Behavioural intervention trials for HIV/STD prevention in schools: are they feasible?

Objective: To assess the feasibility of conducting a large randomised contr olled trial (RCT) of peer led intervention in schools to reduce the risk of HIV/STD and promote sexual health. Methods: Four secondary schools in Greater London were randomly assigned to receive peer led intervention (two experimental schools) or to act as cont rol schools. In the experimental schools, trained volunteers aged 16-17 yea rs (year 12) delivered the peer led intervention to 13-14 year old pupils ( year 9). In the control schools, year 9 pupils received the usual teacher l ed sex education. Questionnaire data collected from year 9 pupils at baseli ne included views on the quality of sex education/intervention received, an d knowledge and attitudes about HIV/AIDS and other sexual matters. Focus gr oups were also conducted with peer educators and year 9 pupils. Data on the process of delivering sex education/intervention and on attitudes to the R CT were collected for each of the schools. Analysis focused on the acceptab ility of a randomised trial to schools, parents, and pupils. Results: Nearly 500 parents were informed about the research and invited to examine the study questionnaire; only nine raised questions and only one p upil was withdrawn from the study. Questionnaire completion rates were arou nd 90% in all schools. At baseline, the majority of year 9 pupils wanted mo re information about a wide range of sexual matters. Focus group work indic ated considerable enthusiasm for peer led education, among peer educators a nd year 9 pupils. Class discipline was the most frequently noted problem wi th the delivery of the peer led intervention. Conclusion: Evaluation of a peer led behavioural intervention through an RC T can be acceptable to schools, pupils, and parents and is feasible in prac tice. In general, pupils who received the peer led intervention responded m ore positively than those in control schools. A large RCT of the long term (5-7 year) effects of this novel intervention on sexual health outcomes is now under way.