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Infectious diseases
Research
A quasi-experimental evaluation of an HIV prevention programme by peer education in the Anglican Church of the Western Cape, South Africa
  1. Rachel Mash,
  2. Robert James Mash
  1. Department of Family Medicine and Primary Care, Stellenbosch University, Cape Town, Western Cape, South Africa
  1. Correspondence to Dr Rev Rachel Mash; rmash{at}mweb.co.za

Abstract

Introduction Religion is important in most African communities, but faith-based HIV prevention programmes are infrequent and very rarely evaluated.

Objective The aim of this study was to evaluate the effectiveness of a church-based peer education HIV prevention programme that focused on youth.

Design A quasi-experimental study design compared non-randomly chosen intervention and control groups.

Setting This study was conducted in the Cape Town Diocese of the Anglican Church of Southern Africa.

Participants The intervention group of 176 teenagers was selected from youth groups at 14 churches and the control group of 92 from youth groups at 17 churches. Intervention and control churches were chosen to be as similar as possible to decrease confounding.

Intervention The intervention was a 20-session peer education programme (Fikelela: Agents of Change) aimed at changing risky sexual behaviour among youth (aged 12–19 years). Three workshops were also held with parents.

Primary and secondary outcome measures The main outcome measures were changes in age of sexual debut, secondary abstinence, condom use and numbers of partners.

Results The programme was successful at increasing condom usage (condom use score 3.5 vs 2.1; p=0.02), OR 6.7 (95% CI 1.1 to 40.7), and postponing sexual debut (11.9% vs 21.4%; p=0.04) absolute difference 9.5%. There was no difference in secondary abstinence (14.6% vs 12.5%; p=0.25) or with the number of partners (mean 1.7 vs 1.4; p=0.67) and OR 2.2 (95% CI 0.7 to 7.4).

Conclusion An initial exploratory quasi-experimental evaluation of the Agents of Change peer education programme in a church-based context found that the age of sexual debut and condom usage was significantly increased. The study demonstrated the potential of faith-based peer education among youth to make a contribution to HIV prevention in Africa. Further evaluation of the effectiveness of the programme is, however, required before widespread implementation can be recommended.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2011-000638

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    Footnotes

    • Reporting guidelines This is a quasi-experimental study, and the reporting guidelines are not listed.

    • To cite: Mash R, Mash RJ. A quasi-experimental evaluation of an HIV prevention programme by peer education in the Anglican Church of the Western Cape, South Africa. BMJ Open 2012;2:e000638. doi:10.1136/bmjopen-2011-000638

    • Contributors Both Dr Rev R Mash and Prof RJ Mash made substantial contributions to the conception and design, acquisition of data and analysis and interpretation of data. Both authors drafted the article and revised it critically for important intellectual content and both gave final approval of the version to be published.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests The principal researcher Rev Dr Canon Rachel Mash was also the manager of the Fikelela project and creator of the Agents of Change programme. She was however not directly involved in data collection or analysis as this was done by research assistants and a consultant statistician. This research project formed the basis of her doctoral degree that was supervised by Prof PJT de Villiers, Prof C Kapp and Prof R Mash, who ensured a high level of scholarship and research ethics. The research was also independently examined by three experts for her doctoral degree. Both Rev Dr Canon Rachel Mash and Prof Robert Mash made substantial contributions to the conception and design, capturing and cleaning of data and interpretation of the analysed results. Both were involved in writing the article and approving the final manuscript.

    • Ethics approval Ethics approval was provided by Health Research Ethics Committee of the University of Stellenbosch (N06/08/170).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement A copy of the questionnaire is available at rmash{at}mweb.co.za