XIX International AIDS Conference


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WEAC0105 - Oral Abstract

Education and HIV/AIDS in western Kenya: results from a randomized trial assessing the long-term biological and behavioural impact of two school-based interventions

Presented by Vandana Sharma (United States).

P. Dupas1, V. Sharma2, G. Makana3, C. Nekesa3, E. Duflo2

1Stanford University, Palo Alto, United States, 2Massachusetts Institute of Technology, Cambridge, United States, 3Innovations for Poverty Action, Busia, Kenya

Background: Between 2003 and 2006, a large randomized trial was conducted with 328 schools in Western Kenya to compare the effectiveness of two programs conducted either in isolation or combined: 1) training three teachers per primary school on the national HIV/AIDS curriculum; and 2) providing free school uniforms to students in grades 6 and above to reduce dropout rates. We assess the long-term impact of these two programs on transmission of Herpes Simplex Virus type 2 (HSV-2).
Methods: The sample includes 19,310 youths enrolled in grade 6 in 2003 in one of the 328 primary schools. A cross-sectional survey to measure HIV and HSV-2 prevalence and behavioral outcomes was administered between February 2009 and March 2011, six to eight years after the interventions. During a first wave of surveying, 54% of the youths could be successfully surveyed. Of the remainder, 29% were randomly selected for “intensive tracking”, and 81% of those were successfully surveyed. We use sampling weights to account for this sampling strategy.
Results: The HIV prevalence was 0.17% among males (average age: 20.33) and 1.56% among females (average age: 19.93). The HSV-2 prevalence was 7.14% among males and 11.79% among females. Students in schools where both programs were implemented were less likely to be infected with HSV-2 than those in control schools (OR= 0.837, p-value: 0.056, 95% CI=[0.697 - 1.00]). This effect was more pronounced for females (OR= 0.812, p-value: 0.10, 95% CI=[0.63 - 1.04]) than for males (OR= 0.888, p-value: 0.37, 95% CI=[0.68 - 1.15]). No significant differences in HSV-2 prevalence were detected between youth in the control group and those in schools receiving only one of the programs.
Conclusions: The national HIV/AIDS curriculum for primary school does not seem sufficient, by itself, to reduce risky sexual behaviors among youths. Ensuring that youths can stay in school appears a necessary complement.

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