RESULTS OF A MODEL AIDS-PREVENTION PROGRAM FOR HIGH-SCHOOL-STUDENTS IN THE PHILIPPINES

Objectives: To describe the sexual practices of high school students; to describe the process of development of a school-based AIDS preventi on program; and to evaluate the effect of this program on students' AI DS-related knowledge, attitudes and AIDS-preventive behaviors. Subject s and methods: A cluster-randomized, controlled trial with pretest/pos t-test evaluation was conducted in four demographically similar public high schools in a semi-urban district of Metro Manila, the Philippine s. Of 845 high school students who participated in the baseline survey , 804 (95%) completed a postintervention questionnaire. Intervention: An AIDS prevention program was developed by public high school teacher s together with local AIDS experts, social scientists and health educa tors. The teacher-led AIDS program was designed to provide students wi th accurate information about AIDS, particularly in dispelling misconc eptions about casual contagion, to foster positive attitudes towards p eople with AIDS and to develop skills aimed at clarifying values and a ssessing intended behavior. Results: At baseline, 11% of students (20% of males and 4% of females) reported ever having had sexual intercour se (mean age 14 years). Among these, condom use was low (24%). After i mplementation of the AIDS prevention program, statistically significan t effects favoring the intervention group were observed in knowledge a nd attitudes towards people with AIDS. While there was no statisticall y significant overall effect on intended preventive behavior, the prog ram appeared to delay the students' intended onset of sexual activity. Conclusions: A sizable number of Filipino high school students are se xually active but condom use is low. School-based AIDS prevention prog rams can be developed and implemented in developing countries with the assistance of school personnel to address sexual issues. Our program was successful in increasing AIDS-related knowledge and improving atti tudes towards people with AIDS. Supplementation with other preventive activities may be needed to achieve lasting changes in students' risk- taking behavior.