Cho, Hyunsan,Hallfors, Denise D.,Itindi, Janet,Mbai, Isabella,Milimo, Benson
"Itindi, Janet: Moi University","Mbai, Isabella: Moi University","Milimo, Benson: Moi University",
We conducted a 2-year pilot randomized controlled trial (N = 105) in a high HIV-prevalence area in rural western Kenya to test whether providing young orphan adolescents with uniforms, school fees, and community visitors improves school retention and reduces HIV risk factors. The trial was a community intervention, limited to one community. In this paper, we examined intervention implementation and its association with outcomes using longitudinal data. We used both quantitative and qualitative methods to evaluate the community-based model for orphan HIV prevention, with recommendations for future studies. Despite promising effects after 1 year, GEE analyses showed effects after 2 years. Volunteer community visitors, a key element of the intervention, showed little of the expected effect although qualitative reports documented active assistance to prevent orphans' school absence. For future research, we recommend capturing the transition to high school, a larger sample size, and biomarker data to add strength to the research design. We also recommend a school-based intervention approach to improve implementation and reduce infrastructure costs. Finally, we recommend evaluating nurses as agents for improving school attendance and preventing dropout because of their unique ability to address critical biopsychosocial problems.
"ADOLESCENT HEALTH","community-based intervention","global health","HIV/AIDS PREVENTION","RURAL HEALTH",BEHAVIOR,GIRLS,HIV,"RANDOMIZED CONTROLLED-TRIAL",RISK,SCHOOL,"SUB-SAHARAN AFRICA",YOUNG-WOMEN,ZIMBABWE