The Effect of HIV/AIDS Education on Adolescents in Trinidad and Tobago

"This study was conducted to determine the effectiveness of an HIV/AIDS educational intervention on adolescents' knowledge about and perceptions of susceptibility and severity of HIV/AIDS. We also examined whether providing information about assertiveness skills led to an intention to delay initiation of sexual activity."

Researchers used a quasi-experimental study design that assigned schools to either intervention or active comparison groups, excluding schools that had active abstinence clubs and students who were participating in HIV/AIDS educational activities or family planning services. Of the total participating 196 students, 104 were placed in the comparison group and 92 in the intervention group. All were between the ages of 11 and 18, and their schools, their parents, or guardians and they were informed and opted into the study and could opt out at any time.

"The five constructs of the Health Belief Model were used to design and test the impact of the educational lessons for the intervention group while the comparison group watched one educational video about HIV over four sessions." The intervention programme consisted of lectures and active skills-based learning on basic facts about HIV, ways to decrease the spread of HIV, and assertiveness training: "The first session of the intervention program provided information about HIV, modes of transmission, risk factors, and effects of HIV/AIDS on the health of individuals. The class was divided into teams and a game quiz was used to spark discussion. The second session covered how to decrease and prevent the spread of HIV. The third and fourth sessions included information about assertiveness skills about how to say 'no' to unwanted sexual advances. The students engaged in role playing activities on how to refuse sexual advances using potential scenarios that the student may encounter."

The comparison programme was passive instruction that included watching 3 DVDs - viewed over 4 sessions - about HIV/AIDS called: Force Ripe Man Part 1, Force Ripe Man Part 2, Understanding HIV/AIDS, and Voices. Each DVD was 25-30 minutes long, and there were no structured lectures for this group.

Students took pre- and post-test in order to measure any change in their knowledge and/or attitudes such as:

• perceived susceptibility of contracting HIV/AIDS;
• Condom Use Self-Efficacy Scale;
• Parent-Adolescent Communication Scale;
• Attitudes toward Abstinence;
• Beliefs about Preventing AIDS; and
• Postponing Sexual Initiation Scale.

Those in the comparison group had slightly higher knowledge scores at post-test than the intervention group, controlling for pre-test knowledge, but those in the intervention group were more likely to plan to delay sexual initiation. The authors found that, while knowledge scores increased for both groups, intention to delay sexual intercourse was only seen among the intervention group and within the younger age groups, possibly because they had more open family communication and, therefore, may be more receptive to open dialogue about HIV/AIDS and making age-appropriate decisions about engaging in sexual activity. "Even though the comparison group had higher pretest knowledge, seriousness, self efficacy in relationship to speaking to peers about condoms and practicing safe sex, attitudes toward abstinence and intention to delay sexual initiation score the scores for the intervention group improved at posttest. The intervention was effective in that the direction of the change for the intervention group was positive."

Because the students indicated that they would like all young people to be able to use condoms correctly, the authors suggest educating parents and teachers about issues that pertain to sexuality and how to discuss these issues with their children, requiring establishing trust between parents/guardians and the Ministry of Education (so parents know the schools are not trying to corrupt their children). The research suggests that it is also important to teach parents that education about condom use does not lead to increased sexual activity and that if responsible adults do not share accurate information with children, those children may learn about HIV/AIDS from their peers, possibly propagating myths and misconceptions.

Researchers recommend "further intervention studies among larger groups followed over a longer period to determine if there is a sustained effect of increased knowledge about HIV/AIDS that occurs during an intervention programme", self-efficacy as it pertains to condom use, attitude towards abstinence, and intention to delay initiation of sexual activity.