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El Proyecto Regai Dzive: un ensayo aleatorizado, controlado, por grupos ( clusters ) para determinar la efectividad de una intervención multi‐componente basada en la comunidad para prevenir el VIH en una población rural y joven de Zimbabwe: diseño del estudio y resultados de base
Author(s) -
Cowan Frances M.,
Pascoe Sophie J. S.,
Langhaug Lisa F.,
Dirawo Jeffrey,
Chidiya Samson,
Jaffar Shabbar,
Mbizvo Michael,
Stephenson Judith M.,
Johnson Anne M.,
Power Robert M.,
Woelk Godfrey,
Hayes Richard J.
Publication year - 2008
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2008.02137.x
Subject(s) - medicine , cluster randomised controlled trial , cluster (spacecraft) , human immunodeficiency virus (hiv) , intervention (counseling) , baseline (sea) , randomized controlled trial , population , physical therapy , environmental health , family medicine , surgery , nursing , political science , computer science , programming language , law
Summary Objective To assess the effectiveness of a community‐based HIV prevention intervention for adolescents in terms of its impact on (1) HIV and Herpes simplex virus type 2 (HSV‐2) incidence and on rates of unintended pregnancy and (2) reported sexual behaviour, knowledge and attitudes. Methods Cluster randomised trial of a multi‐component HIV prevention intervention for adolescents based in rural Zimbabwe. Thirty communities were selected and randomised in 2003 to early or deferred intervention implementation. A baseline bio‐behavioural survey was conducted among 6791 secondary school pupils (86% of eligibles) prior to intervention implementation. Results Baseline prevalences were 0.8% (95% CI: 0.6–1.0) for HIV and 0.2% (95% CI: 0.1–0.3%) for HSV‐2. Four girls (0.12%) were pregnant. There was excellent balance between study arms. Orphans who made up 35% of the cohort were at increased risk of HIV [age–sex adjusted odds ratio 3.4 (95% CI: 1.7–6.5)]. 11.9% of young men and 2.9% of young women reported that they were sexually active ( P < 0.001); however, there were inconsistencies in the sexual behaviour data. Girls were less likely to know about reproductive health issues than boys ( P < 0.001) and were less likely to have used and to be able to access condoms ( P < 0.001). Conclusion This is one of the first rigorous evaluations of a community‐based HIV prevention intervention for young people in southern Africa. The low rates of HIV suggest that the intervention was started before this population became sexually active. Inconsistency and under‐reporting of sexual behaviour re‐emphasise the importance of using externally validated measures of sexual risk reduction in behavioural intervention studies.