The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67524

Dilys Walker, MD¹, Pilar Torres², Juan Pablo Gutierrez Reyes, MPH², and Stefano Bertozzi, MD, PhD². (1) Centro de Investigación de Salud Poblacional, Instituto Nacional de Salud Publica, Avenida Universidad 655, Cuernavaca, Mexico, 52 777 311 3783, dwalker@correo.insp.mx, (2) Division of Health Economics and Policy, Instituto Nacional de Salud Publica, Avenida Universidad 655, Cuernavaca, Mexico

Objective: To measure the impact of an HIV/AIDS/ sexuality curriculum on condom use among first-year high school students. Materials and methods: A prospective, randomized, controlled evaluation of a 32 hour 16 week curriculum that followed the UNAIDS curriculum guidelines. Forty schools were randomized (30 intervention, 10 controls). Prior to the intervention, in January 2002, we applied 11,192 questionnaires about sexual experience and condom use at most recent intercourse. Six months later, following the course, we applied 9,399 follow up questionnaires. Using a fixed-effects regression model to correct for intra-school correlation, we estimated the impact of the intervention on condom use. Results: At baseline, 14% of the controls and 17% of the intervention group reported having had sexual relations. Of these, 52% and 50% respectively reported using a condom at last sexual relation. At six months follow up, controlling for school-level characteristics, more of the intervention group had used a condom at last relation (OR 1.32, 95%CI 1.02-1.70). Although a rarer event, the intervention group was also more likely to have used a condom at first intercourse (OR1.24, 95%CI 1.00-1.55). Conclusions: The results show a positive and significant impact on condom use among students following the intervention even after only six months. The data suggest that a school based intervention aimed at 15-16 year old public high school students can affect positive changes in risk behavior. Longer-term follow-up will enable evaluation of whether other factors, such as changes in social norms, further enhance effectiveness over time.

Learning Objectives:

• Describe risk behavior among first year high school students in México.
• Evaluate the effectiveness of a low cost HIV/AIDS prevention curriculum aimed at Mexican high school students.
• Recognize the importance of school based interventions for improving the sexual and reproductive health of Mexican adolescents.

Keywords: Condom Use, School-Based Programs

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.