Results of a Community Mentoring Programme for Youth Heads of Household in Rwanda: Effects on Youth Sexual Risk Behaviours and Maltreatment

Abstract

Background: While mentorship programmes, which connect orphans with adults to whom they can turn to for help and advice, are proliferating in an attempt to prevent high-risk behaviours in adolescents, there are few data to show that mentorship actually makes a difference among youth heads of households (YHH). The purpose of this study was to: (a) investigate the impact of mentoring relationship on sexual risk behaviours outcomes among YHH, and (b) examine the impact of the mentoring programme on youth maltreatment including sexual abuse. Methods: The research used a quasi-experimental design to assess the impact of the adult mentoring programme on sexual risk behaviours and maltreatment of youth living without adult care in four districts of the then Gikongoro province. In the design, which includes a baseline and a follow-up survey, the intervention group (Maraba and Nyamagabe districts) with youth heads of households receiving the home visitation programme were compared to a comparison
group (Mudasomwa and Nyaruguru districts). Analyses explored linkages between exposure to the intervention and various outcomes: HIV/AIDS knowledge, perception of HIV risk infection, sexual risk behaviours, and maltreatment. Logistic regression was used to examine whether the mentoring programme predicted outcomes of maltreatment or sexual behaviours when controlling for demographic characteristics and any other variables significant at the bivariate level. Results: The overall HIV/AIDS knowledge was higher in the intervention group (16.3% versus 12.5%) and more YHH in this group knew a place where to get a condom (64.5% versus 57.8%). In this group, youth were more likely to report use of condom (20.5 versus 12.4%), to perceive a risk of HIV/AIDS infection at the follow-up survey (44.7% versus 32.8%), and less consumption of alcohol (56.3 versus 41.7%). In the logistic regression, respondents who reported more adult support had a significantly high likelihood of being sexually inexperienced (OR = 1.20, score for adult support=3.67 versus 3.53, p=.05). During the last twelve months, being in school, male gender, and less marginalization were highly associated with being abstinent (AOR=4.68, 2.72, and 1.46, respectively). The level of maltreatment has sensibly diminished in the intervention group (from 1.53 to 1.27) during the last two years. There were more youth who reported physical abuse among the comparison group (24% versus 15.9%) and labour exploitation (29.5% versus 19.6%). YHH exposed to the intervention were less likely to suffer from labour exploitation and physical abuse (AOR = .52 and .63, respectively). Conclusions: Results indicate that the utilization of community adult mentors should be supported as a key strategy in working with YHH to decrease sexual risk behaviours and maltreatment from community members. For interventions to be optimally effective, specific strategies to promote community support and decrease marginalization need to be identified.

Key words: Youth heads of household, mentoring, sexual risk behaviours, maltreatment, abuse, Rwanda