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Determine Risks, Knowledge and Behaviors Regarding HIV and AIDS Among Students Aged 9 – 18 in Nairobi County and Its Environs
1. Determine Risks, Knowledge and Behaviors
Regarding HIV and AIDS Among Students Aged
9 – 18 in Nairobi County and Its Environs
NOPE BIANNUAL CONFERENCE
20th June 2014, NAIROBI
Presented by:
Lily Murei, Global Communities
1
3. Background
• Healthy Outcome through Prevention Education (HOPE) is
a prevention program that seeks to improve HIV and AIDS
knowledge, attitudes and practices among primary and
secondary-aged students through peer, school, and
community-based interventions.
• To ensure evidence based programming, a HIV and AIDS
KAP baseline assessment among students was conducted
between July and September 2012
• The program is implemented by Global Communities in
partnership with USAID and Ministry of Education Science
and Technology 3
4. Objective/Study
To determine the Knowledge, Attitude and Practices of
Primary School Pupils and Secondary School Students on
HIV and AIDS
Study area;
The assessment was conducted in informal settlements in
Nairobi in Langata, Westlands, Embakasi, Njiiru, Dagoretti,
Starehe, Kamukuji, Kasarani, Makadara, Kiambu, Kikuyu,
Kajiado North, Athi River and Isinya
4
5. Methods
• Program used cross-sectional, descriptive, quasi-
experimental survey design and stratified multi-stage for
sampling.
• Study subjects comprised of students (classes 5-7) and
(forms 1-3) in formal and non-formal primary and
secondary schools.
• Interviews, focus group discussions, key informant
interviews were used to collect data.
• Secondary students used self administered questionnaires
• Primary students used interviewer guided questionnaires5
6. Methods- Sampling
A total of 1791 students were surveyed of which 58% were
primary and 42% were in secondary
School Sample Size Determination
• Rule of thumb used to select 10-12% of schools due to
constraints of time and finances
• Thus 48 schools selected out of the 400 (upper limit of
12%)
• Half of sample was intervention and half control.
• Questions touching on sexual behavior were only
administered to secondary students 6
7. Methods-Sampling continued
• Schools selected considering:
– Primary and secondary at a ratio of 60:40
– Public or Privately owned
– Mixed or Non-Mixed schools
– Formal or Non-formal
– Geographical Locations
• Stratification by sex from school class registers then
• Systematic random sampling for the selection of 6 girls
and 6 boys in each class stream to participate in the study
7
8. Results
• 93.6% have heard of HIV AIDS; 26.3% of all respondents
could correctly identify ways of preventing sexual
transmission of HIV
• 70.5% of all respondents have stigmatizing attitudes
towards People Living with HIV (PLHIV)
• On current risks of HIV infection; 30.3% of respondents
aged 15-24 (secondary students) had had sex of which
70% had sex with three or fewer people
• 13.7% of secondary students who reported to have had sex
said that they had sexual intercourse before 15 years 8
9. Methods-Selection Criteria
Inclusion Criteria
• Primary pupils in standard
5, 6 and 7
• Secondary Students in form
1, 2 and 3
• Key Informants from the
community (HTs, Teachers,
PTA reps, BoG reps,
DQASOs, Community
Leaders ) who were willing
to participate in the study
Exclusion Criteria
• Any pupils and students
who are not in standards 5,
6 and 7 and forms 1, 2 and
3.
• Any pupils/students and
community members who
were not willing to
participate in the study
9
10. Results
Responses of those who had sex
• 62.9% of secondary school students who had sex did not
use condoms in first sexual intercourse;
• 24.2% had sex with a partner at least ≥10 years older.
• 753 secondary students were asked how often they have
had drugs other than those prescribed by the doctor and
2.8% responded they were influenced by friends, 1.6% it
makes them feel better.
10
12. 12
Results
Figure 2: Distribution of subjects(secondary) based on their age at
first sexual intercourse (N=228)
7%
11%
14%
1%
67%
0
10
20
30
40
50
60
70
80
Less than 11yrs 12 to 14 yrs 15 to 17 yrs 18 to 20yrs Did not indicate age
13. Lessons Learnt
• Prior to the study, sensitization was done to schools
(teachers, HTs, students) – this was a success factor
• Interviewers needed to be young people who could
speak the spoken language (sheng) in the informal
settlements
• Peers are more confident sharing information with other
peers
• Partnerships, networking and collaboration, is crucial
for success not only in programming but also in research
involving young people 13
14. Recommendations
• Strengthen life skills education delivery in schools with a
focus on promotion of delayed sexual debut and
abstinence among the learners
• Enhance students knowledge on prevention of alcohol and
drug use/abuse
• Enhance students capacity to make healthier sexual and
reproductive health choices and adopt more positive
attitudes towards PLHIV
14
15. Conclusions
• In-spite of the fact that many young people have heard of
HIV and AIDS, they need to be supported to adopt more
positive attitudes towards PLHIV
• Mothers appear to be key confidants of most children &
need to be sensitized to better support young people
• Need to incorporate fathers to support young people adopt
healthier sexual lifestyles
• Enabling environment within families, in schools & and
among peers to support young people adopt and sustain
healthier lifestyle 15