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I. PROGRAM RESOURCES
1. Assessing Change in the Knowledge, Attitudes and Practices of Youth in Two Districts of Imereti, Georgia, Regarding Healthy Lifestyles and Reproductive Health
2. Assessing the Quality of Youth Peer Education Programmes
3. Building a Better Future for Youth: Learning from Experience and Evidence
4. Children and AIDS: A Stocktaking Report
5. Communication Impact: "Know Yourself" Toolkit
6. In Their Own Words: The Formulation of Sexual and Health-related Behaviour among Young Men in Bangladesh
7. Our Future: Sexuality and Life Skills Education for Young People
8. Performance Improvement: A Resource for Youth Peer Education Managers
9. Promoting Young People's Sexual Health: International Perspectives
10. Scaling Up a Reproductive Health Curriculum in Youth Training Courses
11. Social Relationships and Adolescents' HIV Counseling and Testing Decisions in Zambia
12. Tuko Pamoja: A Guide for Talking with Young People about their Reproductive Health and Tuko Pamoja: Adolescent Reproductive Health and Life Skills Curriculum
II. RESEARCH SUMMARIES
1. AIDS health beliefs and intention for sexual abstinence among male adolescent students in Kathmandu, Nepal: A test of perceived severity and susceptibility
2. Continuity and change in premarital sex in Vietnam
3. Factors inhibiting educated mothers in Kenya from giving meaningful sex-education to their daughters
4. Health consequences of child marriage in Africa
5. Internet use among Ugandan adolescents: implications for HIV intervention
6. Poor pregnancy outcomes among adolescents in South Nyanza region of Kenya
7. Teachers' attitude is not an impediment to adolescent sexuality education in Enugu, Nigeria
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I. PROGRAM RESOURCES
1. Assessing Change in the Knowledge, Attitudes and Practices of Youth in Two Districts of Imereti, Georgia, Regarding Healthy Lifestyles and Reproductive Health (2006, PDF, 1.16 MB)
This document reports on the mid-term results of the behavior change and communication component of the Healthy Women in Georgia project and includes three case studies of project participants. The population-based study examined reproductive health and related lifestyle issues of youth.
Organization: Save the Children, JSI
Contact: larry@savechildren.ge
2. Assessing the Quality of Youth Peer Education Programmes (2006)
Part of a global peer education toolkit, this manual is a series of checklists with guidance for program managers to use in assessing a peer education program. Developed through YouthNet's peer education research project, these evidence-based checklists can help determine how a peer education project can best function.
Organization: Family Health International, UNFPA, Y-PEER
Contact: youthnetpubs@fhi.org
3. Building a Better Future for Youth: Learning from Experience and Evidence (2006, PDF, 943 KB)
This report summarizes a regional forum on youth reproductive health and HIV programs in sub-Saharan Africa. About 90 national, regional, and international researchers, donors, program managers, youth, and policy-makers from nine African countries and global organizations participated.
Organization: Population Council/FRONTIERS, WHO/RHR, FHI/YouthNet
Contact: youthnetpubs@fhi.org
4. Children and AIDS: A Stocktaking Report (2007, PDF, 2.11 MB)
This report assesses some of the most important actions and changes for children affected by HIV/AIDS that have taken place in the first year of the "Unite for Children, Unite against AIDS" campaign. It seeks to identify trends through comparing data against a baseline used here for the first time in the areas of preventing mother-to-child transmission of HIV, preventing infection among adolescents and young people, and other areas.
Organization: UNAIDS, UNICEF and WHO
Contact: pubdoc@unicef.org
5. Communication Impact: "Know Yourself" Toolkit (2007, PDF, 365 KB)
This brief describes an intervention in Bangladesh focused on reducing premarital sex among young men. The interactive, multi-media toolkit, part of the Bangladesh Adolescent Reproductive Health Communication Program, contributed to a reduction in premarital sex among adolescent males, improved adolescents' knowledge of reproductive health, and increased the perception that their peers favor safer sexual behavior and abstinence until marriage. The program includes radio and TV magazine programs, a TV variety show with mini-drama for youth, an HIV/AIDS awareness campaign, and a national campaign encouraging youth to "Know Themselves."
Organization: Health Communication Partnership
Contact: orders@jhuccp.org
6. In Their Own Words: The Formulation of Sexual and Health-related Behaviour among Young Men in Bangladesh (Summary Report, 2006, PDF, 3.16 MB)
A study conducted in Bangladesh has generated qualitative data to better understand the scripts through which sexual attitudes and sexual and health-related behaviors among young men aged 10-24 are influenced and formulated. Both a Full Report and a Summary Report describing the methodology, findings, and recommendations have been produced, as well as a CD-ROM entitled A Guide for Conducting Research on the Formulation of Sexual and Health-related Behaviour among Young Men. The CD-ROM provides all the information needed to replicate the study and related resources and guides for participatory research discussion groups, interviews, and focus groups. The full report and the CD-ROM content can be downloaded in PDF format here or the PDF of the CD-ROM can be accessed directly by clicking here (10.57 MB).
Organization: Naz Foundation International, ICCDRB, AED
Contact: London@nfi.net
7. Our Future: Sexuality and Life Skills Education for Young People (2006, PDF, 2.87 MB)
This book, the first in a series of three, is intended for children and provides information about puberty, friendship, gender, sexuality, pregnancy, sexually transmitted infections, HIV and AIDS, and drug use. Designed for children in grades 4-5, the books contain many learning activities and illustrations. The topics and activities were designed for the Zambian national curriculum or to be used in extra curricular activities in or out of school. The books are accompanied by a Teachers' Guide. The second and third books, designed for children in grades 6-9, are forthcoming.
Organization: International HIV/AIDS Alliance
Contact: mail@aidsalliance.org
8. Performance Improvement: A Resource for Youth Peer Education Managers (2006)
Part of a global peer education toolkit, this manual is designed for managers to improve the quality of their programs. It builds on quality improvement materials from other fields, providing a tool for self-assessment, group resolution, and action planning, with sample activities from the field. It has a section on program management basics with common examples from peer education projects.
Organization: Family Health International, UNFPA, Y-PEER
Contact: youthnetpubs@fhi.org
9. Promoting Young People's Sexual Health: International Perspectives (2006). Available for purchase at www.routledge.com or www.amazon.co.uk.
This book is the culmination of the six year Safe Passages to Adulthood project. Intended for policy-makers, practitioners, researchers, teachers, and students, the book covers understanding young people and sexual health, most vulnerable groups, and approaches to improving youth sexual and reproductive health.
Contact: http://www.safepassages.soton.ac.uk
10. Scaling Up a Reproductive Health Curriculum in Youth Training Courses (2006, PDF, 599 KB)
The Population Council and the Government of Bangladesh have been working to improve adolescent reproductive health for many years through a reproductive health education project. This paper reports on the expansion of the work to introduce it to vocational training centers, and on the results of the scale-up.
Organization: Population Council
Contact: dipak@pcdhaka.org
11. Social Relationships and Adolescents' HIV Counseling and Testing Decisions in Zambia (2006, PDF, 416 KB)
This research summary describes a study that examined individual, relational, and environmental factors that influenced experiences related to voluntary counseling and testing. The brief includes programmatic implications of research results.
Organization: Population Council
Contact: horizons@pcdc.org
12. Tuko Pamoja: A Guide for Talking with Young People about their Reproductive Health (2006, PDF, 444 KB) and Tuko Pamoja: Adolescent Reproductive Health and Life Skills Curriculum (2006, PDF, 1.17 MB)
These two documents were developed by the Kenya Adolescent Health Project. The guide is designed for adult health professionals and provides information and tips to improve their communication skills. The life skills curriculum includes 30 sessions and is designed for teachers, group leaders, health professionals and others working with youth.
Organization: PATH
Contact: info@path-kenya.or.ke
II. RESEARCH SUMMARIES
1. AIDS health beliefs and intention for sexual abstinence among male adolescent students in Kathmandu, Nepal: A test of perceived severity and susceptibility. Iriyama S, Nakahara S, Jimba M, et al. Public Health 2007;121(1).
This study examined whether two subscales of the Health Belief Model (HBM), perceived severity and perceived susceptibility, are associated with abstinence intention among Nepalese male adolescent students, as it relates to HIV/AIDS prevention. A school-based study was conducted at a single school located in central Kathmandu from July to August 2002, with 183 male students in grades 9-12 and aged 14-19 years. Anonymous self-reported questionnaires were used, and Zagumny's AIDS Health Belief Scale was adopted as a measure of perceived severity and perceived susceptibility. Over half of the students (53%) strongly agreed with abstinence intention. Students with higher levels of perceived severity strongly agreed with abstinence intention [crude odds ratio 1.86, 95% confidence interval (CI) 1.02-3.38; adjusted odds ratio 1.94, 95% CI 1.05-3.58], but those with higher levels of perceived susceptibility did not. Moreover, age-stratified analysis showed that a high level of perceived susceptibility tended to decrease strong abstinence intention among students aged 16-19 years. Perceived severity enhanced abstinence intention. The interpretations of perceived susceptibility need further examination through a longitudinal study among students aged 16-19 years. Furthermore, future research is needed to assess the effect of HIV/AIDS education on HIV/AIDS prevention strategies using perceived severity as a motivational tool to help persuade Nepalese male students to abstain from sexual intercourse.
2. Continuity and change in premarital sex in Vietnam (PDF, 238 KB). Ghuman S, Loi VM, Huy VT, et al. Int Fam Plan Perspect 2006;32(4).
Premarital sexual activity is thought to be rising in Vietnam. However, there is little evidence documenting such an increase, and it is unknown whether levels of premarital sex differ between northern and southern Vietnam and whether premarital sex occurs primarily with a future spouse. Surveys conducted in northern Vietnam (Red River Delta) and southern Vietnam (Ho Chi Minh City and surrounding environs) in 2003-2004 among individuals married during one of three important periods in Vietnamese history (1963-1971, 1977-1985 or 1992-2000) were used to assess trends and regional differences in the prevalence and context of premarital sex. In both regional samples, 31% of men who married in 1992-2000 reported having had premarital sex. The proportion was much lower among women (8% in the South, 12% in the North). The prevalence of premarital sex rose markedly across cohorts in the North but only modestly in the South. Relatively few men had premarital sex with someone other than a future spouse (3-23%). The proportion of the rise in the prevalence of premarital sex that was due to sex exclusively with a future spouse was greater in the North (42%) than in the South (25%). These results suggest that premarital sex is becoming more common in Vietnam but is still not widespread. Better information about the sexual networks of men in the general population and their contacts with high-risk groups (e.g., commercial sex workers) is needed to ascertain the likelihood that HIV/AIDS will spread to the general population.
3. Factors inhibiting educated mothers in Kenya from giving meaningful sex education to their daughters. Mbugua N. Soc Sci Med 2007;64(5).
Educated mothers are highly likely to pass on their education regarding infectious diseases such as influenza to their children, as well as enforce in their homes healthy practices thereby protecting entire families from disease. However, it is not usually the case when it comes to sexually transmitted infections (STIs) such as HIV/AIDS. The research is based on a survey focus group discussion with high-school students (aged 17-19) and interviews with 10 high-school teachers in 1996. In 2003, data were collected from a focus group with fourth-form students and interviews with 4 teachers and 15 mothers whose daughters were in high school. The findings indicate that most educated mothers in urban Kenya experience socio-cultural and religious inhibitions that hinder them from providing meaningful sex education to their pre-adolescent and adolescent daughters. This paper discusses these inhibitions and the steps educated mothers can take to ensure that their daughters receive some form of sex education.
4. Health consequences of child marriage in Africa. Nour NM. Emerg Infect Dis 2006;12(11).
Despite international agreements and national laws, marriage of girls <18 years of age is common worldwide and affects millions. Child marriage is a human rights violation that prevents girls from obtaining an education, enjoying optimal health, bonding with others their own age, maturing, and ultimately choosing their own life partners. Child marriage is driven by poverty and has many effects on girls' health: increased risk for sexually transmitted diseases, cervical cancer, malaria, death during childbirth, and obstetric fistulas. Girls' offspring are at increased risk for premature birth and death as neonates, infants, or children. To stop child marriage, policies and programs must educate communities, raise awareness, engage local and religious leaders, involve parents, and empower girls through education and employment.
5. Internet use among Ugandan adolescents: implications for HIV intervention (PDF, 125 KB). Ybarra ML, Kiwanuka J, Emenyonu N, Bangsberg DR. PLoS Med 2006;3(11).
The feasibility and accessibility of Internet-based health interventions in resource-limited settings, where cost-effective interventions are most needed, is unknown. To determine the utility of developing technology-based interventions in such settings, availability and patterns of usage of the Internet need to be assessed. The Uganda Media and You Survey was a cross-sectional survey of Internet use among adolescents (ages 12-18 years) in Mbarara, Uganda, a municipality mainly serving a rural population in sub-Saharan Africa. Participants were randomly selected among eligible students attending one of five participating secondary day and boarding schools in Mbarara, Uganda. Of a total of 538 students selected, 93% (500) participated. Of the respondents, 45% (223) reported ever having used the Internet, 78% (175) of whom reported going online in the previous week. As maternal education increased, so too did the odds of adolescent Internet use. Almost two in five respondents (38% [189]) reported already having used a computer or the Internet to search for health information. Over one-third (35% [173]) had used the computer or Internet to find information about HIV/AIDS, and 20% (102) had looked for sexual health information. Among Internet users, searching for HIV/AIDS information on a computer or online was significantly related to using the Internet weekly, emailing, visiting chat rooms, and playing online games. In contrast, going online at school was inversely related to looking for HIV/AIDS information via technology. If Internet access were free, 66% (330) reported that they would search for information about HIV/AIDS prevention online. Both the desire to use, and the actual use of, the Internet to seek sexual health and HIV/AIDS information is high among secondary school students in Mbarara. The Internet may be a promising strategy to deliver low-cost HIV/AIDS risk reduction interventions in resource-limited settings with expanding Internet access.
6. Poor pregnancy outcomes among adolescents in South Nyanza region of Kenya. Magadi M. Afr J Reprod Health 2006;10(1).
This paper examines factors associated with poor pregnancy outcomes among teenagers in the South Nyanza region of Kenya. The analysis is based on a recent WHO-funded study on adolescent safe motherhood in the region, which involved a survey of 1,247 adolescents aged 12-19 and in-depth interviews with 39 of the adolescents who had experienced very early pregnancies or a pregnancy wastage. The indicators of poor pregnancy outcomes analyzed include pregnancy wastage and pre-term delivery. A striking finding is the unusually high rate of pre-term deliveries, especially in cases of unintended pregnancies. Analysis of the qualitative data based on in-depth interviews sheds some light on possible explanations for the poor pregnancy outcomes observed among these adolescents. In particular, unsafe abortion attempts and poor maternal healthcare emerge as important issues of concern.
7. Teachers' attitude is not an impediment to adolescent sexuality education in Enugu, Nigeria. Iyoke CA, Onah HE, Onwasigwe CN. Afr J Reprod Health 2006;10(1).
A nationally-approved school curriculum on sexuality education has not been applied in many secondary schools in Nigeria, possibly due to a negative attitude of teachers. This study sought to determine the attitude of secondary school teachers in Enugu, Southeastern Nigeria, to adolescent sexuality education and to determine whether this depends on their socio-demographic characteristics. A cross-sectional study of the attitude of teachers to adolescent sexuality education was done, with 249 teachers. Their mean age was 38.7 years +/- 8.08 SD. Two hundred and ten teachers (84%) were females. Two hundred and twenty-four teachers (90%) were married and 168 (67.5%) were of Roman Catholic faith. The awareness of reproductive health activities was high. There was a high proportion of respondents who approved of sexuality education for adolescents (77.5%) and an equally high proportion who believed that it was important (89%). One hundred and ninety-eight (79%) of the respondents were willing to teach sexuality education. The attitude to sexuality education was independent of religion, sex, or marital status (p>0.05). It was concluded that secondary school teachers in urban Enugu were willing to offer sexuality education to adolescents under their care, irrespective of their religion, sex, or marital status. It is, therefore, recommended that teachers in Enugu be given the necessary special training in the teaching of sexuality education now and that sexuality education be officially incorporated into the school curriculum in Enugu, preferably as part of moral studies.
