Adolescent human immunodeficiency virus and sexually transmitted disease prevention programmes: are gender-blind approaches justified?

Summary 

Objective

To present findings that gender might be more predictive of human immunodeficiency virus (HIV) and sexually transmitted disease (STD) knowledge, and sexual behaviour, compared with participation in knowledge-based HIV prevention programmes.

Study design

A cross-sectional study comparing students attending public high schools running an HIV and STD prevention programme. It is based on a study that evaluated the City of Houston HIV and STD prevention programme in public high schools. Comparison was initially between groups (intervention vs comparison) and subsequently between gender. The main variables for comparison were level of interest and knowledge of the subject of HIV and STD, and a range of sexual behaviour variables.

Methods

Self-administered questionnaires were used for eliciting both knowledge and behavioural data. A specific question required participants to rate their level of interest in the subject of HIV and STD on a scale of 1–4 (lowest to highest). The knowledge component was marked and scores awarded in percentage form. Descriptive statistical analysis was followed by stratified analysis. Finally, a select number of variables were used in a logistic regression model. STATA version 8 was the main statistical software.

Results

A significantly large proportion of girls reported the highest level of interest in the subject of HIV and STD (a score of 4); had higher HIV and STD knowledge scores; and reported less risk-taking sexual behaviour compared with boys. The only variable in which boys faired better was condom use, reporting higher rates of condom use than girls.

Conclusions

Gender-blind HIV and STD prevention programmes seem to have a minimal effect on boys. Although a myriad of other factors influence male response to such programmes, the relatively low level of interest in the subject of HIV and STD among boys might be contributory. HIV and STD prevention programmes need to be re-designed using approaches that are more appealing to boys. Boys will otherwise remain the weak link and therefore the rate-limiting step in the quest for sexual behaviour change among adolescents.

Keywords: HIV/STD, Evaluation, Adolescents, Sexuality, Gender and prevention