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同伴教育干预对埃塞俄比亚亚的斯亚贝巴中学生与艾滋病毒/艾滋病相关性行为的影响:一项准实验研究。

Effects of peer education intervention on HIV/AIDS related sexual behaviors of secondary school students in Addis Ababa, Ethiopia: a quasi-experimental study.

作者信息

Menna Takele, Ali Ahmed, Worku Alemayehu

机构信息

St Paul's Hospital Millennium Medical College, P.O.Box:1271, Addis Ababa, Ethiopia.

School of Public Health, College of Health Sciences, Addis Ababa University, P.O. Box: 33412, Addis Ababa, Ethiopia.

出版信息

Reprod Health. 2015 Sep 7;12:84. doi: 10.1186/s12978-015-0077-9.

Abstract

BACKGROUND

Worldwide, about 50% of all new cases of HIV occur in youth between age 15 and 24 years. Studies in various sub-Saharan African countries show that both out of school and in school adolescents and youth are engaged in risky sexual behaviors. School-based health education has been a cornerstone of youth-focused HIV prevention efforts since the early 1990s. In addition, peer-based interventions have become a common method to effect important health-related behavior changes and address the HIV/AIDS pandemic. Thus, the aim of this study was to evaluate efficacy of peer education on changing HIV related risky sexual behaviors among school youth in Addis Ababa, Ethiopia.

METHODS

A quasi experimental study with peer education intervention was conducted in purposively selected four secondary schools (two secondary schools for the intervention and other two for the control group) in Addis Ababa, Ethiopia. Five hundred sixty students from randomly selected sections of grade 11 were assessed through anonymous questionnaires conducted in pre- and post-intervention periods. Pertinent data on socio-demographic and sexual behavior related factors were collected. The statistical packages used for data entry and analysis were epi-info version 3.5.4 and SPSS version 20.0 respectively. Chi-square test and multivariable logistic regressions were used for testing association between peer education intervention and sexual behaviors of students. In addition to testing association between dependent and independent variables, multi-variable analysis was employed to control for the effects of confounding variables.

RESULTS

When the pre and post intervention data of each group were compared, comprehensive Knowledge of HIV (P-Values =0.004) and willingness to go for HIV counseling and testing (P-value = 0.01) showed significant differences among intervention group students during post intervention period. Moreover, students in the intervention group were more likely to use condoms during post intervention period compared to students of the control group [AOR = 4.73 (95% CI (1.40-16.0)].

CONCLUSION

Despite short follow up period, students in the intervention group demonstrated positive changes in HIV related comprehensive knowledge and showed better interest to go for HIV testing in the near future. Furthermore, positive changes on risky sexual behaviors were reported from the intervention group. Implementing secondary school targeted peer education by allocating appropriate amounts of resources (money, man power, materials and time) could play significant role to prevent and control HIV/AIDS among school youth.

摘要

背景

在全球范围内,约50%的新增艾滋病病毒感染病例发生在15至24岁的青年人群中。撒哈拉以南非洲各国的研究表明,失学以及在校的青少年和青年都存在危险性行为。自20世纪90年代初以来,以学校为基础的健康教育一直是针对青年人群的艾滋病预防工作的基石。此外,同伴教育干预已成为促使重要的健康相关行为改变以及应对艾滋病疫情的常用方法。因此,本研究的目的是评估同伴教育对改变埃塞俄比亚亚的斯亚贝巴在校青年中与艾滋病病毒相关的危险性行为的效果。

方法

在埃塞俄比亚亚的斯亚贝巴,对四所经过有目的选择的中学(两所中学作为干预组,另外两所作为对照组)开展了一项采用同伴教育干预的准实验研究。通过在干预前后两个阶段进行的匿名问卷调查,对从11年级随机选取的班级中的560名学生进行了评估。收集了有关社会人口统计学和性行为相关因素的相关数据。分别用于数据录入和分析的统计软件包为Epi-Info 3.5.4版本和SPSS 20.0版本。采用卡方检验和多变量逻辑回归来检验同伴教育干预与学生性行为之间的关联。除了检验因变量和自变量之间的关联外,还采用多变量分析来控制混杂变量的影响。

结果

当比较每组干预前后的数据时,干预组学生在干预后阶段对艾滋病病毒的全面知识(P值=0.004)以及接受艾滋病病毒咨询和检测的意愿(P值=0.01)显示出显著差异。此外,与对照组学生相比,干预组学生在干预后阶段更有可能使用避孕套[AOR=4.73(95%CI(1.40 - 16.0)]。

结论

尽管随访期较短,但干预组学生在与艾滋病病毒相关的全面知识方面表现出积极变化,并且在不久的将来对接受艾滋病病毒检测表现出更高的兴趣。此外,干预组报告了在危险性行为方面的积极变化。通过分配适量的资源(资金、人力、物资和时间)实施针对中学的同伴教育,对于预防和控制在校青年中的艾滋病病毒/艾滋病可能会发挥重要作用。

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