Cognitive and Behavioral Effects of Participatory Sex Education on the Dual Prevention of STI/HIV/AIDS and Unwanted Pregnancies among Adolescents in Kinshasa High Schools, DR Congo

Abstract

Context: With the view to reorient both STI/HIV/AIDS prevention and adolescents pregnancies, this research study aims at evaluating cognitive and behavioral acquisitions, as well as the process of interactive sex education participatory approach among adolescents in Kinshasa high schools. Methods: Based on a "pre and post" virtually experimental design, two crosswise surveys were conducted in Kinshasa, for six months in 2011-2012 on 484 high school students (pre-survey) and on 441 high school students (post-survey), whose age range from 14-19 years including both sexes. Two participatory educational talks (PET) "A" and "B", covered weekly in two different schools, were compared to a control group school. The PET "A" consisted of interactive interpersonal communication sessions given by an external expert as a substitute for the life education course in one school. The PET "B" carried out in another school, included more educational talk sessions, led by the external expert and supplemented by a close follow-up of teenagers divided into small groups of 10 participants. The subjects' assessment was based on their knowledge, attitudes and practices relating to STI/HIV/AIDS dual prevention as well as to unwanted pregnancies. Results: The subjects involved in the PET "B" displayed a better/higher performance based on their knowledge, attitudes and practices related to STI/HIV/AIDS dual prevention and unwanted pregnancies. Broadly speaking, knowledge has been improved 6 times with the PET "B" (OR=6, 10, IC 95%) (3.24-11.9), and 3 times with the PET "A" (OR=3, 45, IC 95%) (1.79-6.81), compared to control school. Similarly, findings on subjects' attitudes show an improvement rated 12 times with the PET "B" (OR=11, 99, IC 95%) (5.67-27.38) and 5 times for the PET "A" (OR=5.51, IC 95%) (2.54-12.87). As far as the subjects' practices are concerned, an improvement of 6 more times of protected sexual intercourses with the PET "B" compared with the control school group (OR=6, 52, IC 95%) (3.60-12.0). The process assessment records a spontaneous involvement of schools enhanced by the positive contribution of Life Education and Biology teachers; add a massive participation of adolescents who requested permanent PET program. Conclusion: The results of this study suggest that school sexual education programs can be improved to increase the quality of apprenticeship. The use of interactive methods and the consideration of the adolescents' specific needs that take into account the gender approach may bring about beneficial advantages on both educational outcomes and reproductive health of adolescents.