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Table 2 Study Results for Eight Youth HIV Prevention Interventions included in Systematic Review1

From: HIV prevention for South African youth: which interventions work? A systematic review of current evidence

Project Name and Location Impact of Intervention on: Knowledge, Attitudes, Perceptions, Social Norms Behavioral skills and intentions for risk reduction (communication, negotiation, self-efficacy) Sexual and other HIV risk behaviours Clinical and biological outcomes and/or Structural and Community Effects
HAPS [32] [HIV/AIDS Prevention Study] KwaZulu/Natal NB: Study results presented as scores from scaled measures; analyzed using ANOVA for each group, and showing net intervention effect for difference between intervention (I) and comparison (C) groups Positive attitudes to condom use 0.17I vs 0.08C, interv effect: 0.09 Positive attitudes toward alcohol -0.01I vs 0.16C, interv effect: -0.17 Negative attitudes toward alcohol -0.15I vs -0.08C, interv effect: -0.07 Self efficacy for sex refusal 0.08I vs- 0.16C, intervention effect: 0.24 Self efficacy for condom use -0.08I vs -0.06C, intervention effect: -0.02 Self-efficacy for alcohol refusal 0.17I vs 0.44C, intervention effect: -0.27 Condom use intentions: 0.18I vs -0.01C, intervention effect: 0.19 Intentions to have sex - next 3 months: 0.00I vs 0.06C, intervention effect: -0.06 Alcohol Behaviors: Frequency of alcohol use: last 14 days 0.23I vs 0.28C, intervention effect: -0.05 Number of drinks last time drinking 0.36I vs -0.08C, intervention effect: 0.44 Self or partner drinking at last sex -0.9I vs 4.5C, intervention effect: -4.4 HIV-related behavior: Condom use at last sex 4.2I vs 2.2C, intervention effect: 2.0 Not measured
HealthWise [34] CapeTown NB: Assessment of intervention conducted in 5 waves of data collection; unless otherwise specified, results are presented as comparison between intervention (I) and comparison (C) groups at last followup (wave 5) Non-users of alcohol, cigarettes, and marijuana at wave 1* Lifetime Use Alcohol: 62%I vs 60%C, OR = 0.9 [0.7-1.2] Cigarettes: 39%I vs 45%C, OR = 1.2 [0.9-1.6]3 Marijuana: 45%I vs 45%C, OR = 1.0 [0.8-1.2]** Use in past month: Alcohol: 22%I vs 29%C, OR = 1.4 [0.99-2.0]3 Cigarettes: 28%I vs 35%C, OR = 1.4 [1.04-1.8]3 Marijuana: 18%I vs 15%C, OR = 0.8 [0.6-1.1]** Heavy use: Alcohol: 8%I vs 12%C, OR = 1.7 [1.04-2.6]3 Cigarettes: 13%I vs 17%C, OR = 1.4 [0.9-1.9]3 Sexual risk: Perception of condom availability (condom access: can get condoms): 95%I vs 92%C, OR = 1.6 [1.03-2.4] Alcohol, Smoking and Marijuana* Alcohol use in: Past month: 32%I vs 39%C, OR = 1.4 [1.1-1.8]3 Heavy use: 13%I vs19%C, OR = 1.6 [1.2-2.2]3 Cigarette use in: Past month: 41% vs 48%, OR = 1.4 [1.1-1.7]3 Heavy use: 22%I vs 28%, OR = 1.4 [1.1-1.8]2.3 Marijuana use in past month: 22%I vs 18%C, OR = 0.8 [0.6-1.1]** **in males, significantly higher reported use in intervention group Sexual Behavior Sexually active (lifetime) among those not sexually experience at baseline: 22%I vs 21%C, OR = 1.0 [0.8-1.3] Frequency of: Sexual activity (past month)***: -6 I [-19 -+6] vs -2C [-12 - +8] Condom use (always)**: 0 I [-12 -+12] vs +2C [-9 -+12] *Since knowledge and attitudes of alcohol and other substances were not reported, these columns report data on use behaviors in those experienced (column 2) and not experienced (column 1) at baseline. ***reported as 'change in prevalence' between waves 4 and 5 of assessment Not measured
Mpondombili Project [33] KwaZulu/Natal NB: *denotes significance at p < 0.05 level, based on analysis of data using regression methods for comparison of I and C groups at follow up. General HIV Knowledge3: 67.3%I vs 54.7C, beta coefficient: .26 [-4.30 - +4.35]* Know where to access HIV test2: 76.6%I vs 62.6%C, beta: 0.57 [0.08-1.05] Peer norms for abstinence (mean score): 3.38I vs 3.67C, beta: 0.28 [-0.04-0.59]* Peer norms for girls' condom use (mean): 2.42I vs 2.24C, beta: -0.07 [-0.27-0.12] Egalitarian beliefs about sex refusal: 6.27I vs 6.07C, beta: 0.38 [-0.20-0.97] Self-efficacy for sex refusal3: 84.8%I vs 77.8%C, beta: 0.49 [0.25-1.24]* Self-efficacy for condom use3: 93.8%I vs 87.0%C, beta: 0.61 [0.06-1.16]* Communication with partner about condoms3: 74.7%I vs 57.5%C, beta: 2.18 [1.21-3.91]* Perceived risk for HIV: 90.8%I vs 86.5%C, beta: 0.09 [-0.40-0.58] Perceived risk for pregnancy: 57.8%I vs 49.2%C, beta: 0.19 [-0.16-0.54] Ever condom use3: 67.3% I vs 41.9%C, OR = 2.85 [1.62-5.04]* Condom use at last sexual intercourse2,3: 54.3%I vs 27.9%C, OR = 3.21 [1.76-5.85]* Ever had sex2: 28.5%I vs 22.2%C, OR = 1.39 [1.02-1.91]* Not measured
Adolescent Livelihoods [35] KwaZulu/Natal NB: Preliminary findings. No measures of significance provided. Indicators of financial well-being Has savings: M: 34%I vs 34%C; F:27%I vs 8%C Used financial services from a bank: M: 49%I vs 32%C; F:17%I vs 3%C Discussed financial decisionmaking M: 56%I vs 23%C; F: 75% I vs 21%C Partner communication in last year Self-esteem: M: 51%I vs 23%C; F: 70%I vs 26%C Delay/avoid sex in last 12 months F: 76%I vs 66%C Sexuality M: 49%I vs 19%C; F: 67%I vs 26%C Contraception M: 49%I vs 19%C; F: 60%I vs 29%C Violence/Sexual Abuse M: 51%I vs 21%C; F: 62%I vs 24%C Condom use M: 56%I vs21%C; F: 75%I vs 29%C Among women: Reported HIV testing: 34% baseline vs 57% post-I Discussed avoiding STDs with partner: 91%I vs 89%C Discussed avoiding HIV with partner: 87%I vs 77%C Not measured
SATZ [31, 37] CapeTown and Northern Province NB: With regard to outcomes, preliminary findings only are available. Process evaluations have been published[51, 52]. Knowledge, Attitudes, Social Norms, Self-efficacy were measured. Knowledge increased in intervention schools No intervention effects observed. No effects on sub-groups or for secondary outcomes. Sexual Risk Behavior Ever had sex: 25.6%I vs 24.6%C, OR = 1.0 [0.85-1.18] Transition to sexual activity: 19.0%I vs 16.7%C, OR = 1.05 [0.85-1.29] Condon use at last sex: 50.2%I vs 44.9%C, OR = 1.13 [0.79-1.62] Not measured
Stepping Stones [11, 38] Eastern Cape NB: As knowledge, attitudes and related measures were not reported in main outcome paper, these categories are not included here. Results are from 24 month follow-up. Correct condom use at last sex M: 73.2%I vs 75.1%C, OR = 0.88 [0.64-1.21], p = 0.43 F: 57.5%I vs 59.6%C, OR = 0.90 [0.70-1.17], p = 0.45 Problem drinking: M: 26.6%I vs 25.7%C, OR = 1.1 [0.81-1.49], p = 0.56 F: 3.4%I vs 2.2%C, OR = 1.4 [0.61-3.17], p = 0.43 Ever misused drugs M: 6.5%I vs 12.0%C, OR = 0.50 [0.23-1.11], p = 0.88 F: 2.3%I vs 1.9%C, OR = 1.2 [0.51-2.83], p = 0.68 Depression M: 2.8%I vs 5.0%C, OR = 0.52 [0.24-1.13], p = 0.56 F: 12.8%I vs 16.1%C, OR = 0.76 [0.51-1.15], p = 0.20 Number of partners (past year): M (mean): 2.15I vs 2.39 C, effect: -0.0045 [-0.023-0.0003], p = 0.12 F: (mean): 1.19I vs 1.19 C, effect: 0.0001 [-0.0012-0.0025], p = 0.73 Transactional sex w/casual partner M: 1.8%I vs 1.9%C, OR = 1.02 [0.39-2.65], p = 0.031 F: 2.0%I vs 2.2%C, OR = 0.94 [0.41-2.18], p = 0.89 >1 incident intimate partner violence M: 6.2%I vs 96%C, OR = 0.62 [0.38-1.01], p = 0.054 F: 14.7%I vs 13.5%C, OR = 1.12 [0.77-1.68], p = 0.51 Any casual partner M: 53.1%I vs 56.9%C, OR = 0.85 [0.62-1.13], p = 0.29 F: 18.3%I vs 16.3%C, OR = 1.17 [0.85-1.63], p = 0.34 Biological HIV incidence: F: 5.65I vs 6.95C M: 1.4I vs 1.29C, p = 0.78 HSV-2: F: 5.35I vs 7.71C M: 1.46I vs 2.04C, p = 0.36 Pregnancy F: 14.4I vs 11.6C, OR = 1.45 [0.92-2.28], p = 0.11 M: 11.3I vs 12.9C, OR = 0.88 [0.60-1.31], p = 0.53
Tshwane Peer Education and Support Programme [36] Tshwane (Pretoria), Gauteng NB: In published results, measures of significance were based on 'within group' comparisons (eg., pre- and post-test). For consistency, we present 'between group' comparisons of the post-test measures in I (n = 1572) and C (n = 532) groups. Perception of peer sexual activity (most friends having sex) 20.7%I vs 25.4%C Friends practice safe sex 51.0%I vs 54.2%C Most friends drink alcohol 25.0%I vs 27.2%C Findings reported as difference in scale scores: Psychological well-being: 52.44I (SD6.8) vs 51.51C(SD6.8) Personal control: 7.48I(SD2.1) vs 8.10C(SD2.1) School Climate: 57.49I(SD11.4) vs 58.31C(11.7) Sexual experience: 41.6%I vs 46.2%C Sex during past 3 months: 36.9%I vs 30.8%C Multiple partners in past 3 months 15.6%I vs 17.3%C Condom use every time in last 3 months: 59.3%I vs 54.7%C Sex without consent 19.7%I vs 20.8%C Current Alcohol Use 21.9%I vs 22.7%C Excessive alcohol use 13.1%I vs 18.0%C Illicit drug use 6.5%I vs 7.2%C Not measured
IMAGE - Intervention with Microfinance fir AIDS and Gender Equity [12, 13] Knowing HIV+ person can look healthy: 91% I vs 87%C, RR = 1.09 [0.73-1.62] Comfort discussing sexuality in the home: 84%I vs 68%C, RR = 1.22 [0.53-2.80] Communication in h'hold about sex (past year): 74%I vs 50%C, RR = 1.46 [1.01-2.12] >1 sexual partner in past year: 4%I vs 3%C, RR = 0.95 [0.40-2.27] Unprotected last sex, non-spousal partner: 55%I vs 78%C, RR = 0.76 [0.60-0.96] ?HIV test: 29%I vs 18%C, RR = 1.64 [1.06-2.56] No biological outcome measures for analysis of women under age 35
  1. 1All data are presented for combined male and female results, except where published results included only gender-disaggregated results (eg., Stepping Stones and Adolescent Livelihoods projects). 2 Indicates significant findings for sub-sample of males in Intervention vs Control at followup (not shown). 3 Indicates significant findings for sub-sample of females in Intervention vs Control at followup (not shown).