A quasi-experimental evaluation of an HIV prevention programme by peer education in the Anglican Church of the Western Cape, South Africa

作者：Mash Rachel; Mash Robert James^*

来源：BMJ Open, 2012, 2(2): e000638.

DOI：10.1136/bmjopen-2011-000638

Introduction: Religion is important in most African communities, but faith-based HIV prevention programmes are infrequent and very rarely evaluated. %26lt;br%26gt;Objective: The aim of this study was to evaluate the effectiveness of a church-based peer education HIV prevention programme that focused on youth. %26lt;br%26gt;Design: A quasi-experimental study design compared non-randomly chosen intervention and control groups. %26lt;br%26gt;Setting: This study was conducted in the Cape Town Diocese of the Anglican Church of Southern Africa. %26lt;br%26gt;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. %26lt;br%26gt;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 12-19 years). Three workshops were also held with parents. %26lt;br%26gt;Primary and secondary outcome measures: The main outcome measures were changes in age of sexual debut, secondary abstinence, condom use and numbers of partners. %26lt;br%26gt;Results: The programme was successful at increasing condom usage (condom use score 3.5 vs 2.1; p=0.02), OR 6.7 (95% CI 1.1 to 40.7), and postponing sexual debut (11.9% vs 21.4%; p=0.04) absolute difference 9.5%. There was no difference in secondary abstinence (14.6% vs 12.5%; p=0.25) or with the number of partners (mean 1.7 vs 1.4; p=0.67) and OR 2.2 (95% Cl 0.7 to 7.4). %26lt;br%26gt;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.

• 出版日期2012