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Implementation of a School-Based HIV Prevention Curriculum Following National Dissemination in Nyanza Province, Kenya
Abstract
Background: Primary School Action for Better Health (PSABH) became the national HIV prevention curriculum of Kenya in 2005.
Objective: To examined implementation of PSABH and student risk behaviours.
Setting: Muhuru, a rural division of Nyanza Province.
Subjects: One thousand one hundred and forty six students aged 9-21 years from six primary schools in Muhuru.
Outcome measures: Anonymous surveys were administered to assess students’ exposure to PSABH curriculum components, sexual activity, condom use, and self-efficacy related to engaging in lower risk behaviours.
Results: The six schools implementing PSABH were not implementing the full curriculum. Fifty-five percent of males and 44% of females reported a history of sexual activity. For females, condom self-efficacy was related to lower risk behaviour , while HIV education during pastoral instruction was associated with higher risk. Boys who reported higher self-efficacy and learning about abstinence strategies engaged in lower risk behaviour , while exposure to HIV education in assemblies and communication with relatives about HIV was associated with higher risk.
Conclusion: Previous studies documented benefits of PSABH. However, it is unclear how effective the curriculum is after national scale-up. In this community, PSABH was implemented at a low level, with some curriculum components associated with higher risk behaviour , calling into question how PSABH is being delivered. Future studies should examine effective strategies for ongoing support, monitoring, and evaluation. Successfully disseminating evidence-based prevention strategies could reduce HIV incidence and the burden on healthcare providers struggling to care for
people living with HIV/AIDS.
Objective: To examined implementation of PSABH and student risk behaviours.
Setting: Muhuru, a rural division of Nyanza Province.
Subjects: One thousand one hundred and forty six students aged 9-21 years from six primary schools in Muhuru.
Outcome measures: Anonymous surveys were administered to assess students’ exposure to PSABH curriculum components, sexual activity, condom use, and self-efficacy related to engaging in lower risk behaviours.
Results: The six schools implementing PSABH were not implementing the full curriculum. Fifty-five percent of males and 44% of females reported a history of sexual activity. For females, condom self-efficacy was related to lower risk behaviour , while HIV education during pastoral instruction was associated with higher risk. Boys who reported higher self-efficacy and learning about abstinence strategies engaged in lower risk behaviour , while exposure to HIV education in assemblies and communication with relatives about HIV was associated with higher risk.
Conclusion: Previous studies documented benefits of PSABH. However, it is unclear how effective the curriculum is after national scale-up. In this community, PSABH was implemented at a low level, with some curriculum components associated with higher risk behaviour , calling into question how PSABH is being delivered. Future studies should examine effective strategies for ongoing support, monitoring, and evaluation. Successfully disseminating evidence-based prevention strategies could reduce HIV incidence and the burden on healthcare providers struggling to care for
people living with HIV/AIDS.
