Educational Foundations, University of Botswana, Gaborone, Botswana.
Statistics, University of Botswana, Gaborone, Botswana.
Prev Sci. 2022 Aug;23(6):865-878. doi: 10.1007/s11121-021-01306-8. Epub 2021 Dec 22.
Few studies have investigated mediator effects of HIV prevention interventions on adolescents in sub-Saharan Africa. Herein, we report on a secondary analysis of an intervention that increased intentions to use condoms, abstain from sexual intercourse, and seek safe male circumcision among adolescents in Botswana. In a study conducted in Botswana, 806 grade 9 students from 21 public Junior Secondary Schools were randomly assigned to either the OWN THE FUTURE: Pulling Together We Will" ( PTWW) intervention group or a health promotion control group. Both conditions consisted of 12 1-h modules, with two modules delivered during each of the six sessions on six consecutive school days. The students in both groups completed confidential computer-based surveys at several time points: pre-, immediately post-, 3, 6, and 12 months post-intervention. Mediation was assessed using the product-of-coefficients approach in a generalized estimating equations (GEE) framework. The analyses showed that condom use beliefs were significant mediators of the intervention effect on the intention to consistently use condoms over time. Also, negative socio-cultural beliefs, prevention beliefs, and HIV/STI knowledge were significant mediators of the intervention's effects on the intention to abstain from sex. Additionally, normative beliefs, prevention beliefs, parental negotiation, and circumcision knowledge were significant mediators of the intervention's effect on intention to seek safe male circumcision. The mediation analysis delineated a theoretical model and isolated activities that positively impact condom use, abstinence from sex, and circumcision intentions of Batswana middle school adolescents.
很少有研究调查过预防艾滋病干预措施对撒哈拉以南非洲青少年的中介效应。在此,我们报告了一项增加博茨瓦纳青少年使用避孕套、避免性行为和寻求安全男性割礼意愿的干预措施的二次分析。在博茨瓦纳进行的一项研究中,21 所公立初中的 806 名 9 年级学生被随机分配到 OWN THE FUTURE:Pulling Together We Will(PTWW)干预组或健康促进对照组。两种条件都包括 12 个 1 小时的模块,在六个连续的上学日的六节课中各进行两个模块。两组学生在几个时间点完成了保密的基于计算机的调查:干预前、立即干预后、3 个月、6 个月和 12 个月。使用广义估计方程(GEE)框架中的系数乘积法评估中介作用。分析表明,避孕套使用信念是干预对随着时间的推移持续使用避孕套的意图的影响的重要中介因素。此外,消极的社会文化信念、预防信念和 HIV/性传播感染知识是干预对避免性行为意图的影响的重要中介因素。此外,规范信念、预防信念、父母协商和割礼知识是干预对寻求安全男性割礼意图的影响的重要中介因素。中介分析描绘了一个理论模型,并确定了对博茨瓦纳中学青少年的避孕套使用、避免性行为和割礼意图产生积极影响的活动。
Health Educ Q. 1992
J Adolesc Health. 1994-9
Arch Pediatr Adolesc Med. 2010-2