Increased protected sex and abstinence among Namibian youth following a HIV risk-reduction intervention: a randomized, longitudinal study

Objective: To evaluate an HIV risk-reduction intervention among Namibian ad olescents. Methods: A randomized trial of a 14-session face-to-face intervention empha sizing abstinence and safer sexual practices conducted among 515 youths (me dian age 17 years and median grade 11) attending 10 secondary schools locat ed in two districts in Namibia. Youths were randomly assigned to the interv ention or control condition at the level of the individual. HIV risk behavi ours, intentions and perceptions were assessed at baseline, immediately pos t-intervention and at 6 and 12 months post-intervention. Results: Among all 515 youths who enrolled in the programme, rates of eithe r abstinence or sex with a condom were not different between control and in tervention youths at baseline or in the follow-up period. However, analyses conducted among the subset of youths who were sexually inexperienced at ba seline (n = 255) revealed that a higher percentage of intervention youths ( 17%) than control youths (9%, P < 0.05) remained sexually inexperienced one year later. Moreover, in the immediate post-intervention period, among bas eline virgins who subsequently initiated sex, intervention youths were more likely than control youths to use a condom (18 versus 10%, P < 0.05). Addi tional HIV-related risk behaviours (failure to discuss previous HIV risk ex posure with one's sexual partner and alcohol use), intentions to use condom s, and perceptions of the ability to use condoms were positively affected b y the intervention. Conclusions: There is evidence that the 'My Future is My Choice' (MFMC) int ervention is reducing HIV risk behaviours among sexually inexperienced part icipants aged 15-18. Related risk behaviours and perceptions are also posit ively impacted by the intervention. (C) 1998 Lippincott Williams & Wilkins.