Introduction
Methods
Intervention
Educational programme | ||
---|---|---|
Topic and number of sessions | Objectives | Sample activities |
Values and aspirations related in intimate relationships (1) | Meet the facilitator and learn about the programme Identify personal values and aspirations including how they want to treat people and be treated | Students complete a worksheet to design a “roadmap” to their chosen life goals Group discussion about relationships and their place in the roadmap |
Assertive communication (2) | Identify four styles of communication and their consequences Develop assertive communication skills for sexual decision making | Students practice assertive communication to convey a wish to a sexual partner |
Gender power inequities (2) | To critically analyse the dominant social ideas about gender power and roles To explore the kind of man or woman they want to be. | Group discussion of experiences of gender norms and gender inequality in home life/intimate relationships |
Relationships (6) | To identify the characteristics of a caring relationship To identify qualities they value in an intimate partner To identify, and develop skills to respond to relationship problems To develop skills to end relationships respectfully and safely | Read custom-made photo-novella and discuss in a group the relationship problems experienced by the adolescent characters: alcohol, poor communication, pressure to have sex, IPV Enact resolutions to the problems through role-plays |
Sexual decision-making (4) | To develop motivations and skills to delay sex, use condoms and reduce sex partners: Learn about positive and negative consequences of having sex Develop action plans to prevent having sex when they are not ready Identify risk behaviours for HIV, STI and unwanted pregnancy Critically analyse the risks of multiple partnerships, intergenerational partnerships, and transactional sex Develop skills to use a condom | Complete a worksheet to develop a set of personal criteria for assessing their own readiness to have sex Play a game to learn the steps in using a condom |
IPV and sexual violence (4) | Recognize types of relationship violence and warning signs Understand the reasons people use violence and leading to intimate partner violence control to manipulate others Reflect on their own values and aspirations in relation to violence Understand the laws related to violence and sexual violence, and the legal support services Demonstrate risk monitoring and safety planning skills | Read a story in which a girl is forced to have sex by her boyfriend, and through discussion identify the underlying factors, the triggers and the opportunity factors leading to IPV |
Support for victims of IPV and sexual violence (1) | Develop empathy towards victims of violence and learn how to support them Understand the importance of seeking help if a victim of violence, and to learn how to seek help | Read a story in which a girl is forced to have sex by her boyfriend and discuss issues of power, blame, responsibility and human rights violations |
Creating lasting change Consolidating lessons learned (1) | To consolidate lessons learned To reflect on their ability to act as agents of change within their schools and communities | Complete and discuss a worksheet focusing on “What am I going to do to be more respected and respectful?” |
School health service | ||
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Activity and participants | Objectives | Sample activities |
“Health check” offered to each PREPARE participant | To increase adolescent access to sexual and reproductive health (SRH) education, services and social support | SRH education, screening and referral for SRH problems Screening and referral for psychosocial problems Follow-up consultation |
School safety programme (1) | ||
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Activity and participants | Objectives | Sample activities |
School safety training School teams from each intervention school, comprising principal, teachers, school safety officer, parent representatives, local police officer | To reduce acceptability and prevalence of IPV and sexual violence in the school To raise awareness of the relevant laws concerning sexual violence To develop skills to implement a participatory school safety audit and safety plan | Presentation of the laws regarding sexual violence Presentation of concepts of participatory safety audit and plan Small group-work to plan school safety audit |
School safety programme (2) | ||
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Activity and participants | Objectives | Sample activities |
Photovoice (five 2-h sessions) 20 randomly selected PREPARE participant volunteers | To empower students to be the driving force in improving physical, emotional and sexual safety at school To influence school safety policy and prompt changes to address violence in schools | Risk mapping of unsafe situations and places in school Take photographs to portray safe and unsafe situations and places Present to forum of principals, teachers, parents, police officers, and community stakeholders |
Control Condition
Sampling
Randomisation and Masking
Recruitment of Participants
Measures
Variable | Number of items | Items | Scoring | Alpha |
---|---|---|---|---|
Sexual behavior | ||||
Sexual debut | Have you ever had vaginal sex? Have you ever had anal sex? | h | NA | |
Sexual debut including oral sex | Have you ever had vaginal sex? Have you ever had anal sex? Have you ever had oral sex? | h | NA | |
Unwilling first sex (defined by b, c, or d) | The first time I had sex, was it Something I wanted Something I did not want Something I was forced to do against my will I was raped | NA | ||
Regretted first sex (defined by a or d) | Think back to the first time you had sex and tell us what you feel about it now I wish I’d waited longer before having sex I wish I’d not waited so long It was about the right time It shouldn’t have happened at all Don’t know | NA | ||
Vaginal sex frequency | How many times in the past 6 months have you had vaginal sex? | i | NA | |
Anal sex frequency | How many times in the past 6 months have you had anal sex? | i | NA | |
Gave money or gifts for sex | In the past 6 months, have you given someone gifts or money in exchange for sex? | h | NA | |
Received money or gifts for sex | In the past 6 months, have you had sex because you expected to get money, food, drinks or other gifts? | h | NA | |
Number of sex partners | How many people have you had sex with in your life? | NA | ||
Condom use at last sex (defined by a, b, or c) Contraception use at last sex (defined by b, c, d, or e) | The last time you had sex, what did you or your partner do to prevent pregnancy? Condom only Condom with pill Condom with injection Injection alone Pill alone | h | NA | |
Condom use frequency | In the past 6 months, how often did you use a condom when having sex? | j | NA | |
Carrying condoms | Have you carried a condom with you in the past 6 months? | h | ||
Intimate partner violence (IPV) | ||||
IPV victimization (defined by at least once on a, b, c or d) | In the past 6 months how often has a boyfriend or girlfriend Insulted you or humiliated you or made you feel bad about yourself? Threatened to hurt you? Hit, pushed, kicked, choked or burned you? Forced you to have sex with him/her? | k | NA | |
IPV perpetration (defined by at least once on a, b, c or d) | In the past 6 months, how often have you Insulted or humiliated a girlfriend or boyfriend or made them feel bad? Threatened to hurt a boyfriend or girlfriend? Hit, pushed, kicked, choked or burned a boyfriend or girlfriend? Forced a boyfriend or girlfriend to have sex with you? | k | NA | |
Theorized motivational variables for sexual behaviour | ||||
Knowledge condom use | 3 | Does a condom have an expiry date? Should a man leave a bit of air at the top of the condom when putting it on? Is it true that the only time a person should use a condom is when they have sex with someone for the first time? | a | NA |
Knowledge HIV/AIDS | 5 | If you have sex only once with a person who is HIV positive, can you become infected with HIV? If you kiss with a person who is HIV positive, can you become infected with HIV? If you have anal sex with a person who is HIV positive, can you become infected with HIV? Is it true that a person who is strong and health can be HIV positive? When a girl uses contraceptive pills or the injection for family planning, does this protect her against STIs? | a | NA |
Risk susceptibility | 2 | If I do not use a condom when having sex, my risk of getting a STI will be.. If I do not use a condom when having sex, my risk of HIV infection will be.. | b | 0.73 |
Risk severity | 2 | If I got a STI, I would find this… If I was infected with HIV, I would find this.. | c | 0.82 |
Attitude: pros condom use | 4 | If I use a condom when I have sex this will Show that I take responsibility for myself Make me less worried about having sex Show that I respect my partner Show that I am sexually experienced | d | 0.63 |
Attitude: pros delaying sex | 4 | Waiting until I am older before I have sex will: Help me achieve my life’s goals Help prevent me from getting hurt emotionally Please my parents Lower my risk of getting HIV | d | 0.73 |
Attitude: cons condom use |
4
| If I use a condom when I have sex this will Be unacceptable for me because of my religion Feel unnatural t me Takes too much effort Will make me feel nervous/awkward | d | 0.78 |
Attitude: cons delaying sex |
4
| Waiting until I am older before I have sex will: Make me look uncool Will be frustrating for me Make my partner frustrated with me Make me look unsuccessful | d | 0.82 |
Social norm condom use |
4
| Most of my friends think that I should use a condom when I have sex My parents/caregivers think that I should use a condom when I have sex Most of my other family members think that I should use a condom when I have sex x My boyfriend or girlfriend thinks that I should use a condom when I have sex | d | 0.86 |
Social norm delaying sex |
4
| Most of my friends think that I should wait until I am older before I have sex My parents/caregivers think that I should wait until I’m older to have sex Most of my other family members think that I should wait until I’m older before I have sex My boyfriend or girlfriend thinks that I should wait until I am older before I have sex | d | 0.76 |
Self-efficacy condom usee
| 5 | Using a condom when I have a steady partner is… Using a condom when I feel sexually excited is… Using a condom when I am drunk is… Using a condom when I do not feel comfortable (when I am shy) is… Going to a clinic to get condoms is… | e | 0.73 |
Self-efficacy delaying sexe
| 4 | If I have been drinking alcohol, waiting until I’m older before I have sex is… If my partner is older than me, waiting until I am older before I have sex is… If someone offers me money or gifts, waiting until I am older before I have sex with that person is… If I am deeply in love, waiting until I am older before I have sex is… | e | 0.79 |
Action planning condom used
| 4 | I plan to use a condom when I have a steady partner I plan to always keep a condom in a safe place at home I plan to discuss condom use with each partner before we have sex I plan to get a new condom when I have only one left | d | NA |
Action planning delaying sexd
| 4 | I plan to not have sex when I have had more than one glass of alcohol I plan to not get a partner who is much older than me I plan to not have sex for money, food or gifts I plan to find other ways of showing my love (instead of having sex | d | NA |
Intentions delaying sex | 1 | I intend to have sex during next month | d | NA |
Intentions delaying sex | 1 | I intend to have sex during the next 6 months | d | NA |
Intentions condom use | 1 | I intend to use a condom the next time I have sex | d | NA |
Process Evaluation
Analysis
Results
Response Rate and Retention
Exposure at the School Level
Exposure at the Individual Participant Level
Fidelity to Programme
Acceptability to Students
Effect Evaluation
Control | Intervention | Difference |
p
| |||
---|---|---|---|---|---|---|
Mean | SD | Mean | SD | |||
Age | 13.7 | 1.07 | 13.71 | 0.99 | F(1,40) < 1 | Ns |
Gender (% male, N) | 37.9 % | (628) | 41.5 % | (706) | Fa(1,40) = 1.86 | Ns |
SES | 5.99 | 1.65 | 5.98 | 1.68 | F(1,40) < 1 | Ns |
Risk susceptibility | 3.59 | 1.19 | 3.64 | 1.19 | F(1,40) < 1 | Ns |
Risk severity | 3.99 | 1.17 | 4.05 | 1.13 | F(1,40) < 1 | Ns |
Knowledge condom use | 0.28 | 0.24 | 0.29 | 0.24 | F(1,40) < 1 | Ns |
Pros condom use | 3.83 | 0.76 | 3.85 | 0.74 | F(1,40) < 1 | Ns |
Cons condom use | 2.78 | 0.90 | 2.74 | 0.94 | F(1,40) < 1 | Ns |
Social norm condom use | 4.26 | 0.84 | 4.28 | 0.79 | F(1,40) < 1 | Ns |
Self-efficacy condom use | 2.95 | 0.89 | 2.96 | 0.89 | F(1,40) < 1 | Ns |
Action planning condom use | 4.13 | 0.91 | 4.15 | 0.90 | F(1,40) < 1 | Ns |
Knowledge HIV/AIDS | 0.56 | 0.28 | 0.58 | 0.26 | F(1,40) < 1 | Ns |
Pros delaying sex | 3.99 | 0.83 | 4.03 | 0.88 | F(1,40) < 1 | Ns |
Cons delaying sex | 2.57 | 1.02 | 2.51 | 1.07 | F(1,40) < 1 | Ns |
Social norm delaying sex | 4.34 | 0.78 | 4.30 | 0.79 | F(1,40) < 1 | Ns |
Self-efficacy delaying sex | 3.08 | 1.07 | 3.11 | 1.09 | F(1,40) < 1 | Ns |
Action planning delaying sex | 3.65 | 1.18 | 3.64 | 1.21 | F(1,40) < 1 | Ns |
I intend to have sex during next month | 1.86 | 1.27 | 1.92 | 1.31 | F(1,40) < 1 | Ns |
I intend to have sex during the next 6 months | 1.78 | 1.19 | 1.78 | 1.16 | F(1,40) < 1 | Ns |
I intend to use a condom the next time I have sex | 3.85 | 1.44 | 3.94 | 1.43 | F(1,40) = 1.01 | Ns |
Primary outcomes | ||||||
Ever had sex (vaginal or anal) | 22.0 % | (270) | 23.3 % | (299) | Fa(1,40) < 1 | Ns |
Ever had sex (vag., anal or oral) | 29.5 % | (339) | 31.0 % | (374) | Fa(1,40) < 1 | Ns |
Vaginal sex frequencya
| 1.55 | 1.04 | 1.69 | 1.20 | F(1,40) = 2.32 | Ns |
Anal sex frequencya
| 1.43 | 0.96 | 1.47 | 1.04 | F(1,40) < 1 | Ns |
Lifetime number of sexual partnersa
| 3.35 | 3.04 | 3.36 | 2.76 | F(1,40) < 1 | Ns |
Condom use last intercoursea
| 87.7 % | (350) | 88.2 % | (373) | Fa(1,40) < 1 | Ns |
Condom use frequencya
| 1.87 | 1.45 | 1.80 | 1.41 | F(1,40) < 1 | Ns |
Ever carried a condom | 16.5 % | (261) | 16.6 % | (273) | Fa(1,40) < 1 | Ns |
Contraception use (excl cu)a
| 25.6 % | (69) | 27.1 % | (81) | Fa(1,40) < 1 | Ns |
Secondary outcomes | ||||||
IPV victim (%, N) | 45.5 % | (626) | 46.1 % | (632) | Fa(1,40) < 1 | Ns |
IPV perpetrator (%, N) | 26.4 % | (352) | 27.4 % | (363) | Fa(1,40) < 1 | Ns |
Unwilling at first sexa
| 31.4 % | (58) | 25.7 % | (53) | Fa(1,40) = 2.04 | Ns |
Gave money or gifts for sexa
| 8.1 % | (25) | 12.3 % | (42) | Fa(1,40) = 2.05 | Ns |
Received money or gifts for sexa
| 9.1 % | (29) | 10.3 % | (36) | Fa(1,40) < 1 | Ns |
Prevalence/mean at 6 months | Unadjusted effect estimate | Adjusted effect estimate | ||||||
---|---|---|---|---|---|---|---|---|
Control (M, SD) | Intervention (M, SD) | B/OR | 95 % CI | Test statistic | B/OR | 95 % CI | Test statistic | |
Risk susceptibility | 3.73 (1.10) | 3.87 (1.15) | 0.13 | −0.06 to 0.33 | F(1,40) = 1.88 | 0.12 | −0.03 to 0.27 | F(1,40) = 2.53 |
Risk severity | 4.11 (1.05) | 4.14 (1.13) | 0.02 | −0.20 to 0.24 | F(1,40) < 1 | −0.01 | −0.15 to 0.13 | F(1,40) < 1 |
Knowledge condom use | 0.29 (0.25) | 0.37 (0.27) | 0.07*** | 0.04 to 0.11 | F(1,40) = 18.10 | 0.07*** | 0.04 to 0.10 | F(1,40) = 27.27 |
Pros condom use | 3.87 (0.73) | 3.92 (0.75) | 0.04 | −0.05 to 0.12 | F(1,40) < 1 | 0.03 | −0.05 to 0.10 | F(1,40) < 1 |
Cons condom use | 2.62 (0.88) | 2.56 (0.97) | −0.07 | −0.20 to 0.07 | F(1,40) < 1 | −0.03 | −0.12 to 0.06 | F(1,40) < 1 |
Social norm condom use | 4.36 (0.75) | 4.35 (0.81) | −0.02 | −0.10 to 0.07 | F(1,40) < 1 | −0.02 | −0.08 to 0.05 | F(1,40) < 1 |
Self − efficacy condom use | 3.29 (1.23) | 3.39 (1.33) | −0.01 | −0.14 to 0.12 | F(1,40) < 1 | −0.02 | −0.13 to 0.09 | F(1,40) < 1 |
Action planning condom use | 4.18 (0.84) | 4.23 (0.83) | 0.06 | −0.02 to 0.14 | F(1,40) = 1.80 | 0.04 | −0.03 to 0.11 | F(1,40) = 1.51 |
Knowledge HIV/AIDS | 0.57 (0.28) | 0.62 (0.27) | 0.06** | 0.02 to 0.10 | F(1,40) = 8.38 | 0.05** | 0.02 to 0.08 | F(1,40) = 10.84 |
Pros delaying sex | 4.06 (0.81) | 4.14 (0.82) | 0.06 | −0.06 to 0.18 | F(1,40) = 1.13 | 0.07 | −0.02 to 0.16 | F(1,40) = 2.75 |
Cons delaying sex | 2.38 (0.98) | 2.28 (1.03) | −0.09 | −0.25 to 0.07 | F(1,40) = 1.42 | −0.07 | −0.16 to 0.02 | F(1,40) = 2.49 |
Social norm delaying sex | 4.36 (0.73) | 4.30 (0.76) | −0.05 | −0.16 to 0.06 | F(1,40) < 1 | −0.03 | −0.10 to 0.04 | F(1,40) < 1 |
Self − efficacy delaying sex | 3.25 (1.04) | 3.23 (1.07) | −0.03 | −0.17 to 0.11 | F(1,40) < 1 | −0.03 | −0.11 to 0.05 | F(1,40) < 1 |
Action planning delaying sex | 3.79 (1.15) | 3.83 (1.14) | 0.05 | −0.07 to 0.16 | F(1,40) < 1 | 0.05 | −0.04 to 0.15 | F(1,40) = 1.22 |
I intend to have sex during next month | 1.86 (1.24) | 1.88 (1.27) | 0.02 | −0.22 to 0.26 | F(1,40) < 1 | −0.01 | −0.13 to 0.12 | F(1,40) < 1 |
I intend to have sex during the next 6 months | 1.79 (1.16) | 1.80 (1.17) | 0.02 | −0.18 to 0.22 | F(1,40) < 1 | 0.01 | −0.11 to 0.12 | F(1,40) < 1 |
I intend to use a condom the next time I have sex | 4.07 (1.32) | 4.11 (1.32) | 0.06 | −0.11 to 0.24 | F(1,40) < 1 | 0.02 | −0.13 to 0.16 | F(1,40) < 1 |
Primary outcomes | ||||||||
Sexual debut (%, N, OR) | 9.3 % (143) | 10.5 % (165) | 1.14 | 0.84 to 1.55 | t(40) < 1 | 1.09 | 0.82 to 1.45 | t(40) < 1 |
Sexual debut (incl oral) (%, N, OR) | 11.0 % (173) | 13.2 % (211) | 1.23 | 0.95 to 1.59 | t(40) = 1.61 | 1.19 | 0.95 to 1.49 | t(40) = 1.55 |
Vaginal sex frequencya
| 1.75 (1.09) | 1.85 (1.27) | 0.04 | −0.13 to 0.20 | F(1,40) < 1 | 0.12 | −0.03 to 0.26 | F(1,40) = 2.67 |
Anal sex frequencya
| 1.40 (1.00) | 1.42 (0.93) | 0.03 | −0.10 to 0.15 | F(1,40) < 1 | 0.02 | −0.09 to 0.14 | F(1,40) < 1 |
Number of sexual partners, past 6 monthsa
| 0.31 (2.63) | 0.56 (2.42) | 0.65 | −0.08 to 1.23 | F(1,40) < 1 | 0.35 | −0.37 to 1.07 | F(1,40) < 1 |
Condom use last intercourse (%, N, OR)a
| 83.0 % (88) | 79.2 % (95) | 0.80 | 0.50 to 1.30 | t(40) < 1 | 0.69 | 0.35 to 1.37 | t(40) = 1.20 |
Condom use frequencya
| 2.34 (1.61) | 2.32 (1.63) | −0.04 | −0.40 to 0.32 | t(40) < 1 | 0.09 | −0.24 to 0.42 | F(1,40) < 1 |
Ever carried a condom (%, N, OR) | 16.4 % (234) | 17.4 % (254) | 1.09 | 0.82 to 1.45 | t(40) < 1 | 1.04 | 0.81 to 1.34 | t(40) < 1 |
Contraception use (excl condoms) (%, N, OR)a
| 18.8 % (26) | 23.8 % (36) | 0.97 | 0.61 to 1.56 | t(40) < 1 | 1.22 | 0.65 to 2.28 | t(40) < 1 |
Secondary outcomes | ||||||||
IPV victim (%, N, OR) | 38.7 % (423) | 37.2 % (401) | 0.94 | 0.72 to 1.23 | t(40) < 1 | 0.90 | 0.71 to 1.14 | t(40) < 1 |
IPV perpetrator (%, N, OR) | 27.1 % (282) | 27.5 % (281) | 1.02 | 0.77 to 1.35 | t(40) < 1 | 0.98 | 0.76 to 1.27 | t(40) < 1 |
Unwilling at first sex (%, N, OR)b
| 32.2 % (48) | 28.9 % (44) | 0.86 | 0.54 to 1.36 | t(40) < 1 | 0.85 | 0.71 to 1.02 | t(40) = 1.05 |
Regretted first sex (%, N, OR)b
| – | – | – | – | – | – | – | – |
Gave money or gifts for sex (%, N, OR)a
| 8.6 % (13) | 11.4 % (19) | 1.61 | 0.81 to 3.22 | t(40) = 1.39 | 1.24 | 0.55 to 2.78 | t(40) < 1 |
Received money or gifts for sex (%, N, OR)a
| 6.8 % (11) | 11.8 % (20) | 2.28 | 0.97 to 5.36 | t(40) = 1.95 | 2.15 | 0.87 to 5.30 | t(40) = 1.72 |
Prevalence/mean at 12 months | Unadjusted effect estimate | Adjusted effect estimate | |||||||
---|---|---|---|---|---|---|---|---|---|
Control (M, SD) | Intervention (M, SD) | B/OR | 95 % CI | Test statistic | B/OR | 95 % CI | Test statistic | ||
Risk susceptibility | 3.79 (1.10) | 3.78 (1.20) | −0.01 | −0.20 to 0.19 | F(1,40) < 1 | −0.01 | −0.17 to 0.14 | F(1,40) < 1 | |
Risk severity | 4.12 (1.07) | 4.08 (1.17) | −0.05 | −0.28 to 0.18 | F(1,40) < 1 | −0.07 | −0.21 to 0.08 | F(1,40) < 1 | |
Knowledge condom use | 0.30 (0.25) | 0.39 (0.28) | 0.09** | 0.04 to 0.13 | F(1,40) = 13.20 | 0.09*** | 0.05 to 0.13 | F(1,40) = 19.00 | |
Pros condom use | 3.89 (0.77) | 3.91 (0.79) | 0.01 | −0.09 to 0.10 | F(1,40) < 1 | −0.01 | −0.09 to 0.08 | F(1,40) < 1 | |
Cons condom use | 2.55 (0.90) | 2.55 (1.00) | 0.01 | −0.12 to 0.14 | F(1,40) < 1 | 0.01 | −0.10 to 0.10 | F(1,40) < 1 | |
Social norm condom use | 4.35 (0.82) | 4.34 (0.83) | −0.03 | −0.12 to 0.06 | F(1,40) < 1 | −0.02 | −0.09 to 0.06 | F(1,40) < 1 | |
Self − efficacy condom use | 3.23 (0.90) | 3.25 (0.91) | 0.02 | −0.10 to 0.13 | F(1,40) < 1 | 0.01 | −0.09 to 0.11 | F(1,40) < 1 | |
Action planning condom use | 4.27 (0.86) | 4.21 (0.89) | −0.06 | −0.16 to 0.04 | F(1,40) = 1.30 | −0.06 | −0.14 to 0.03 | F(1,40) = 1.63 | |
Knowledge HIV/AIDS | 0.56 (0.30) | 0.60 (0.29) | 0.04 | −0.01 to 0.09 | F(1,40) = 2.84 | 0.03 | −0.01 to 0.07 | F(1,40) = 3.19 | |
Pros delaying sex | 4.15 (0.83) | 4.18 (0.88) | 0.03 | −0.10– 0.17 | F(1,40) < 1 | 0.02 | −0.09 to 0.12 | F(1,40) < 1 | |
Cons delaying sex | 2.26 (1.08) | 2.24 (1.12) | −0.02 | −0.17 to 0.14 | F(1,40) < 1 | −0.01 | −0.09 to 0.07 | F(1,40) < 1 | |
Social norm delaying sex | 4.36 (0.76) | 4.31 (0.76) | −0.05 | −0.14 to 0.04 | F(1,40) = 1.09 | −0.04 | −0.11 to 0.02 | F(1,40) = 1.78 | |
Self − efficacy delaying sex | 3.45 (1.07) | 3.38 (1.15) | −0.07 | −0.21 to 0.07 | F(1,40) = 1.07 | −0.07 | −0.16 to 0.02 | F(1,40) = 2.44 | |
Action planning delaying sex | 3.84 (1.17) | 3.82 (1.19) | −0.01 | −0.12 to 0.10 | F(1,40) < 1 | −0.01 | −0.09 to 0.09 | F(1,40) < 1 | |
I intend to have sex during next month | 1.89 (1.27) | 1.99 (1.34) | 0.09 | −0.20 to 0.37 | F(1,40) < 1 | 0.07 | −0.09 to 0.23 | F(1,40) < 1 | |
I intend to have sex during the next 6 months | 1.81 (1.15) | 1.90 (1.25) | 0.10 | −0.14 to 0.34 | F(1,40) < 1 | 0.09 | −0.06 to 0.23 | F(1,40) = 1.38 | |
I intend to use a condom the next time I have sex | 4.04 (1.35) | 4.07 (1.34) | 0.02 | −0.14 to 0.18 | F(1,40) < 1 | −0.02 | −0.15 to 0.12 | F(1,40) < 1 | |
Primary outcomes | |||||||||
Sexual debut (%, N, OR) | 12.0 % (168) | 12.7 % (177) | 1.07 | 0.81 to 1.43 | t(40) < 1 | 1.07 | 0.83 to 1.40 | t(40) < 1 | |
Sexual debut (incl oral) (%, N, OR) | 13.4 % (192) | 14.3 % (203) | 1.08 | 0.81 to 1.44 | t(40) < 1 | 1.09 | 0.84 to 1.41 | t(40) < 1 | |
Vaginal sex frequencya
| 1.91 (1.13) | 2.00 (1.34) | 0.08 | −0.07 to 0.23 | F(1,40) = 1.16 | 0.08 | −0.09 to 0.25 | F(1,40) < 1 | |
Anal sex frequencya
| 1.40 (0.86) | 1.51 (1.03) | 0.12 | −0.02 to 0.27 | F(1,40) = 3.14 | 0.14 | −0.02 to 0.26 | F(1,40) = 2.65 | |
Number of sexual partners, past 12 months a
| 0.40 (2.82) | 0.62 (2.75) | 0.33 | −0.06 to 0.71 | F(1,40) = 2.88 | −0.03 | −0.71 to 0.64 | F(1,40) < 1 | |
Condom use last intercourse (%, N, OR)a
| 83.5 % (81) | 80.6 % (83) | 0.73 | 0.46 to 1.16 | t(40) = 1.38 | 0.64 | 0.33 to 1.25 | t(40) = 1.35 | |
Condom use frequencya
| 2.67 (1.70) | 2.56 (1.69) | −0.15 | −0.47 to 0.17 | F(1,40) < 1 | −0.06 | −0.42 to 0.31 | F(1,40) < 1 | |
Ever carried a condom (%, N, OR) | 15.6 % (209) | 15.6 % (210) | 1.02 | 0.76 to 1.36 | t(40) < 1 | 0.98 | 0.74 to 1.29 | t(40) < 1 | |
Contraception use (excl condoms) (%, N, OR)a
| 22.1 % (29) | 28.1 % (34) | 1.26 | 0.80 to 1.98 | t(40) = 1.04 | 1.21 | 0.70 to 2.09 | t(40) < 1 | |
Secondary outcomes | |||||||||
IPV victim (%, N, OR) | 40.9 % (402) | 35.1 % (342) | 0.80 | 0.60 to 1.05 | t(40) = 1.68 | 0.77* | 0.61 to 0.99 | t(40) = 2.14 | |
IPV perpetrator (%, N, OR) | 27.2 % (255) | 27.6 % (254) | 1.05 | 0.77 to 1.43 | t(40) < 1 | 1.03 | 0.79 to 1.35 | t(40) < 1 | |
Unwilling at first sex (%, N, OR)b
| 26.4 % (48) | 34.8 % (69) | 1.49 | 0.83 to 2.68 | t(40) = 1.39 | 1.57 | 0.88 to 2.80 | t(40) = 1.58 | |
Regretted first sex (%, N, OR)b
| 47.5 % (94) | 44.9 % (101) | 0.90 | 0.65 to 1.25 | t(40) < 1 | 0.91 | 0.63 to 1.33 | t(40) < 1 | |
Gave money or gifts for sex (%, N, OR)a
| 10.4 % (14) | 13.2 % (18) | 1.88 | 0.79 to 4.51 | t(40) = 1.46 | 1.96 | 0.83 to 4.61 | t(40) < 1 | |
Received money or gifts for sex (%, N, OR)a
| 9.2 % (13) | 15.4 % (22) | 1.64 | 0.59 to 4.51 | t(40) = 1.59 | 1.80 | 0.66 to 4.93 | t(40) = 1.12 |
Effect of Rate of Session-Attendance on Outcomes
Results after 6 months | Results after 12 months | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Attended at least 1 session | Attended >10 sessions | Attended at least 1 session | Attended >10 sessions | |||||||||
M (SD) | B/OR | 95 % CI | M (SD) | B/OR | 95 % CI | M (SD) | B/OR | 95 % CI | M (SD) | B/OR | 95 % CI | |
Risk susceptibility | 3.90 (1.16) | 0.12 | −0.03 to 0.28 | 4.04 (1.12) | 0.21*
| 0.05 to 0.38 | 3.85 (1.19) | 0.02 | −0.14 to 0.18 | 3.98 (1.17) | 0.12 | −0.07 to 0.30 |
Risk severity | 4.17 (1.11) | −0.01 | −0.14 to 0.15 | 4.31 (1.05) | 0.07 | −0.08 to 0.22 | 4.11 (1.17) | −0.05 | −0.20 to 0.10 | 4.28 (1.08) | 0.06 | −0.09 to 0.21 |
Knowledge condom use | 0.38 (0.27) | 0.08***
| 0.05 to 0.11 | 0.43 (0.27) | 0.13***
| 0.09 to 0.17 | 0.41 (0.28) | 0.10***
| 0.06 to 0.14 | 0.46 (0.28) | 0.15***
| 0.11 to 0.19 |
Pros condom use | 3.93 (0.75) | 0.04 | −0.04 to 0.11 | 3.98 (0.74) | 0.08*
| 0.01 to 0.16 | 3.93 (0.78) | 0.02 | −0.06 to 0.11 | 3.95 (0.80) | 0.04 | −0.05 to 0.13 |
Cons condom use | 2.49 (0.98) | −0.08 | −0.17 to 0.02 | 2.39 (0.97) | −0.14**
| −0.24 to −0.04 | 2.51 (1.02) | −0.01 | −0.12 −0.10 | 2.36 (0.98) | −0.14**
| −0.24 to −0.05 |
Social norm condom use | 4.38 (0.80) | 0.01 | −0.06 to 0.06 | 4.44 (0.77) | 0.06 | −0.09 to 0.13 | 4.38 (0.81) | 0.02 | −0.06 to 0.09 | 4.43 (0.76) | 0.06 | −0.02 to 0.14 |
Self − efficacy condom use | 3.34 (1.32) | 0.02 | −0.09 to 0.13 | 3.43 (1.32) | 0.10 | −0.03 to 0.22 | 3.26 (0.92) | 0.02 | −0.09 to 0.12 | 3.25 (0.91) | 0.01 | −0.12 to 0.12 |
Action planning condom use | 4.26 (0.82) | 0.06 | −0.01 to 0.12 | 4.35 (0.79) | 0.14***
| 0.07 to 0.20 | 4.21 (0.90) | −0.06 | −0.14 to 0.02 | 4.27 (0.88) | −0.01 | −0.11 to 0.08 |
Knowledge HIV/AIDS | 0.63 (0.27) | 0.05**
| 0.02 to 0.08 | 0.67 (0.27) | 0.09***
| 0.06 to 0.13 | 0.61 (0.29) | 0.04*
| 0.01 to 0.08 | 0.64 (0.29) | 0.07**
| 0.02 to 0.11 |
Pros delaying sex | 4.18 (0.81) | 0.10*
| 0.01 to 0.18 | 4.24 (0.78) | 0.13**
| 0.04 to 0.23 | 4.20 (0.87) | 0.02 | −0.08 to 0.13 | 4.27 (0.84) | 0.08 | −0.03 to 0.18 |
Cons delaying sex | 2.21 (1.02) | −0.11*
| −0.20 to −0.02 | 2.08 (0.99) | −0.16**
| −0.28 to −0.05 | 2.19 (1.12) | −0.04 | −0.13 to 0.04 | 2.05 (1.09) | −0.11*
| −0.19 − − 0.02 |
Social norm delaying sex | 4.33 (0.75) | −0.02 | −0.10 to 0.05 | 4.41 (0.70) | 0.04 | −0.04 to 0.12 | 4.33 (0.77) | −0.04 | −0.11 to 0.03 | 4.38 (0.73) | 0.01 | −0.07 to 0.08 |
Self − efficacy delaying sex | 3.27 (1.07) | −0.01 | −0.09 to 0.08 | 3.35 (1.09) | 0.03 | −0.06 to 0.11 | 3.41 (1.16) | −0.06 | −0.16 to 0.04 | 3.50 (1.17) | −0.01 | −0.12 to 0.10 |
Action planning delaying sex | 3.87 (1.14) | 0.07 | −0.03 to 0.18 | 3.92 (1.13) | 0.10 | −0.05 to 0.24 | 3.86 (1.16) | 0.03 | −0.07 to 0.13 | 3.91 (1.16) | 0.05 | −0.07 to 0.17 |
I intend to have sex during next month | 1.85 (1.26) | −0.02 | −0.14 to 0.11 | 1.69 (1.16) | −0.09 | −0.21 to 0.03 | 1.95 (1.34) | 0.05 | −0.12 to 0.21 | 1.82 (1.28) | −0.02 | −0.19 to 0.14 |
I intend to have sex during the next 6 months | 1.79 (1.17) | 0.01 | −0.11 to 0.11 | 1.73 (1.71) | −0.02 | −0.15 to 0.11 | 1.88 (1.24) | 0.06 | −0.08 to 0.21 | 1.73 (1.18) | −0.03 | −0.17 to 0.11 |
I intend to use a condom the next time I have sex | 4.13 (1.31) | 0.03 | −0.12 to 0.18 | 4.22 (1.26) | 0.13 | −0.03 to 0.29 | 4.12 (1.30) | 0.05 | −0.08 to 0.17 | 4.15 (1.31) | 0.09 | −0.07 to 0.24 |
Primary outcomes | ||||||||||||
Sexual debut (%, N, OR) | 11.0 % (139) | 1.17 | 0.87 to 1.57 | 10.0 % (65) | 1.11 | 0.80 to 1.54 | 12.5 % (142) | 1.08 | 0.84 to 1.39 | 12.9 % (76) | 1.15 | 0.86 to 1.53 |
Sexual debut (incl oral) (%, N, OR) | 13.6 % (175) | 1.26 | 0.99 to 1.61 | 13.9 % (91) | 1.39*
| 1.05 to 1.85 | 14.1 % (162) | 1.09 | 0.85 to 1.41 | 14.4 % (85) | 1.16 | 0.87 to 1.55 |
Vaginal sex frequencya
| 1.84 (1.27) | 0.10 | −0.06 to 0.26 | 1.56 (1.07) | −0.11 | −0.28 −0.06 | 1.94 (1.29) | 0.01 | −0.16 to 0.18 | 1.77 (1.10) | −0.11 | −0.30 to 0.08 |
Anal sex frequencya
| 1.39 (0.93) | 0.02 | −0.11 to 0.14 | 1.27 (0.73) | −0.08 | −0.19 to 0.04 | 1.45 (0.96) | 0.09 | −0.05 to 0.23 | 1.29 (0.77) | −0.04 | −0.20 to 0.12 |
Number of sexual partnersa
| 4.32 (3.36) | 0.33 | −0.35 to 1.02 | 3.53 (2.82) | −0.18 | −0.92 to 0.56 | 4.15 (3.11) | −0.01 | −0.77 to 0.75 | 3.05 (1.63) | −0.88 | −2.17 to 0.41 |
Condom use last intercourse (%, N, OR)a
| 80.9 % (76) | 0.71 | 0.35 to 1.44 | 83.3 % (20) | 1.00 | 0.50 to 2.04 | 79.7 % (59) | 0.65 | 0.33 to 1.27 | 73.9 % (17) | 0.38 | 0.11 to 1.37 |
Condom use frequencya
| 2.35 (1.62) | 0.15 | −0.21 to 0.52 | 1.97 (1.49) | −0.10 | −0.52 to 0.32 | 2.48 (1.67) | −0.08 | −0.46 to 0.30 | 2.17 (1.57) | −0.34 | −0.75 to 0.08 |
Ever carried a condom (%, N, OR) | 17.2 % (204) | 1.06 | 0.82 to 1.38 | 15.2 % (91) | 0.98 | 0.71 to 1.34 | 14.6 % (159) | 0.95 | 0.70 to 1.29 | 12.6 % (71) | 0.83 | 0.57 to 1.21 |
Contraception use (excl condoms) (%, N, OR)a
| 23.9 % (27) | 1.24 | 0.68 to 2.29 | 14.7 % (5) | 0.76 | 0.31 to 1.90 | 23.3 % (21) | 0.86 | 0.46 to 1.60 | 14.3 % (4) | 0.61 | 0.24 to 1.54 |
Secondary outcomes | ||||||||||||
IPV victim (%, N, OR) | 34.7 % (297) | 0.82 | 0.63 to 1.06 | 28.8 % (115) | 0.66*
| 0.49 to 0.90 | 34.3 % (268) | 0.76* | 0.58 to 0.99 | 32.2 % (123) | 0.73 | 0.53 to 1.01 |
IPV perpetrator (%, N, OR) | 27.1 % (221) | 0.99 | 0.77 to 1.27 | 22.8 % (87) | 0.82 | 0.58 to 1.16 | 26.9 % (198) | 1.01 | 0.77 to 1.31 | 25.6 % (93) | 1.01 | 0.71 to 1.44 |
Unwilling at first sex (%, N, OR)b
| 27.2 % (34) | 0.81 | 0.47 to 1.40 | 22.8 % (13) | 0.72 | 0.34 to 1.51 | 35.7 % (56) | 1.61 | 0.85 to 3.05 | 35.9 % (28) | 1.72 | 0.65 to 4.54 |
Regretted first sex (%, N, OR)b
| – | – | – | – | – | – | 45.9 % (83) | 0.94 | 0.63 to 1.42 | 45.8 % (44) | 0.98 | 0.59 to 1.62 |
Gave money or gifts for sex (%, N, OR)a
| 8.8 % (11) | 0.95 | 0.39 to 2.37 | 8.9 % (4) | 1.96 | 0.90 to 4.26 | 8.5 % (9) | 0.98 | 0.34 to 2.79 | 15.0 % (6) | 2.11 | 0.82 to 5.39 |
Received money or gifts for sex (%, N, OR)a
| 7.9 % (10) | 1.25 | 0.53 to 2.97 | 6.7 % (3) | 2.20 | 0.86 to 5.64 | 15.2 % (17) | 1.75 | 0.68 to 4.50 | 10.0 % (4) | 1.14 | 0.37 to 3.54 |