WHO-Afro

357 Pages·2006·2.55 MB·English

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WHO Technical Report Series
938
PREVENTING HIV/AIDS
IN YOUNG PEOPLE
A SYSTEMATIC REVIEW OF THE
EVIDENCE FROM DEVELOPING COUNTRIES
UNAIDS Inter-agency Task Team on Young People
Edited by
David A. Ross, Bruce Dick & Jane Ferguson
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WHO Library Cataloguing-in-Publication Data
Preventing HIV/AIDS in young people : a systematic review of the evidence from developing countries :
UNAIDS interagency task team on HIV and young people / editors: David Ross, Bruce Dick, Jane Ferguson.
(WHO technical report series ; no. 938)
1.HIV infections - prevention and control. 2.Acquired immunodeficiency syndrome
- prevention and control. 3.Adolescent. 4.Sex education. 5.Program evaluation.
6.Developing countries. I.Ross, David A. II.Dick, Bruce. III.Ferguson, Jane. IV.World
Health Organization. V.Series.
ISBN 92 4 120938 0 (NLM classification: WC 503.6)
ISBN 978 92 4 120938 0
ISSN 0512-3054
©World Health Organization2006
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Typeset in India
Printed inGeneva
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Table of contents
1. Introduction and rationale
Bruce Dick,Jane Ferguson,&David A. Ross 1
1.1 Background 1
1.2 Young people, HIV/AIDS and the global goals 2
1.3 Priorities for action 4
1.4 Objectives and limitations 5
1.5 Process and methodology 7
1.6 Scope and limitations of the data 9
1.7 Challenges in interpreting the findings and follow up 10
2. Young people: the centre of the HIV epidemic
Roeland Monasch&Mary Mahy 15
2.1 Introduction 16
2.2 Data and methods 17
2.3 Types of epidemics 17
2.4 Progress towards UNGASS commitments 24
2.5 Limitations of the data 34
2.6 Conclusions 35
3. Overview of effective and promising interventions to prevent
HIV infection
Judith D. Auerbach,Richard J. Hayes,&Sonia M. Kandathil 43
3.1 Introduction 43
3.2 Interventions to change behaviour 44
3.3 Biomedical interventions: evaluating technologies 51
3.4 Social interventions 58
3.5 Behavioural and social issues in developing and
implementing interventions 61
3.6 Conclusion 63
4. The weight of evidence: a method for assessing the
strength of evidence on the effectiveness of HIV prevention
interventions among young people
David A. Ross,Danny Wight,Gary Dowsett,Anne Buvé,&
Angela I.N. Obasi 79
4.1 Introduction 80
4.2 Types of interventions and evidence on effectiveness 81
4.3 Thresholds for strength of evidence needed for widespread
implementation 84
4.4 What information do policy-makers need? 88
4.5 Assessing the quality of an intervention 91
4.6 Types of evidence and their relative weight 92
4.7 Conclusion 98

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5. The effectiveness of sex education and HIV education
interventions in schools in developing countries
Douglas Kirby,Angela Obasi,&B.A. Laris 103
5.1Introduction and background 104
5.2Methods 111
5.3Findings 117
5.4Discussion an d recommendations 142
6. Review of the evidence for interventions to increase young
people’s use of health services in developing countries
Bruce Dick,Jane Ferguson,Venkatraman Chandra-Mouli,
Loretta Brabin,Subidita Chatterjee,&David A. Ross 151
6.1Introduction 152
6.2Methods 153
6.3Findings 158
6.4Discussion 191
6.5Conclusions 199
7. The effectiveness of mass media in changing HIV/AIDS-
related behaviour among young people in developing
countries
Jane T. Bertrand&Rebecca Anhang 205
7.1Introduction 206
7.2Methods 207
7.3Findings 226
7.4Discussion 236
8. The effectiveness of community interventions targeting HIV
and AIDS prevention at young people in developing
countries
Eleanor Maticka-Tyndale&C hris Brouillard-Coyle 243
8.1Introduction 244
8.2Methods 244
8.3Findings 247
8.4Go, ready, steady, do not go 276
8.5Conclusions 281
9. Achieving the global goals on HIV among young people most
at risk in developing countries: young sex workers, injecting
drug users and menwho have sex with men
Oliver Hoffmann,Tania Boler,&B ruce Dick 287
9.1Introduction 288
9.2Methods 289
9.3Findings 293
9.4Discussion 306
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10. Conclusions and recommendations
Jane Ferguson,Bruce Dick,&David A. Ross 317
10.1 Introduction 317
10.2 The road to “Steady, Ready, Go” 319
10.3 Results 322
10.4 Discussion 328
10.5 Recommendations 335
Glossary 343
Acknowledgements 347
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Introduction and rationale
1.
Bruce Dick,a Jane Ferguson,a & David A. Rossb
1.1 Background
In 1995, WHO in collaboration with UNFPA and UNICEF convened a study
group on programming for adolescent health and development. One of the
products of this group was a joint technical report publication on Program-
ming for adolescent health anddevelopment (1). The report synthesized the
evidence for the effectiveness of interventions for adolescent health and de-
velopment, and it set the direction and provided the conceptual framework
for much of the programming for young people’s health and development
that has taken place since its publication (2–6).
The challenges posed by HIV have progressed inexorably during the past
decade, especially for young people in developing countries. (Young people
are defined in this report as those aged 10–24 years; this group combines
adolescents – aged 10–19 years – and youth – aged 15–24 years). At the same
time, many lessons have been learnt about developing and implementing
programmes for young people’s health and development, including pro-
grammes to prevent the spread of HIV. In 2004, the UNAIDS Inter-Agency
Task Team on Young People decided that it was time to review the progress
that had been made and to look again at the evidence for the effectiveness of
interventions, focusing explicitly on interventions to prevent the spread of
HIV among young people in developing countries.
This report is an attempt to rise to the challenge by providing systematic
reviews of the evidence for policies and programmes to decrease HIV preva-
lence among young people, as a contribution towards achieving universal
access to prevention, treatment and care (7) and attaining the Millennium
Development Goal on AIDS (8).
a Department of Child and Adolescent Health and Development, WHO, Geneva, Switzerland.
Correspondence should be sent to Bruce Dick (email: [email protected]).
b Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine,
London, England.
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