可接受的方式。
