1. Primary Investigator: Prof. P Reddy Project Director: Ms S James
Health Promotion Research and
Development Unit
Presentation to the Portfolio Committee
April 12, 2005

2. The Evaluation of a Life Skills HIV / AIDS Prevention Programme

3. AIM
Test whether learners that participate in a fact – based interactive curriculum will have:
More knowledge about HIV risks, prevention and care practices
More positive attitudes towards safe practices and PLWA
Higher prevalence of safe behaviours than comparable learners that did not participate in the programme

4. KZN Lifeskills Programme
Training
Master training
Teacher training
Implementation with learners
Training of peer educators 

5. Lifeskills Programme (cont)
Supportive Strategies
Motivational workshops – Middle management, members of the school governing body, parents, traditional leaders and healers.
On – going support and workshops with trained educators.
On – going collaboration with other role players and partners in the integrated plan.
On – going monitoring and evaluation of programme implementation.

6. MRC Evaluation
Multi – level evaluation aiming to determine the effects of the teacher training programme on learners
Master Training
Teacher Training
Learner Implementation

7. Evaluation Learner Programme
16 hour programme
HIV and AIDS facts
Lifeskills
Methodology and Materials
Implemented over two school terms
Life orientation lesson

8. Learner Evaluation Study Design: Randomised Control Trial
Study Area : Midlands District, KwaZulu – Natal
Study Sample : Grade 9 learners: 22 randomly allocated schools
Study Time frame: Baseline (T1), T2 ( 6 months after baseline), T3 (4 months after T2
Study Instrument: Semi-structured questionnaire
Data analysis: SPSS version 10 using ANOVA with repeated measures on the interval dependent measures
Ethical Approval: Nelson R. Mandela School of Medicine

9. Results Sexual behaviour Overview of learner responses
Attitudes towards HIV+ people
Gender norms

10. Figure 1: Learners’ Reported Sexual Activity at T1 and T2

11. Figure 2a: Learners’ report of intended sexual activity in the next three months (Intervention)

12. Figure 2b: Learners’ report of intended sexual activity in the next three months (Control)

13. Data Analysis Two categories of intervention implementation
Full programme (Intervention 1)
- programme implemented every week for many weeks
- worked on all 11 topics
Partially implemented programme (intervention 2)
- programme implemented a few weeks, or often or occasionally
- Worked on 7 of the 11 topics

14. Results Effectiveness of teacher training programme
Knowledge of HIV and AIDS
Social acceptability of condoms
Social perceptions about sexual behaviour
Perception of social support
Sexual behaviour

15. Figure 3: Secondary school learners knowledge about transmission of HIV / AIDS

16. Figure 4: Secondary school learners’ perceived negative consequences of condom use

17. Figure 5: Secondary school learners’ perceptions of social support

18. Figure 6: Secondary school learners’ social perceptions of sexual behaviour

19. Sexual Behaviour Sex in the recalled period
Group was a significant predictor of sex in the recalled period at T3
30% of control group responded yes to having had sex vs 21% in the intervention group at T3 (p = 0.01)
Intention not to have sex amongst learners who received the full programme vs the control at T3 (p = 0.05)
Learners that received the partial programme reported more intention to have sex with a condom in the next three months than those in the full programme or control groups (p < 0.01)
The intervention did not impact on reported condom use at last sex at T2 or T3

20. Conclusions and Recommendations
Quality and content of lessons effected learner outcomes
Implementation takes place within the context of the present school environment, school culture, communication amongst stakeholders, teacher efficacy and teacher behaviour.
Full implementation of the programme resulted in statistically significant changes in variables that impact on intention to safer sex practices and subsequent sexual behaviour

21. Conclusions and Recommendations
Choose and train teachers who are committed to the programme
Provide teachers with moral, material and technical support
Ensure dedicated time and teachers to implement the programme
Provide a programme that teaches skills as well as information
Address the needs of learners

22. Utilization of the Results
Dissemination to Policy Makers
Launch of the data to the Departments of Health and Education
(Nationally and Provincially)
Dissemination to the scientific community
Peer reviewed journal article – The impact of a HIV and AIDS lifeskills programme on secondary school students in KwaZulu-Natal, South Africa: The need for full implementation.
James S, Reddy P, Ruiter R, van den Borne B
Conferences
Reproductive Health Priorities Conf (2002)
International AIDS Conference (2003)
Synthesis Workshop on Stigma (UK 2003)
Dissemination to the stakeholder community
Horizons international comparison report
Horizons/MRC final report
On-going education
PhD Thesis