A quasi-experimental evaluation of an HIV prevention programme by peer education in the Anglican Church of the Western Cape, South Africa
Date
2012-02
Authors
Mash, Rachel
Mash, Robert James
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ publishing group
Abstract
Introduction: Religion is important in most African
communities, but faith-based HIV prevention
programmes are infrequent and very rarely evaluated.
Objective: The aim of this study was to evaluate the
effectiveness of a church-based peer education HIV
prevention programme that focused on youth.
Design: A quasi-experimental study design compared
non-randomly chosen intervention and control groups.
Setting: This study was conducted in the Cape Town
Diocese of the Anglican Church of Southern Africa.
Participants: The intervention group of 176 teenagers
was selected from youth groups at 14 churches and
the control group of 92 from youth groups at 17
churches. Intervention and control churches were
chosen to be as similar as possible to decrease
confounding.
Intervention: The intervention was a 20-session peer
education programme (Fikelela: Agents of Change)
aimed at changing risky sexual behaviour among youth
(aged 12e19 years). Three workshops were also held
with parents.
Primary and secondary outcome measures: The
main outcome measures were changes in age of
sexual debut, secondary abstinence, condom use and
numbers of partners.
Results: The programme was successful at increasing
condom usage (condom use score 3.5 vs 2.1;
p¼0.02), OR 6.7 (95% CI 1.1 to 40.7), and postponing
sexual debut (11.9% vs 21.4%; p¼0.04) absolute
difference 9.5%. There was no difference in secondary
abstinence (14.6% vs 12.5%; p¼0.25) or with the
number of partners (mean 1.7 vs 1.4; p¼0.67) and OR
2.2 (95% CI 0.7 to 7.4). Conclusion: An initial exploratory quasi-experimental
evaluation of the Agents of Change peer education
programme in a church-based context found that the
age of sexual debut and condom usage was
significantly increased. The study demonstrated the
potential of faith-based peer education among youth to
make a contribution to HIV prevention in Africa.
Further evaluation of the effectiveness of the
programme is, however, required before widespread
implementation can be recommended.
Description
Publication of this article was funded by the Stellenbosch University Open Access Fund.
The original publication is available at http://bmjopen.bmj.com/
Bibliography
The original publication is available at http://bmjopen.bmj.com/
Bibliography
Keywords
Faith-based HIV prevention programmes, Church-based peer education, Anglican Church of Southern Africa, HIV infections -- South Africa Western Cape -- Prevention, Unsafe sex -- South Africa -- Prevention -- Programmes
Citation
Mash, R & Mash, R. J. 2012. A quasi-experimental evaluation of an HIV prevention programme by peer education in the Anglican Church of the Western Cape, South Africa. BMJ Open, 2, e000638, doi:10.1136/bmjopen-2011-000638.