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Determine Risks, Knowledge and Behaviors Regarding HIV and AIDS Among Students Aged 9
– 18 in Nairobi County and Its Environs
NOPE BIANNUAL CONFERENCE
20th June 2014, NAIROBI
Presented by:
Lily Murei, Global Communities
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Presentation Outline • Background• Objectives• Methods • Results and Discussions• Recommendations • Conclusion
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Background • Healthy Outcome through Prevention Education (HOPE) is
a prevention program that seeks to improve HIV and AIDS knowledge, attitudes and practices among primary and secondary-aged students through peer, school, and community-based interventions.
• To ensure evidence based programming, a HIV and AIDS KAP baseline assessment among students was conducted between July and September 2012
• The program is implemented by Global Communities in partnership with USAID and Ministry of Education Science and Technology 3
Objective/Study To determine the Knowledge, Attitude and Practices of Primary School Pupils and Secondary School Students on HIV and AIDS
Study area;
The assessment was conducted in informal settlements in Nairobi in Langata, Westlands, Embakasi, Njiiru, Dagoretti, Starehe, Kamukuji, Kasarani, Makadara, Kiambu, Kikuyu, Kajiado North, Athi River and Isinya
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Methods• Program used cross-sectional, descriptive, quasi-
experimental survey design and stratified multi-stage for sampling.
• Study subjects comprised of students (classes 5-7) and (forms 1-3) in formal and non-formal primary and secondary schools.
• Interviews, focus group discussions, key informant interviews were used to collect data.
• Secondary students used self administered questionnaires • Primary students used interviewer guided questionnaires 5
Methods- Sampling
A total of 1791 students were surveyed of which 58% were primary and 42% were in secondary
School Sample Size Determination• Rule of thumb used to select 10-12% of schools due to
constraints of time and finances• Thus 48 schools selected out of the 400 (upper limit of
12%)• Half of sample was intervention and half control. • Questions touching on sexual behavior were only
administered to secondary students 6
Methods-Sampling continued• Schools selected considering:
– Primary and secondary at a ratio of 60:40– Public or Privately owned – Mixed or Non-Mixed schools– Formal or Non-formal – Geographical Locations
• Stratification by sex from school class registers then • Systematic random sampling for the selection of 6 girls
and 6 boys in each class stream to participate in the study7
Results• 93.6% have heard of HIV AIDS; 26.3% of all respondents
could correctly identify ways of preventing sexual transmission of HIV
• 70.5% of all respondents have stigmatizing attitudes towards People Living with HIV (PLHIV)
• On current risks of HIV infection; 30.3% of respondents aged 15-24 (secondary students) had had sex of which 70% had sex with three or fewer people
• 13.7% of secondary students who reported to have had sex said that they had sexual intercourse before 15 years
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Methods-Selection Criteria Inclusion Criteria• Primary pupils in standard
5, 6 and 7• Secondary Students in form
1, 2 and 3• Key Informants from the
community (HTs, Teachers, PTA reps, BoG reps, DQASOs, Community Leaders ) who were willing to participate in the study
Exclusion Criteria• Any pupils and students
who are not in standards 5, 6 and 7 and forms 1, 2 and 3.
• Any pupils/students and community members who were not willing to participate in the study
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Results
Responses of those who had sex• 62.9% of secondary school students who had sex did not
use condoms in first sexual intercourse; • 24.2% had sex with a partner at least ≥10 years older. • 753 secondary students were asked how often they have
had drugs other than those prescribed by the doctor and 2.8% responded they were influenced by friends, 1.6% it makes them feel better.
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Television Radio Billboard Clinic Counselor/Teacher/Peer educator
27% 27%
10%
13%
23%24%
16%
10%12%
39%
Primary Secondary
Results Figure 1: Study subjects response on where they heard about HIV and
AIDS (n=1791)
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ResultsFigure 2: Distribution of subjects(secondary) based on their age at first sexual intercourse (N=228)
Less than 11yrs 12 to 14 yrs 15 to 17 yrs 18 to 20yrs Did not indicate age0
10
20
30
40
50
60
70
80
7%11%
14%
1%
67%
Lessons Learnt • Prior to the study, sensitization was done to schools
(teachers, HTs, students) – this was a success factor• Interviewers needed to be young people who could
speak the spoken language (sheng) in the informal settlements
• Peers are more confident sharing information with other peers
• Partnerships, networking and collaboration, is crucial for success not only in programming but also in research involving young people
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Recommendations • Strengthen life skills education delivery in schools with a
focus on promotion of delayed sexual debut and abstinence among the learners
• Enhance students knowledge on prevention of alcohol and drug use/abuse
• Enhance students capacity to make healthier sexual and reproductive health choices and adopt more positive attitudes towards PLHIV
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Conclusions • In-spite of the fact that many young people have heard of
HIV and AIDS, they need to be supported to adopt more positive attitudes towards PLHIV
• Mothers appear to be key confidants of most children & need to be sensitized to better support young people
• Need to incorporate fathers to support young people adopt healthier sexual lifestyles
• Enabling environment within families, in schools & and among peers to support young people adopt and sustain healthier lifestyle 15
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Thank you