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Our search identified 22 studies (16,17, 24-44) meeting the inclusion criteria. The characteristics of the 22 interventions and their respective evaluations are summarized in Table 5.3 and Table 5.4, respectively. The impact of all these interventions on specified behaviours is summarized in Table 5.5 as well as in Table 5.4a and Table 5.4b.

5.3.1 Characteristics of interventions

Of the 22 studies and respective interventions, 17 were curriculum-based and 5 were non-curriculum based. Of the 17 curriculum-based interventions, 14 incorporated at least four fifths of the characteristics described in Box 5.1. Altogether, 15 of the 17 were taught primarily by adults and 2 were taught solely by peers. Of the 15 taught by adults, 10 were taught by the schools' teachers and the remaining 5 were taught by other adults, such as health-workers, trained counsellors and facilitators, and young adult volunteers. However, of the 15 interventions led by adults, 2 also involved peer educators in significant ways. Of the five non-curriculum-based interventions, four were primarily led by teachers or other adults and one by peers.

A total of 16 of the interventions evaluated had been implemented in secondary schools; five had been implemented in primary schools; and three had been implemented in night schools or teacher-training colleges. (The sum exceeds 22 because one intervention was implemented in both primary and secondary schools and another in both secondary and night schools.)

Finally, only three of the interventions were abstinence-only interventions; the remainder of the interventions encouraged abstinence but also discussed or promoted the use of condoms or contraception for young people who chose to be sexually active.

5.3.2 Characteristics of the studies

Eight of these studies used an experimental design, while the remaining 14 used a quasi-experimental design. In order to be included in the review, all

Table 5.3

Descriptions of the interventions by study

Study, location and programme

Target population and primary objectives

Description

Curriculum-based interventions with characteristics of effective programmes

Adult-led (teachers)

A-Thailand,

Teens on Smart Sex (16)

•Youths aged 18-21 years in urban areas • Targeted sexual initiation, number of partners and condom use

• Addressed issues of love, attitudes toward HIV and sexuality, living with HIV/AIDS, HIV and pregnancy prevention, health services

• Practiced negotiating skills

B-Chile, Teen Star (24)

• Youths aged 15-16 years in urban areas

• Pregnancy prevention

• Minimum 10.5 hours involving participants in group discussions, brainstorming

•Tackled issues such as gender, prejudice, anatomy, puberty, fertility, emotions, media, self-assurance, decision-making, marriage and family, family planning methods, pregnancy and birth

• Used class discussions, fertility awareness activities, role-playing and homework

C - United Republic of Tanzania, "Ngao" (25)

• Youths aged 10-16 years in urban and rural areas

• Targeted sexual initiation

• Covered transmission of AIDS, personal HIV risk, refusal skills, communication with parents and community

• Used lectures, posters, songwriting, discussion, role-playing, etc.

Primary school action for better health (17)

• Youths aged 11-17 years in urban and rural areas

• Targeted sexual initiation

• Tackled issues such as abstinence, condom use, school planning, guidance, transmission and prevention of STIs,a HIV and AIDS; life skills; health, sexuality, HIV management

• Used participatory methods

• Set up school health clubs

E - Mexico, Planeado tu Vida (26)

• Youths with mean age 14.4 years •Targeted sexual initiation and contraceptive use

• Discussed relationships, sexuality, anatomy, physiology, reproduction, STIs, contraception, decision-making, consequences, self-esteem, values, communication, assertiveness

• Used role-plays and writing exercises

F-South Africa, Life skills (27, 28)

G - United Republic of Tanzania, MEMA kwa Vijana (Good things for young people) (29)

1 Youths aged 12-21 years in urban and rural areas

> Targeted frequency of sexual activity, condom use, number of partners

> Youths aged 12-19 years in rural areas

> Targeted sexual initiation, condom use, number of partners, STIs, pregnancy

• Covered HIV/AIDS, immune system, self-esteem, self-awareness, relationships, values, sexuality, abstinence, condom use, rape/abuse, decision-making, conflict resolution, etc.

• Used interactive and didactic methods, including group work and role-plays

• In-school programme was teacher-led, also peer-assisted

• Covered refusal, self-efficacy, self-esteem, STI/HIV, sexuality, contraception, abstinence, access to reproductive care and contraception, social values, respect, gender

• Used drama, stories, games

• Also developed more youth-friendly health services

H-Chile,

Teen STAR campaign (30)

Adult-led (other than teachers)

»Youths with mean age 15.8 years in urban areas »Targeted sexual initiation

Sexuality, Reproduction and AIDS Prevention (31)

' Youths aged 18-25 years in < urban areas <

» Targeted sexual initiation, condom use, frequency of sex, number of partners, type of < partners, unprotected sex Curriculum-based interventions with characteristics of effective J-Jamaica, »Youths aged 11-14 years in <

Grade 7 project (32) urban and rural areas <

• Targeted sexual initiation, contraceptive use

18 units

Discussed male and female fertility, menstrual cycle, psychosexual development, sexual responsibility, relationships, contraception, STIS Used experiential learning methods to explore feelings, values and attitudes

12 hours

Covered AIDS symbolism, knowledge and impact of AIDS, risk perception, sexual norms, reproduction and sexual pleasure, condom use negotiation

Used discussions, role-plays, group dynamics, models, demonstrations programmes

27 hours

Covered reproductive anatomy and physiology, STIs, contraceptive methods and myths, risks and consequences of sex and pregnancy, media, norms

Used classroom lectures, visual aids, question and answer sessions, small group discussions

Study, location and programme

Target population and primary objectives

Description

K - Nigeria, School-based AIDS education (33)

•Youths with mean age 17.7 in urban areas • Targeted sexual initiation, contraceptive use, number of partners, STIs

•Covered transmission and prevention of AIDS, attitudes towards HIV/ AIDS, sexual practices, contraceptive use

• Used lectures, films, role-plays, stories, songs, debates, essays, condom use demonstrations

L - Mexico, HIV prevention workshop and condom distribution (34)

• Youths with mean age 17.6 years in urban areas

• Targeted sexual initiation, frequency of sexual intercourse, unprotected sex

• Covered HIV attitudes, myths, facts and risk, effects of AIDS, HIV transmission and prevention, living with HIV, condom use and negotiation skills

• Used dramas, games, role-plays, videos, HIV-positive speaker, discussions, condom use demonstration

M - Namibia, My future is my choice (35)

• Youths aged 9-11 years in urban and rural areas •Targeted sexual initiation, number of partners, condom use, frequency of sexual activity

• Discussed reproductive biology and HIV/AIDS, risk behaviours, communication skills, framework for decision-making

• Used narratives, games, facts, exercises, questions and discussions

Peer-led

N - Belize, Project Light (36)

•Youths aged 13-17years in urban areas

•Targeted sexual initiation, number of partners, condom use

• Covered HIV transmission and prevention, barriers and solutions to avoiding sex or using condoms, peer pressure, condom use, communication

• Used role-plays, exercises, skill-building activities, peer role-model testimonials

Curriculum-based interventions without characteristics of effective programmes

Adult-led (teachers)

A Team Against AIDS (37)

•Youths aged 13-23years in urban areas

• Targeted sexual initiation, condom use

• Covered sexuality, anatomy and physiology, values, HIV/AIDS transmission, myths, prevention, risk perception, safer sex, abstinence, assertiveness, self-esteem, etc.

P-Chile,

• Urban youths

• Duration of 2 years

Adolescence, a time of

• Targeted sexual initiation,

• Covered relationships, parent-child communication, goals,

decision-making (38)

contraceptive use

reproductive physiology, postponing sex, STIs, gender, risk

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