Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

The Effect of Theory-Based HIV/AIDS Educational Program on Preventive Behaviors Among Female Adolescents in Tehran: A Randomized Controlled Trial

Authors
Farideh Khalajabadi Farahani 1
Fatemeh Darabi 2
Mehdi Yaseri 3
1 Department of Population and Health, National Population Studies and Comprehensive Management Institute, Tehran, Iran
2 Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
3 Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: Adolescents are increasingly at risks of HIV infection through high-risk sexual behaviors. This paper aimed to assess the effectiveness of a HIV/AIDS educational intervention among female adolescents in Tehran. Methods: A randomized controlled trial was conducted among high school girls aged 12-16 years studying in Tehran in 2016-17. The sample was selected using multistage random cluster sampling. Four schools per district were randomly selected using probability-proportional to size. Adolescents were randomly assigned to the experimental (n=289) and the control (n=289) groups. The theory of planned behavior (TPB) was the basis of both the intervention and the evaluation phase. Both experimental and control groups completed a questionnaire designed for HIV related behaviors for female adolescents (HBQFA) at baseline and after six months follow up. A theory-based educational program was implemented for the experimental group. Results: The mean age of participants was 14.1 years (SD=0.96). In the experimental group, significant improvements were shown in adolescents’ HIV knowledge (31.9%, 95% CI: 28.8-35.0), attitudes towards HIV (16.6%, 95% CI=14.4-18.8), subjective norm (16.8%, 95% CI=12.9-20.6) and perceived behavioral control (19.1%, 95% CI=16.2-22.1), perceived parental support (17%, 95% CI=13.8-20.2), behavioral intention to prevent HIV (19%, 95% CI=16.3-21.6), and HIV preventive behavior (17.3%, 95% CI=13.9-20.6) (p<0.001). Conclusion: Theory-based educational intervention on HIV/AIDS prevention can significantly protect adolescents from misconceptions, wrong attitudes and risky behaviors and unsupportive social environment that expose them to greater HIV risk. Health policy -makers are advised to consider effective training programs related to HIV/AIDS prevention behaviors in the school system.
Keywords
adolescents
Education
HIV/AIDS
Theory of Planned Behavior
  1. Statistical center of Iran [Internet]. Iran: Statistical center of Iran; 2016. Population and housing censuses; 2016 [Cited 2020 Apr 20]; [about 1 screen]. Available from: https://www.amar.org.ir/english/Population-and-Housing-Censuses.
  2. Islamic republic of Iran. Islamic Republic of Iran AIDS Progress report: On monitoring of the united nations general assembly special session on HIV and AIDS. Tehran: National AIDS committee secretariat, ministry of health and medical education. 2012 Mar. 72 p.
  3. Adeomi AA, Adeoye OA, Asekun-Olarinmoye EO, Abodunrin OL, Olugbenga-Bello AI, Sabageh AO. Evaluation of the effectiveness of peer education in improving HIV knowledge, attitude, and sexual behaviours among in-school adolescents in Osun State, Nigeria. AIDS Res Treat. 2014;2014:131756.
  4. Darabi F, Yaseri M, Kaveh MH, Khalajabadi Farahani F, Majlessi F, Shojaeizadeh D. The effect of a theory of planned behavior-based educational intervention on sexual and reproductive health in Iranian adolescent girls: a randomized controlled trial. J Res Health Sci. 2017;17(4):e00400.
  5. Stueve A, O'Donnell LN. Early alcohol initiation and subsequent sexual and alcohol risk behaviors among urban youths. Am J Public Health. 2005;95(5):887-93.
  6. Boonstra HD. Progressive and pragmatic: the national sexuality education standards for US public schools. Guttmacher Policy Rev.2012;15(2):2-7.
  7. Emmanuel F, Salim M, Akhtar N, Arshad S, Reza TE. Second-generation surveillance for HIV/AIDS in Pakistan: results from the 4th round of integrated behavior and biological survey 2011-2012. Sex Transm Infect. 2013;89 Suppl 3:iii23-8.
  8. Peter J, Valkenburg PM. Adolescents’ exposure to sexually explicit internet material and sexual satisfaction: a longitudinal study. Hum Commun Res. 2009;35(2):171-94.
  9. World Health Organization. WHO, UNODC, UNAIDS technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users 2012 revision. Geneva: World Health Organization. 2012; 112 p.
  10. Khalajabadi Farahani F, Akhondi M, Shirzad M, Azin A. HIV/STI risk-taking sexual behaviours and risk perception among male university students in Tehran: implications for HIV prevention among youth. J Bioscoc Sci. 2018;50(1):86-101.
  11. Mohammad K, Khalajabadi Farahani F, Mohammadi MR, Alikhani S, Zare M, Tehrani FR, et al. Sexual risk-taking behaviours among boys aged 15-18 years in Tehran. J Adolesc Health. 2007;41 (4):407-14.
  12. Khalajabadi Farahani F, Akhondi MM, Abbasi M. Knowledge on HIV and sexual transmission of HIV among male college students. Payesh. 2018;6:687-702.
  13. Panjalipoue S, Bostani Khalesi Z, Mirhaghjoo SN. Iranian female adolescents’ reproductive health needs: a systematic review. Int J Women’s Health Reprod Sci. 2018;6(3):226-32.
  14. Shariati M, Babazadeh R, Mousavi SA, Najmabadi KM. Iranian adolescent girls’ barriers in accessing sexual and reproductive health information and services: a qualitative study. J Fam Plann Reprod Health Care. 2014;40(4):270-5.
  15. Abedian K, Shahhosseini Z. University students’ point of views to facilitators and barriers to sexual and reproductive health services. Int J Adolesc Med Health. 2014;26(3):387-92.
  16. Tan X, Pan J, Zhou D, Wang C, Xie C. HIV/AIDS knowledge, attitudes and behaviors assessment of Chinese students: a questionnaire study. Int J Environ Res Public Health. 2007;4(3):248-53.
  17. Zakiei A, Khazaie H, Komasi S. A more understanding about aids: design and assessment of validity and reliability of several new scales. J Caring Sci. 2019;8(4):249-56.
  18. Alimoradi Z, Kariman N, Simbar M, Ahmadi F. Contributing factors to high-risk sexual behaviors among Iranian adolescent girls: a systematic review. Int J Community Based Nurs Midwifery. 2017;5(1):2-12.
  19. Khalajabadi Farahani F. Exposure to sexual explicit materials (Pornography) in internet & cyber space and its influences on sexual behavior and interpersonal relationships among adolescents in tehran. J Fam Res. 2019;15(1):127-53.
  20. Khalajabadi Farahani F, Mansson SA, Cleland J. Engage in or refrain from? a qualitative exploration of premarital sexual relations among female college students in Tehran. J Sex Res. 2019;56(8): 1009-22.
  21. National AIDS committee secretariat, Ministry of Health and Medical Education. Latest statistics on AIDS in the Islamic Republic of Iran by the end of 2017. Iran: Ministry of health and medical education, office of infectious disease management; 2017. 72 p.
  22. Darabi F, Kaveh MH, Majlessi F, Farahani FKA, Yaseri M, Shojaeizadeh D. Effect of theory-based intervention to promote physical activity among adolescent girls: a randomized control trial. Electronic Physician. 2017;9(4):4238-47.
  23. Schwartländer B, Stover J, Hallett T, Atun R, Avila C, Gouws E, et al. Towards an improved investment approach for an effective response to HIV/AIDS. Lancet. 2011;377(9782):2031-41.
  24. Anderssen N, Jacobs DR Jr, Aas H, Jakobsen R. Do adolescents and parents report each other's physical activity accurately? Scand J Med Sci Sports. 1995;5(5):302-7.
  25. Olfati F, Aligholi S. A study on educational needs of teenager girls regarding the reproductive health and determination of proper strategies in achieving the target goals in Qazvin. J Qazvin Univ Med Sci. 2008;12(2):80-2.
  26. Mirzaei K, Olfati F. Educational needs of adolescent girls for reproductive health in teachers views. J Qazvin Univ Med Sci. 2014;18 (2):67-76.
  27. Cleland J, Verrall J, Vaessen M. Preferences for the sex of children and their influence on repro-ductive behaviour. 1st ed. Voorburg: International statistical institute; 1983. 46 p.
  28. Darabi F, Khalajabadi Farahani F, Yaseri M. Psychometric analysis of the HIV behaviors questionnaire for female adolescents (HBQFA) in Iran. J Psychiatry. 2018;20(421):2.
  29. Harvey B, Stuart J, Swan T. Evaluation of a dramain-education programme to increase AIDS awareness in South African high schools: a randomized community intervention trial. Int J STD AIDS. 2000;11(2):105-11.
  30. Kaveh MH, Darabi F, Khalajabadi-Farahani F, Yaseri M, Kaveh MH, Mohammadi MJ, et al. The impact of a tpb-based educational intervention on nutritional behaviors in iranian adolescent girls: a randomized controlled trial. Fresenius Environ Bull. 2018;27(6):4349-56.
  31. Gańczak M, Barss P, Alfaresi F, Almazrouei S, Muraddad A, Al-Maskari F. Break the silence: HIV/AIDS knowledge, attitudes, and educational needs among Arab university students in United Arab Emirates. J Adolesc Health. 2007;40(6):572. e1-8.
  32. Jones V, Modeste N, Hopp Marshak H, Fox C. The effect of HIV/AIDS education on adolescents in Trinidad and Tobago. ISRN Infect Dis. 2013;2013: 1-8.
  33. Gao X, Wu Y, Zhang Y, Zhang N, Tang J, Qiu J, et al. Effectiveness of school-based education on HIV/AIDS knowledge, attitude, and behavior among secondary school students in Wuhan, China. PLoS One. 2012;7(9):e44881.
  34. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179-211.
  35. Bisallah CI, Rampal L, Lye MS, Sidik SM, Ibrahim N, Iliyasu Z, et al. Effectiveness of health education intervention in improving knowledge, attitude, and practices regarding Tuberculosis among HIV patients in general hospital Minna, Nigeria–a randomized control trial. PloS One. 2018;13(2): e0192276.
  36. Albarracin D, Johnson BT, Fishbein M, Mueller leile PA. Theories of reasoned action and planned behavior as models of condom use: a meta- analysis. Psychol Bull. 2001;127(1):142-61.
  37. Lal P, Nath A, Badhan S, Ingle GK. A study of awareness about HIV/AIDS among senior secondary school children of Delhi. Indian J Community Med. 2008;33(3):190-2.
Journal of Reproduction & Infertility
Volume 21, Issue 3
Summer 2020
Pages 194-206