A School-Based Hiv/aids Prevention Education Program: Outcomes of Peer-Led versus Community Health Nurse-Led Interventions

Article excerpt

ABSTRACT: This study evaluated a brief school-based HIV/AIDS prevention intervention for adolescents delivered by either community health nurses (CHNs) or by trained peer educators (PEs). The interventions consisted of two one-hour sessions. Following the sessions, subjects in the CHN-led (n = 58) and PE-led (n = 53) groups and a control group (n = 49) filled out questionnaires measuring HIV/AIDS prevention knowledge, attitudes, self-efficacy, and behavioural intentions. Students in both the CHN and PE-led groups had significantly higher scores than controls in HIV/AIDS prevention knowledge and students in the PE-led group had significantly higher knowledge scores than students in the CHN-led group. Students in the PE-led group had significantly higher scores on the HIV/AIDS prevention attitudes, self-efficacy, and behavioural intentions questionnaire than did controls. There were no significant differences between the CHN-led group and the PE-led group in total attitude, self-efficacy, and behavioural intention scores. On specific questionnaire items concerning key predictor variables associated with condom use, student scores indicated that the PE-led intervention, and to a lesser extent the CHN-led intervention, had a significant positive impact. The findings suggest that brief school-based interventions can improve adolescents short-term HIV/AIDS prevention knowledge, attitudes, self-efficacy, and behavioural intentions.

Key Words: HIV/AIDS prevention Adolescents Peer educators Community health nurses Evaluation

INTRODUCTION

By the beginning of 1998, over 40,000 people had tested positive for human immunodeficiency virus (HIV) in Canada (Health Canada, 1998) and in recent years the incidence of acquired immunodeficiency syndrome (AIDS) has steadily increased among youth (Health Canada, 1996). The Canada Youth & AIDS Study reported that 31% of males and 21% of females in Grade 9 reported sexual intercourse experience and 49% of males and 46% of females in Grade 11 had had sexual intercourse at least once (King, Beazley, Warren, Hankins, Robertson, & Radford, 1988). A recent review of the Canadian literature confirms that a majority of teens of both sexes will initiate intercourse between 16 and 19 years of age (Maticka-Tyndale, 1997). Although there is growing evidence that behaviourally-based HIV/AIDS prevention interventions can reduce high HIV sexual risk behaviour among adolescents (Kim, Stanton, Li, Dickersin, & Galbraith, 1997), many sexually active adolescents do not consistently practice STD/HIV risk reduction behaviours (Maticka-Tyndale, 1997). For example, a recent study of sexually active 12-to 17-year-olds in Ontario found that less than half used condoms consistently (Thomas, DiCenso, & Griffith, 1998).

Given the foregoing observations, it is important to continue to look for the best ways to provide effective HIV/AIDS education to adolescents. Schools, because they have meaningful contact with nearly all young people, are a logical and important setting for providing sexual health education (Health Canada, 1994).

This paper describes an HIV/AIDS prevention education program for grade 9 high school students in Ontario and compares questionnaire outcome results of students in peer educator (PE) -led vs. community health nurse (CHN) -led interventions.

PEER EDUCATORS AND HIV/AIDS PREVENTION EDUCATION

The HIV/AIDS prevention intervention described and evaluated here emerged as part of a wider objective to increase the amount of school-based sexual health education provided to high school students in our community. Within that context, we sought to increase students knowledge, attitudes, self-efficacy, and skills related to HIV/AIDS prevention. Because most schools have only a limited amount of time to allocate to sexual health education, it is important to evaluate the effectiveness of existing program types and to search for new, time-efficient ways to deliver effective programs. …