The aim of the project is to implement and rigorously evaluate an innovative adolescent HIV/STI prevention program involving school students, professional peer educators, teachers, parents, rural health clinics and the wider community, by means of a community randomized trial. Primary objective: To measure the effectiveness of an adolescent HIV prevention intervention delivered to secondary school students and the wider community in reducing the incidence of HIV-1, Herpes simplex virus type 2 (HSV2) and unintended pregnancy among the students. Secondary objectives: I) To use a combination of quantitative and qualitative research methods to explore the evolution of sexual behavior in adolescents in rural Zimbabwe. II) To assess the impact of the intervention on knowledge and attitudes regarding reproductive and sexual health, reported behavior, and measures of self-efficacy. III) To determine through rigorous process evaluation whether these programs are delivered as intended. IV) To refine and assess the validity of research instruments for measuring sexual behavior in Zimbabwean adolescents. V) To examine through rigorous process evaluation acceptability and feasibility of providing VCT in rural community settings. VI) To study the epidemiology of HSV2 infection among adolescents, and to measure the extent to which HSV2 facilitates acquisition of HIV infection. Trial Design: 30 communities (60 schools) will be randomly allocated to either early or deferred program implementation. The impact of the program will be measured in a cohort of 6,600 students aged >12 (median age 15), who will be followed for 4 years (median age 19). Participants will be surveyed at the start of the project, after 30 months and after 4 years. At each survey they will complete a questionnaire and provide a saliva sample (and females a urine sample). The impact of the program on cumulative incidence of HIV-1 and HSV2 infection, and unintended pregnancy as well as on reported sexual behavior will be determined. A detailed process evaluation of the program will be conducted to inform wider program implementation.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH066570-03
Application #
6797323
Study Section
Special Emphasis Panel (ZMH1-NRB-W (02))
Program Officer
Brouwers, Pim
Project Start
2002-09-27
Project End
2007-07-31
Budget Start
2004-08-01
Budget End
2005-07-31
Support Year
3
Fiscal Year
2004
Total Cost
$661,471
Indirect Cost
Name
University College London
Department
Type
DUNS #
225410919
City
London
State
Country
United Kingdom
Zip Code
WC1 -6BT
Pascoe, Sophie J S; Langhaug, Lisa F; Mavhu, Webster et al. (2015) Poverty, food insufficiency and HIV infection and sexual behaviour among young rural Zimbabwean women. PLoS One 10:e0115290
Langhaug, Lisa F; Cheung, Yin Bun; Pascoe, Sophie J S et al. (2011) How you ask really matters: randomised comparison of four sexual behaviour questionnaire delivery modes in Zimbabwean youth. Sex Transm Infect 87:165-73
Pascoe, S J S; Langhaug, L F; Durawo, J et al. (2010) Increased risk of HIV-infection among school-attending orphans in rural Zimbabwe. AIDS Care 22:206-20
Langhaug, Lisa F; Sherr, Lorraine; Cowan, Frances M (2010) How to improve the validity of sexual behaviour reporting: systematic review of questionnaire delivery modes in developing countries. Trop Med Int Health 15:362-81
Langhaug, Lisa F; Pascoe, Sophie J; Mavhu, Webster et al. (2010) High prevalence of affective disorders among adolescents living in Rural Zimbabwe. J Community Health 35:355-64
Chirawu, Petronella; Langhaug, Lisa; Mavhu, Webster et al. (2010) Acceptability and challenges of implementing voluntary counselling and testing (VCT) in rural Zimbabwe: evidence from the Regai Dzive Shiri Project. AIDS Care 22:81-8
Cowan, Frances M; Pascoe, Sophie J S; Langhaug, Lisa F et al. (2010) The Regai Dzive Shiri project: results of a randomized trial of an HIV prevention intervention for youth. AIDS 24:2541-52
Langhaug, Lisa F; Cheung, Yin Bun; Pascoe, Sophie et al. (2009) Difference in prevalence of common mental disorder as measured using four questionnaire delivery methods among young people in rural Zimbabwe. J Affect Disord 118:220-3
Pascoe, Sophie J S; Langhaug, Lisa F; Mudzori, James et al. (2009) Field evaluation of diagnostic accuracy of an oral fluid rapid test for HIV, tested at point-of-service sites in rural Zimbabwe. AIDS Patient Care STDS 23:571-6