Assessing the impact of an educational intervention program on sexual abstinence based on the health belief model amongst adolescent girls in Northern Ghana, a cluster randomised control trial (original) (raw)
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Journal Of Clinical Research In HIV AIDS And Prevention
Background: In the absence of a cure for HIV and AIDS, prevention remains the most effective strategy to eliminate the pandemic. Abstinence from sexual intercourse is, therefore, the primary prevention weapon among unmarried adolescents and young adults, especially the school-going ones. This study uses the main constructs of the Health Belief Model (HBM), as the theoretical framework to investigate the psychosocial predictors of sexual abstinence among senior secondary school students in an urban setting in the Southwest region of Cameroon Methods: This study adopted a cross-sectional design, collecting data from a stratified random sample of 420 students in November 2016, using a pretested structured questionnaire, and analyzing them using SPSS version 20 software programme, using binomial logistic regressions at the level 0.05. Results: Only 194 (46.2%) were abstaining from sex. Perceived susceptibility to HIV, perceived severity of HIV/ AIDS, perceived benefits of sexual abstinence and perceived self-efficacy for sexual abstinence were not that high, 79.8%, 71.0%, 86.4% and 68.3% respectively. None of the above constructs of the HBM was a significant predictor of sexual abstinence. However, increasing age was significantly associated with an increased likelihood of sexual abstinence, OR=1.6 (95% CI 1.20-2.24, p=0.002). Conclusions: Senior secondary school students in urban Cameroon were not practicing sexual abstinence. Interventions and strategies to increase sexual abstinence are highly recommended and should focus on increasing the perception of risk of contracting HIV, which is assumed to be the immediate antecedent of sexual abstinence, on overcoming barriers to sexual abstinence and on sexual abstinence negotiating skills, and should target adolescent students (10-19 years old).
Development and Validation of the Sexual Abstinence Scale (Sas)
African Journal for the Psychological Study of Social Issues, 2014
The Sexual Abstinence Scale (SAS) is designed to assess healthy sexual behaviour among adolescents as a way to reduce the incidence of HIV and other sexually transmitted diseases. This cross sectional study took place in two phases. The first phase comprised of 1030 adolescents randomly selected from senior classes in secondary schools in three out of five local government areas within Ibadan municipality. The second phase had 250 participants also randomly selected from senior secondary classes. items generated for the scale were obtained from an extensive literature review. The content validity of the instrument was confirmed through peer reviews of experts in the field of adolescent sexuality. The internal consistencies for the six sub-scales were .8430 for knowledge of sexual abstinence sub-scale, .8170 for perceived risk of sexual abstinence sub-scale, .6310 for attitude towards sexual abstinence sub-scale, .9380 for perceived benefits of sexual abstinence sub-scale,.7910 for s...
Reducing Sexual Risk With Practice of Periodic Secondary Abstinence
Journal of Obstetric, Gynecologic, & Neonatal Nursing, 2008
Objective: Test a novel intervention to help sexually experienced girls increase abstinence behaviors and attitudes. Design: A quasi-experimental repeated measures design using qualitative and quantitative data. Setting: Two alternative public schools. Participants: Thirty-three females whose mean age was 16 and who were 79% African American participated. Most (79%) had experienced a pregnancy. Intervention: A 6 session, weekly, interactive intervention was delivered. Data were collected at baseline, last session, and at 5 and 7 month follow-ups. Main Outcome Measures: Measured outcomes related to abstinence included participants' reasons, behaviors, stages of change, and attitudes. Results: The most common reason for abstinence was not wanting to have sex. At each postintervention data collection point, most participants (greater than or equal to 74%) reported that they had purposefully avoided sex. Duration of consecutive days of abstinence increased although only significantly at 5 month follow-up. Abstinence behaviors increased with the largest change from first to last session. Stage of change advanced from preparation to action by 7 month follow-up. Attitudes toward abstinence became more favorable. Conclusion: Effective sexual risk reduction interventions are critically needed to promote safety. Nurses may assist young women to decrease their sexual risks by teaching them to practice periodic abstinence.
Evidence on the Effectiveness of Abstinence Education: An Update. No. 2372
Heritage Foundation, 2010
Teen sexual activity is costly, not just for teens, but also for society. Teens who engage in sexual activity risk a host of negative outcomes including STD infection, emotional and psychological harm, and out-of-wedlock childbearing. Genuine abstinence education is therefore crucial to the physical and psycho-emotional well-being of the nation's youth. In addition to teaching the benefits of abstaining from sexual activity until marriage, abstinence programs focus on developing character traits that prepare youths for future-oriented goals. When considering effective prevention program aimed at changing teen sexual behavior, lawmakers should consider all of the available empirical evidence and restore funding for abstinence education.
Perspectives Do Abstinence-Plus Interventions Reduce Sexual Risk Behavior among Youth?
2013
Abstinence until marriage has emerged as a primary policy goal in efforts to promote adolescent sexual and reproductive health—in the United States and increasingly world-wide. While few would argue with abstinence as a personal choice (no one should be forced to have sex), there are serious questions about whether government promotion of abstinence should be a public health goal. Marriage is not free of HIV risk. Early marriage— particularly of young women to older, sexually experienced men—carries a substantial risk of HIV infection. Around the globe, a young woman’s primary risk of HIV infection is often through sex with her husband [1]. Sexual intercourse is almost universally initiated during adolescence worldwide. By age 20, 77 % of young people in the US have initiated sex, and 76 % have had premarital sex [2]. By age 25, over 90 % people have had sex, with only about 3 % waiting for marriage. Over the past 40 years, the median age at first intercourse has dropped (and stabil...
Predictors of sexual abstinence among Wolaita Sodo University Students, South Ethiopia
Background: It is over 30 years since the first case of AIDS [Acquired Immune Deficiency Syndrome] was identified. Attention has been focused recently on the promotion of the "ABCs" of HIV prevention (being abstinent or delaying sex, remaining faithful to one sexual partner, and using condoms consistently during sexual intercourse). As programs that focus on ABCs to prevent heterosexual transmission HIV are rolled out, questions of how well university students who come from varied cultural contexts actually understand the terms and address challenges to adopt behaviors is unanswered. In Ethiopia, despite the mushrooming number of students in the higher learning institutions with the current figure being 210,000 students accommodated in 33 public and 72 private higher learning institutions, sexual and reproductive health services, are not delivered in an organized way. The objective of this study is to identify factors associated with Sexual abstinence among Wolaita Sodo University students to provide evidence for designing appropriate interventions. Methods: A Cross-Sectional study was conducted among 750 undergraduate students selected from Wolaita Sodo University using a stratified simple random sampling technique during the academic year. Data were collected using structured self administered questionnaire, focus group discussion and in depth interview guides as tools for data collection. Ethical clearance was obtained from Jimma University and informed consent was obtained from the participants after explaining purpose of study. Statistical tests were employed wherever necessary at the significance level of 0.05. Results: All of the participants had heard about HIV/AIDS of which 97.3% had good knowledge. Higher proportions of male students were sexually active than their counter parts. Students with better knowledge on HIV AIDS were 6.6 (95%CI=1.6, 12.9) times more likely to abstain from sexual intercourse than their counter parts. Conclusions: Knowledge of students about risk of HIV infection is strong predictors of sexual abstinence of students which were less observed among students who came from rural areas. The university needs to intensify strong behavior change communication using multiple strategies through the active involvement of students themselves within the university's premises and in the surrounding community in collaboration with stakeholders to promote Sexual abstinence.
BMC Public Health, 2011
Background: Young people are becoming increasingly exposed to the risk of HIV infection. According to the 2008 HIV/Syphilis sentinel survey in Nigeria, 3.3% of young people aged 15-19 years are infected. Primary prevention especially abstinence, remains one of the most realistic interventions for reducing further spread of the virus. However, the adoption of sexual abstinence as a prevention strategy among adolescents remains low and factors influencing its practice among urban young people in Nigeria are relatively unknown. The aim of the study was to document the sexual abstinence behaviour of in-school adolescents, the factors influencing or obstructing abstinence, and knowledge of HIV and AIDS in Ibadan, South-West Nigeria.
2023
Background Abstinence-plus (comprehensive) interventions promote sexual abstinence as the best means of preventing HIV, but also encourage condom use and other safer-sex practices. Some critics of abstinence-plus programs have suggested that promoting safer sex along with abstinence may undermine abstinence messages or confuse program participants; conversely, others have suggested that promoting abstinence might undermine safer-sex messages. We conducted a systematic review to investigate the effectiveness of abstinence-plus interventions for HIV prevention among any participants in high-income countries as defined by the World Bank. Methods and Findings Cochrane Collaboration systematic review methods were used. We included randomized and quasi-randomized controlled trials of abstinence-plus programs for HIV prevention among any participants in any high-income country; trials were included if they reported behavioural or biological outcomes. We searched 30 electronic databases without linguistic or geographical restrictions to February 2007, in addition to contacting experts, hand-searching conference abstracts, and cross-referencing papers. After screening 20,070 abstracts and 325 full published and unpublished papers, we included 39 trials that included approximately 37,724 North American youth. Programs were based in schools (10), community facilities (24), both schools and community facilities (2), health care facilities (2), and family homes (1). Control groups varied. All outcomes were self-reported. Quantitative synthesis was not possible because of heterogeneity across trials in programs and evaluation designs. Results suggested that many abstinence-plus programs can reduce HIV risk as indicated by self-reported sexual behaviours. Of 39 trials, 23 found a protective program effect on at least one sexual behaviour, including abstinence, condom use, and unprotected sex (baseline n ¼ 19,819). No trial found adverse program effects on any behavioural outcome, including incidence of sex, frequency of sex, sexual initiation, or condom use. This suggests that abstinence-plus approaches do not undermine program messages encouraging abstinence, nor do they undermine program messages encouraging safer sex. Findings consistently favoured abstinence-plus programs over controls for HIV knowledge outcomes, suggesting that abstinence-plus programs do not confuse participants. Results for biological outcomes were limited by floor effects. Three trials assessed self-reported diagnosis or treatment of sexually transmitted infection; none found significant effects. Limited evidence from seven evaluations suggested that some abstinence-plus programs can reduce pregnancy incidence. No trial observed an adverse biological program effect. Conclusions Many abstinence-plus programs appear to reduce short-term and long-term HIV risk behaviour among youth in high-income countries. Programs did not cause harm. Although generalisability may be somewhat limited to North American adolescents, these findings have critical implications for abstinence-based HIV prevention policies. Suggestions are provided for improving the conduct and reporting of trials of abstinence-plus and other behavioural interventions to prevent HIV.