Quasi-experimental evaluation of a national primary school HIV intervention in Kenya.

This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant program impact on targeted objectives of (1) adequate program delivery and, for standard 6 and 7 pupils (ages 11-16 years), (2) increased HIV-related knowledge; (3) increased communication with parents and teachers about HIV and sexuality; (4) increased assistance to fellow pupils to avoid sexual activity; (5) increased self-efficacy related to abstinence and condom use; (6) decreased exposure to HIV through delayed first intercourse, decreased sexual activity and increased condom. Results support the conclusions that the existing infrastructure is adequate for national roll-out of the program; that the program has its most beneficial effect on sexually inexperienced youth and should therefore be implemented with the youngest age groups possible; and that gains are gender specific, with boys reporting increased condom use while girls are more likely to decrease or delay sexual activity. Based on these results, the program began national roll-out to all primary schools in 2005. By June 2006, the program was operating in 11,000 of the country's nearly 19,000 schools.

The sexual scripts of Kenyan young people and HIV prevention.

The scripting of sexual encounters among young people in Kenyan is described using results of 28 focus group discussions conducted with young people attending primary school standard 7, from four different ethnic groups and living in 22 different communities. Sexual encounters were described as both mundane and inevitable and followed a predetermined scripted sequence of events and interactions in which girls and boys played complementary roles. These scripts were set within discourses of force and the exchange of gifts for sex. The gendered nature of the script and its social and cultural foundations are discussed. Potential strategies for developing HIV prevention programming are discussed from the perspective of existing sexual scripts.