Determine Risks, Knowledge and Behaviors Regarding HIV and AIDS Among Students Aged 9 – 18 in Nairobi County and Its Environs

Determine Risks, Knowledge and Behaviors Regarding HIV and AIDS Among Students Aged 9

– 18 in Nairobi County and Its Environs

NOPE BIANNUAL CONFERENCE

20th June 2014, NAIROBI

Presented by:

Lily Murei, Global Communities

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Presentation Outline • Background• Objectives• Methods • Results and Discussions• Recommendations • Conclusion

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Background • Healthy Outcome through Prevention Education (HOPE) is

a prevention program that seeks to improve HIV and AIDS knowledge, attitudes and practices among primary and secondary-aged students through peer, school, and community-based interventions.

• To ensure evidence based programming, a HIV and AIDS KAP baseline assessment among students was conducted between July and September 2012

• The program is implemented by Global Communities in partnership with USAID and Ministry of Education Science and Technology 3

Objective/Study To determine the Knowledge, Attitude and Practices of Primary School Pupils and Secondary School Students on HIV and AIDS

Study area;

The assessment was conducted in informal settlements in Nairobi in Langata, Westlands, Embakasi, Njiiru, Dagoretti, Starehe, Kamukuji, Kasarani, Makadara, Kiambu, Kikuyu, Kajiado North, Athi River and Isinya

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Methods• Program used cross-sectional, descriptive, quasi-

experimental survey design and stratified multi-stage for sampling.

• Study subjects comprised of students (classes 5-7) and (forms 1-3) in formal and non-formal primary and secondary schools.

• Interviews, focus group discussions, key informant interviews were used to collect data.

• Secondary students used self administered questionnaires • Primary students used interviewer guided questionnaires 5

Methods- Sampling

A total of 1791 students were surveyed of which 58% were primary and 42% were in secondary

School Sample Size Determination• Rule of thumb used to select 10-12% of schools due to

constraints of time and finances• Thus 48 schools selected out of the 400 (upper limit of

12%)• Half of sample was intervention and half control. • Questions touching on sexual behavior were only

administered to secondary students 6

Methods-Sampling continued• Schools selected considering:

– Primary and secondary at a ratio of 60:40– Public or Privately owned – Mixed or Non-Mixed schools– Formal or Non-formal – Geographical Locations

• Stratification by sex from school class registers then • Systematic random sampling for the selection of 6 girls

and 6 boys in each class stream to participate in the study7

Results• 93.6% have heard of HIV AIDS; 26.3% of all respondents

could correctly identify ways of preventing sexual transmission of HIV

• 70.5% of all respondents have stigmatizing attitudes towards People Living with HIV (PLHIV)

• On current risks of HIV infection; 30.3% of respondents aged 15-24 (secondary students) had had sex of which 70% had sex with three or fewer people

• 13.7% of secondary students who reported to have had sex said that they had sexual intercourse before 15 years

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Methods-Selection Criteria Inclusion Criteria• Primary pupils in standard

5, 6 and 7• Secondary Students in form

1, 2 and 3• Key Informants from the

community (HTs, Teachers, PTA reps, BoG reps, DQASOs, Community Leaders ) who were willing to participate in the study

Exclusion Criteria• Any pupils and students

who are not in standards 5, 6 and 7 and forms 1, 2 and 3.

• Any pupils/students and community members who were not willing to participate in the study

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Results

Responses of those who had sex• 62.9% of secondary school students who had sex did not

use condoms in first sexual intercourse; • 24.2% had sex with a partner at least ≥10 years older. • 753 secondary students were asked how often they have

had drugs other than those prescribed by the doctor and 2.8% responded they were influenced by friends, 1.6% it makes them feel better.

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Television Radio Billboard Clinic Counselor/Teacher/Peer educator

27% 27%

10%

13%

23%24%

16%

10%12%

39%

Primary Secondary

Results Figure 1: Study subjects response on where they heard about HIV and

AIDS (n=1791)

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ResultsFigure 2: Distribution of subjects(secondary) based on their age at first sexual intercourse (N=228)

Less than 11yrs 12 to 14 yrs 15 to 17 yrs 18 to 20yrs Did not indicate age0

10

20

30

40

50

60

70

80

7%11%

14%

1%

67%

Lessons Learnt • Prior to the study, sensitization was done to schools

(teachers, HTs, students) – this was a success factor• Interviewers needed to be young people who could

speak the spoken language (sheng) in the informal settlements

• Peers are more confident sharing information with other peers

• Partnerships, networking and collaboration, is crucial for success not only in programming but also in research involving young people

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Recommendations • Strengthen life skills education delivery in schools with a

focus on promotion of delayed sexual debut and abstinence among the learners

• Enhance students knowledge on prevention of alcohol and drug use/abuse

• Enhance students capacity to make healthier sexual and reproductive health choices and adopt more positive attitudes towards PLHIV

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Conclusions • In-spite of the fact that many young people have heard of

HIV and AIDS, they need to be supported to adopt more positive attitudes towards PLHIV

• Mothers appear to be key confidants of most children & need to be sensitized to better support young people

• Need to incorporate fathers to support young people adopt healthier sexual lifestyles

• Enabling environment within families, in schools & and among peers to support young people adopt and sustain healthier lifestyle 15

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Thank you