An Assessment of The Full Circle Project: Some Effects of a Theatre-based HIV/STI Prevention Intervention Presented to the World Association for Sexology Havana, Cuba, March 14, 2003 Josephine MacIntosh, Interdisciplinary Studies, University of Victoria, Canada Funded by: Vancouver Island Health Authority, Michael Smith Foundation for Health Research/BC Medical Services Foundation (Population Health), Sara Spencer Foundation for Applied Social Research, and Planned Parenthood Federation of Canada.

Components Of Canadian Sexual Health Education Acquisition of knowledge pertinent to specific sexual health issues Development of motivation and personal insight that is necessary to act on this knowledge Development of skills that support sexual health and reduce the potential of negative outcomes Creation of an environment conducive to sexual health (e.g. access to and promotion of sexual education and sexual health care) (Canadian Guidelines for Sexual Health Education Health Canada, 1997)

AIDS, HIV & STIs In Canada AIDS death rates have dropped due to advances in drug therapy and universal healthcare (Health Canada, 2000) HIV infection rates continue to increase with about 4,200 new infections occur each year across a broadening range of population subgroups (Health Canada, 2000) Chlamydia, gonorrhea and syphilis infection rates have risen by more than one-third in the past three years, especially within the age group (Patrick, Wong & Jordan: SEICCAN, 2000)

The Full Circle Project Theatre-based intervention that used youth culture and language as the framework for HIV/STI and sexuality education Community-based, peer-led initiative to promote sexual health and responsible sexual behaviour Proactive, repeat intervention with the potential to reduce high-risk sexual behaviour (HRSB) among in-school youth

Purpose of the Assessment To test the potential efficacy of a novel, peer-led approach to sexual health education We hoped to help our young audiences gain confidence in their own ability to apply prevention strategies within the context of interpersonal relationships

Subjects Audiences: N = 125 Grade 8, 9 & 10 (mean age yrs) 4 groups comprised of 2 classes each From 2 inner city schools and one suburban school Actor/Educators: N = 10 (aged 15-24)

Methodology Behavioural observations of audiences during Q&A sessions (N=351) Written feedback from audiences after each part of the play (N=363) Analysis of videotaped interviews with actor/educators (N= 10)

Did it Engage the Audience?

Reported Levels of Confidence *p =.02; ** p <.001

Did It Increase Confidence? p <.01 for all weeks

Did it Increase Knowledge? Individual video interviews with actor/educators presented a recurring theme: The youth had started the project feeling they were very well informed about HIV/STI prevention and finished the project with the realization that they had not known as much as they had previously thought. The actor/educators also made very useful observations about which aspects of the project they felt were most effective and which were less so.

Limitations of the Assessment Lack of a randomized, controlled design Use of a post-test only methodology: limits conclusions, results are merely suggestive Inclusion of a suburban school along with the inner city schools was unexpected and presents some confounding factors

Discussion and Recommendations Overall, a theatre-based peer-led approach to sexual health education appears to hold much promise Our young audiences reported increased confidence in their ability to apply prevention strategies in their own lives The Full Circle Project itself appears to have great potential for sexual health promotion for both youth audiences and peer educators Recommend longitudinal study of efficacy

Contact: Josephine MacIntosh Interdisciplinary Studies C/o Sociology Department University of Victoria PO Box 3050 Victoria, BC, Canada, V8W 3P5  