Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

620 Abstracts ThPeF8139-ThPeF8142

XIV International AIDS Conference

requisite to any behaviour change intervention. Efforts to prevent HIV through
changing sexual behaviour must be informed by adequate analysis of the determinants of sexual behaviour in specific contexts. In eastern Uganda, a study was
done to assess the sexual and reproductive health situation of adolescents, identify and analyse the factors influencing this, and propose ways of enhancing the
effectiveness of health information and services targeting adolescents as part of
a project to expand and enhance the effectiveness of district health services.
Methods: Focus group discussions, key informant interviews, and records review
were the methods used to collect data from adolescents in and out of school,
parents, teachers, community leaders and health workers.
Results: Results from this study indicate remarkable understanding of adolescence, its challenges and opportunities; as a time when young people recognise,
understand and are prepared for their adult roles. Adolescent pregnancy and its
consequences were a concern for many, while infections through sex were less
discussed. The home and school environments, perceptions and actual levels
of poverty, culture and religion are factors with strong influence on the sexual behaviour of adolescents. Adolescent perceptions of more benefits than risks in sex,
beliefs that sex is an uncontrollable natural desire, and social expectations of sexual partners and peers influence decision-making about sex and contraception.
Conclusions: The findings in this study underscore the multiplicity in determinants of adolescent sexual behaviour, and the need for multiple and mutually
supportive interventions targeting the different determinants. Strengthening existing interventions has been instituted, through training and deployment of more
service providers, including media and school-based interventions.
Presenting author: nathan nshakira, actionaid kenya, p.o. box 42814,00100,
nairobi, aacc building, waiyaki way, Kenya, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeF8139 Participatory reproductive health education for
Primary school: Lessons learned during the first 3
years of an intervention in Mwanza, Tanzania
K. Chima1, A. Obasi2, B. Cleophas-Frisch1, M. Makokha1, D. Ross3,
A. Gavyole1, R. Hayes4, B. Mujaya5. 1African Medical and Research Foundation
- (AMREF) Mwanza, African Medical and Research Foundation, OP 0. Box 1482,
Mwanza, Tanzania; 2London School of Hygiene and Tropical Medicine - UK,
London, United Kingdom; 3National Institute of Medical Research, AMREFd
London School of Hygiene and Tropical Medicine, Mwanza, Tanzania; 4 London
School of Hygiene and Tropical Medicine, London, Tanzania; 5Ministry of
Education, Mwanza, Tanzania
Issues: The impact of cultural factors e.g teachers' resistance to discussion of
condom use, limited resources, or the prevalence of didactic teaching styles
may undermine school based reproductive health education (RH) in sub Saharan
Africa, especially in rural areas. An innovative teacher-led, participatory adolescent RH intervention is being implemented in the last 3 years of primary school in
Mwanza Tanzania, and it's impact evaluated within a randomised controlled trial.
Lessons learnt from the first 3 years are presented.
Description: Three teachers in each of 62 schools were trained for 1 week in
the facilitation of teacher guides for each of the last 3 years (standard 5,6 & 7)
of primary school. Guides contained between 10 and 15 sessions and used participatory techniques including drama (performed by peer educators), role-play,
stories, group discussions and group competitions. Coverage, quality of teaching
and teachers' experiences were assessed during quarterly supervisory visits by
trainers, government inspectors annual teachers evaluation workshops, and review of the students' notes and forms filled in by the teachers after each session.
Lessons learnt: Over 85% of the sessions were taught, to around 20,000 students. Pupils enjoyed the sessions, the overall standard of teaching was good and
students' knowledge improved. Teachers felt that the intervention was changing
pupil behaviour and their initial resistance to the discussion of condoms rapidly
decreased. Regular supervision and the final year examination were important
motivators
Recommendations: Teacher-led, participatory, peer-assisted RH education is
feasible and replicable in rural Tanzanian primary schools. The active involvement of youth and teachers in developing the materials contributed their success. Teachers come to accept the importance of discussion of sexual practices
and condom use. Supervision and examination legitimise the subject and ensure
quality and coverage.
Presenting author: Kenneth Chima, African Medical and Research Foundation, P. O. Box 1482, Mwanza, Tanzania, Tel.: [phone], Fax: +255 28
2500742, E-mail: [email protected]
ThPeF8140 Scaling up a school-based HIV prevention program
in Thailand
S. Sartsar1, P. Rumakom1, P. Guest1, A. McCauley2, S. Baker3, U. Rewthong4.
1Horizons Project, The Population Council, Bangkok, Thailand; 2Horizons

Project, International Center for Research on Women, Washington, United
States; 3Horizons Project, Program for Appropriate Technology in Health,
Bangkok, Thailand; 4Program for Appropriate Technology in Health, Bangkok,
Thailand
Issues: Pilot school programs have effectively increased knowledge and safe behaviors, but there are few successful national programs outside Europe. A welldone pilot is an important policy step because it shows what can be done, but

governments must also surmount the next barrier, expanding the program within
a school system.
Description: A pilot study of a school program was done in six Thai colleges.
The program planners worked with the Ministry of Education (MOE) designing the
curriculum and the teacher-training course and they also worked with local school
principals and teachers to gain acceptance for the course. Initially most schools
were reluctant to participate in the pilot but, after working with the planners, three
schools agreed to be intervention schools and three agreed to be controls. In the
three intervention schools 35 teachers received training and on-going support.
The school program was evaluated and indicated gains in knowledge, attitudes
and behaviors that may prevent HIV infection.
Post evaluation programmers asked the MOE and two intervention schools how
they would like to expand the program. The central MOE requested demonstration courses for other educators. One intervention school, where few teachers
were willing to teach the pilot course, responded that 80% of the teachers wanted
to receive teacher training so that they could talk about HIV prevention in their
home rooms. The second school asked that the program train secondary school
teachers with whom the college had an ongoing collaborative relationship.
Lessons learned: Programmers learned lessons about program replication including 1) many factors unrelated to HIV were influential (i.e., scheduling); 2) cost
is an issue for schools; 3) the prior on-going relationship with the educators was
necessary; and 4) trained teachers were excellent spokespersons for the program.
Recommendation: Top down and bottom up approaches to scaling up should be
used simultaneously
Presenting author: Srisuman Sartsara, The Population Council, South & East
Asia - Thailand Office, P.O. Box 138 Pratunam, Bangkok 10409, Thailand, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
ThPeF8141 Role of perceptions and judgements in influencing
behaviour in the face of AIDS, the case of
kamwokya II parish, Kampala, Uganda
P.K. Byansi1, R. Mulerwa1, D. Balaba2, J. Busingye3. 1Kamwokya Christian
Caring community p.o.box 25432, kampala, Uganda; 2THETA, kampala,
Uganda; 3Makerere University, kampala, Uganda
Issues: To effect sustainable behaviour change, HIV/AIDS interventions should
critically explore people's perceptions and judgements and how these influence
their attitudes, knowledge and behaviour. This process should take into account
how people have been socialised at home, in school, in the community, workplaces and by their peers.
Description: Our experiences among the youth in Kamwokya slums, Kampala
city, indicate that many youth "know" about AIDS but do not 'understand' the disease and its implications. Some believe 'AIDS chooses the body' - it does not
matter what risks you take. Others think AIDS is 'far' from them or simply liken it
to crossing the road, if you cross recklessly you get knocked, while many say they
wont live for ever - even if they don't die of AIDS, something else will kill them. To
these young people, anticipation and avoidance of risk will not be a priority.
Lessons learnt: In the HIV/AIDS era, Youth's perceptions and judgements about
HIV/AIDS, relationships, sex, life and death ultimately determine their attitudes,
how much knowledge they will acquire and apply
The way youth have been socialised from childhood shapes their perceptions and
judgments, which are manifested in their attitudes, knowledge and behaviour.
For HIV/AIDS intervention strategies to be effective they should take into account
youth's socialisation processes and how these processes have shaped their perceptions and judgements.
Conclusions/Action Steps: To effect sustainable behaviour change, programs
should explore youth's socialisation processes and how these shape their perceptions and judgements.
Youth, who have chosen positive behaviour or those who have always had good
behaviour, should be recognised, supported, reinforced and encouraged.
Presenting author: peter byansi, p.o.box 25432, kampala, Uganda, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeF8142 Topic: Training HIV/AIDS trainers and educators:
A presentation of a comprehensive model of
techniques
R.D. Zielony. International Consultant, 245 Avenue C, Apt. 5 E, New York, NY
10009, United States
Issues: When Training HIV/AIDS Educators, it is optimal to prepare them to
be able to use multiple talents. They need the skills in public speaking, acting,
counselling, culturally sensitive facilitation, advocacy, and negotiation. Training
for HIV/AIDS Educators, and the subsequent delivery of their programs to various target audiences, must ideally utilize a comprehensive and highly interactive
model. Many of these techniques are adaptable for use in the International, (as

well as local) forums.
Description: A Comprehensive Model: This talk will include a presentation of
techniques for training HIV/AIDS and Sexuality Educators following a model which
covers the following areas:
Information: Interactive techniques to engage their audience in factual updates,
such as an interactive password game (to learn/review facts about HIV and Sexuality).