Guyana Youth HIV Prevention Life Skills KAB Study, Sara Krosch 2010 by Sara Krosch Consulting

January 2010

Student Knowledge, Attitudes & Behaviors

Pre‐test Results Sara Krosch

Table of Contents Introduction .................................................................................................................................................. 3 AIDS ISY Program & Evaluation Plan ............................................................................................................. 6 AIDS ISY KAB Pre‐/Post‐test .......................................................................................................................... 7 Baseline Data: What we already know about HIV/AIDS & youth in Guyana .............................................. 10 AIDS ISY KAB Pre‐test Results ..................................................................................................................... 14 Using Pre‐/Post‐test Data ........................................................................................................................... 21 Conducting the ISY KAB Post‐test ............................................................................................................... 22 School Profiles ............................................................................................................................................. 23

Introduction Artistes in Direct Support (A.I.D.S.) was established as a community‐based organization in 1992 and became a non‐governmental, not‐for‐profit organization in 2000. A.I.D.S. receives funding from USAID and the Government of Guyana and technical support from The Guyana HIV/AIDS Reduction Project (GHARP). A.I.D.S. mission is to heighten the awareness of HIV/AIDS and STIs throughout Guyana using theater, peer education and media in order to bring out behavior change amongst youth. The In‐School Youth HIV Prevention Program A 2003 Guyana Ministry of Health Study1 found that the majority of in‐school youth (ISY) in Guyana have high levels of HIV/AIDS knowledge but are still engaging in several risky behaviors and believing common myths. Based on this and other evidence, and in order to continue to reduce HIV/AIDS incidence in Guyana, a 14‐module ISY HIV Prevention curriculum manual, Stepping it up with Better Choices, was developed by USAID/GHARP in 2006. A.I.D.S. has been implementing this ISY HIV Prevention Curriculum since its inception with 3rd Form classes in secondary schools in Region 4, primarily in Georgetown. To date A.I.D.S. has worked in 11 secondary schools (SS): Previously facilitated at:‐ North Rumveldt SS East Rumveldt SS David Rose SS Plasance SS Currently facilitating at‐ Tutorial SS Central SS Queenstown SS St. Mary’s SS Brickdam SS Carmel SS Dolphin SS

Dolphin Secondary School Students with A.I.D.S. Prevention Officer and ISY Facilitator Cilandell Glen

A total of 1,231 in‐school youths, 39% male and 61% female, ages 15‐19, in all regions except 7 were surveyed. 3

Student Knowledge, Attitudes and Behaviors Pre‐/Post‐Test The ISY curriculum modules aim to change students’ knowledge, attitudes and behaviors (KAB). However, the monitoring and evaluation tools included in the ISY curriculum manual Stepping it Up with Better Choices focus primarily on gathering quantitative data—number of students receiving each module by gender. A sample pre‐/post‐KAB questionnaire is provided but it does not adequately enable facilitators to measure changes in knowledge, attitudes or behaviors relevant to the many topics covered in the curriculum. Recognizing this gap, A.I.D.S. created a more comprehensive, 50‐item pre‐ /post‐KAB student questionnaire that contains items relevant to all modules2. This instrument is a critical tool in A.I.D.S.’s overall ISY HIV Prevention Program Plan because it will help to determine if key KAB objectives are being met. (See Program Plan on page 6.)

The overall purpose of a pre‐/post‐test is to give the same questions to students again after they have participated in the ISY Modules and to compare results to see if more students provide the desired answers. ISY Facilitators and Program Planners can learn many things about students by giving a KAB pre‐test before the first Module. The pre‐test can provide a baseline for students in which to compare differences in KAB between genders and schools and even classes within schools. This will enable you to tailor each lesson to the particular needs of the students. The exercise of conducting a pre‐test also helps facilitators see the literacy level of students. Many times students will ask questions about the pre‐test questions revealing prior knowledge or misinformation. It is important for facilitators to not give students the answers on the pre‐test but instead to note the questions they frequently inquire about for future discussion. After the pre‐test data is collected the questions can serve as a basis for classroom discussion.

ISY Facilitator Noel Goodman administering ISY KAB Pre‐test at Brickdam Secondary School

A.I.D.S. also created 5 KAB monitoring quizzes to be administered to students after finishing clusters of modules.

Pre‐test steps: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Drafted new pre‐/post‐test Pre‐tested draft survey with Staff and some students to determine clarity of questions Staff determined “desired’ answers for each question Excel database set up for each school divided by gender Surveys conducted at schools Data entered and number and percent of students providing the ‘desired answer’ reported for clusters of questions by Module topic Comparisons made between genders Results reported noting high and low trends and patterns by school and gender Results compared to baseline data (other research findings) Summary report/presentation of key results given to staff, school administration and staff, donors, etc. Results used to determine or revise Program plan Success Indicators Results shared with students via discussions.

This document reports the results of the first round of pre‐tests conducted with the 7 schools currently receiving the curriculum in January 2010. Pre‐test data was analyzed by school and gender and compared to previous youth HIV KAB studies. Additionally, some schools had received some modules prior to January 2010 so it is hypothesized that their KAB’s related to earlier modules will be more favorable.

A.I.D.S. ISY Program & Evaluation Plan

A.I.D.S’s ISY KAB Pre‐/Post‐test

Artistes in Direct Support ISY Abstinence Program ‐ Student Pre‐/Post‐KAB Test, 2010

Facilitator Instructions 1) Tell students to write the following at the top of a piece of paper. Name: ______________________________ School: ____________________ Class: _____________ Gender: Female Male

Age: __________

2) Announce to students: “Today you will be answering 50 questions about your personal knowledge, attitudes and behaviors about health. It is important that you answer all of the questions so that we can find out what you know about HIV/AIDS and other health topics. Your answers might be different from other students. Please number your paper 1 – 50. Answer all questions by writing either True or False.“ 3) Hand out the ISY pre‐test questionnaire to students. 4) Announce to students: “Do not write on the question paper, only on your own paper. Read each question and write either True or False on your own paper. If you do not understand something, please raise your hand. Do not discuss your answers with other students. Complete the questions on your own.” OR Read each statement aloud to the class. Students write True or False 5) When students are finished with the questionnaire they can work quietly or complete an independent activity you have given them. 6) Collect the questionnaire sheets and the student papers. Make sure each paper has the student’s name, school, class, gender and age. Also check that all 50 questions have been answered. Remember; do not provide answers or too much information to students.

Artistes in Direct Support ISY Abstinence Program ‐ Student Pre‐/Post‐KAB Questionnaire, 2010

DO NOT WRITE ON THIS PAPER Answer all questions True or False on your own paper. 1) A person with good self‐esteem may be easily influenced by others. 2) A person with good self‐esteem is confident but not aggressive. 3) I know what my personal values are. 4) My personal values help me make important decisions. 5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision. 7) Sometimes I feel I have no choices or options in life. 8) I usually make decisions alone without talking to others first. 9) I have several goals I want to reach in my life. 10) Making goals can help me become the person I want to be. 11) I feel I can trust the adults in my life. 12) I feel cared for in most of my relationships. 13) It is more important for girls to abstain from sex than it is for boys to abstain from sex. 14) Sexuality is the same as physical sexual activity or sexual intercourse. 15) I have learned about sexuality from media—movies, songs, television, magazines. 16) Sexually transmitted infections or STIs are not a problem for young people. 17) It is easy for young people to know they have an STI. 18) Having an STI puts people at greater risk for getting HIV. 19) The best way to prevent STIs is to abstain from sex. 20) HIV is the same thing as AIDS. 21) HIV is spread through body fluids. 22) HIV can be spread by touching a person with the disease. 23) HIV can be cured. 24) If a pregnant woman is HIV positive, her baby can contract the disease. 25) You can tell if a person has HIV because they look unhealthy. 26) You can contract HIV from mosquitoes. 27) You can increase your chances of getting HIV if you have sex with many people. 28) You can get HIV from kissing. 29) You can get HIV by sharing a needle (for drugs or tattoos) with some who is infected. 30) People with HIV should be treated the same as people who do not have the disease. 31) Abstaining from sex is the only 100% sure way to not get HIV. 32) If I had HIV, I would keep it a secret. 8

33) People can abstain from many things besides sex. 34) Having sex is the only way to show I have feelings for a boy or girl. 35) Young people can be victims of sexual abuse. 36) Child abuse is the child’s fault. 37) Young people can do things to reduce their risk of being abused. 38) If an adult does not believe you that you or someone you know is being abused, you should not tell anyone else. 39) Using drugs or alcohol can out you more at risk to make unhealthy decisions. 40) Young people are more affected by alcohol and drugs than adults. 41) Smoking marijuana makes you more likely to try other drugs. 42) Alcohol and drugs damage the body and can cause many health problems. 43) Music and music videos often show healthy, loving relationships. 44) Young people can do things to improve their health. 45) One way young people can stay healthy is to abstain from sex. 46) I feel I can talk to a parent or older relative about sex. 47) Most people my age have already had sex. 48) People my age usually have sex with others who are older. 49) If I had HIV I could still reach my goals in life. 50) I know a person or family who has been affected by HIV. FINISHED

Baseline Data: What we already know about HIV/AIDS and Youth in Guyana The following information provides a context and some baseline data with which to compare ISY student KAB pre‐/post‐data.

Population According to the 2002 census, the population of Guyana is approximately 751,223. The majority of which (53%) is 24 years or younger. Two out of five (42%) Guyanese are below 18 years of age (2). Guyana Population by Age (Source: 2000 Census)

11% 13% 25 and older 47%

24 and younger 53%

9% 12% 8%

25 and older

0‐4yrs

5‐9yrs

10‐14yrs

15‐19yrs

20‐24

Region 4, Georgetown and surrounds, accounts for about 40% of Guyana’s total population, but contains 68% of HIV and 58% of AIDS cases (2).

percent of specific population

HIV/AIDS Prevalence By the end of 2006, 5,429 AIDS cases had been officially reported to the Guyana Ministry of Health. The HIV epidemic in Guyana is consistently present in the general population as evidenced by an HIV prevalence3 of greater than one percent among pregnant women attending antenatal care clinics. However, HIV prevalence is higher among specific populations, often referred to as high‐risk behavior groups—commercial sex workers, men who have sex with men, STI patients and prisoners. HIV Prevalence amongst High‐risk BehaviorGroups (Sources: Ministry of Health, UNGASS BSS 2007) 30

Greater than 1 in 4 (27%) commercial sex workers is infected with HIV in Guyana.

20 10 0 Female STI Patients

Male STI Patients

Prisoners

CSWs

MSM

Prevalence refers to the current number of people suffering from an illness in a given year. This number includes all those who may have been diagnosed in prior years, as well as in the current year. HIV is also different form AIDS so prevalence numbers for HIV and AIDS would most likely differ.

Overall, the number of AIDS cases in males outnumbers the number of cases in females, except within the younger age groups (15‐24 years) where there are more female than male cases (2). The figure below shows that a female age 15‐24 is 3 times more likely to contract HIV than her male counterpart in Guyana. HIV Prevalence: General Population and Youth (Source: WHO, UNAIDS, UNICEF 2008)

% population

The prevalence rate of females with HIV more than doubles between ages 15‐19 and ages 20‐24 (2).

3 2.5

High

1.7

Low

Average

0.5 0 Adults 15‐49

females 15‐24

males 15‐24

HIV Testing & Treatment Six percent (6%) of youth ages 15‐19 report being tested for HIV (4). Of those tested, only 9% of females and 4% of males who were tested in the last 12 months report receiving their results (2). The majority of youth known to be HIV positive are receiving antiretroviral treatment. Percent with HIV known to be on antiretrviral treatment 12 months after initiation (Source: UNGASS 2007)

% of population

100 80 60 0‐14 yrs 40

15+ years

20 0 females

males

11 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

HIV/AIDS Knowledge, Attitudes and Behaviors The following percentages and statements pertain to youth ages 15‐19 unless otherwise stated. Knowledge • 62% correctly identified abstinence, faithfulness and condom use as methods of preventing HIV infection (4) • 34% of males and 44% of females ages 15‐24 rejected 3 common misconceptions about HIV transmission (1,2) 4 • 14% believed that mosquitoes can transmit HIV (4) • 58% had knowledge of mother to child transmission (MTCT) of HIV (3) • 28% reported having a close friend or relative with HIV or AIDS (4) Attitudes • 36% have non‐discriminatory attitude towards people with HIV/AIDS (3) • 37% believed that the serostatus of an HIV‐positive family member should be kept secret (4) Behaviors • 44% of males and 22% of females reported ever having sex (4)

• •

The median5 age at first sex was 15 years (4) 30% of males and 12% of females ages 15‐24 report having sexual intercourse before age 15 (1,2) • 64% of males and 74% of females ages 15‐19 reported never having had a sexual encounter, but among 20‐24 year olds the numbers decline to 21% of males and 48% of females never having had a sexual encounter (2) • 57% used a condom at first sex (4) • 31% reported being currently sexually active (2,4) • 64% of sexually active youth reported having sex in the past 12 months (4) • 37% of sexually active youth reported having sex with more than one partner in the past 12 months (4) • 68% of males and 75% of females who had more than one sexual partner in the past 12 months reported use of a condom during last sexual intercourse (2) • 7% of sexually active youth reported an abnormal genital discharge in the preceding 12 months (4) • 24% reported having exchanged sex for money or other material things in the preceding 12 months (4) • 30% of males reported commercial sex in the past 12 months6 (4) • 53% of males reported using a condom at last commercial sex (4) 4

Comprehensive HIV knowledge means knowing 3 ways to prevent HIV transmission and reject 3 common misconceptions about HIV transmission 5 Median is different than mean or mode. Median is the middle number on a list of ages; mean is the average age and mode is the most often reported age. The median is usually reported when the range of ages is large enough so as to provide a skewed average. 6 It is unknown if this number includes males paid for commercial sex and/or were paid for commercial sex. It also appears that only males were asked about participating in commercial sex.

12 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

•

Youth were less likely to use a condom with a sex worker than with noncommercial partner: 53% reported using a condom with their last commercial partner, while 73% reported using a condom at last sex with a noncommercial partner (4)

Other Knowledge, Attitudes and Behaviors related to ISY Module Topics The ISY modules cover a number of life skills and health risk topics in addition to HIV/AIDS KAB. The following percentages and statements pertain to youth ages 15‐19 unless otherwise stated. Alcohol & Substance Use • 54% reported previous alcohol use (4) • 7% reported previous marijuana use (4) • <1% reported previous cocaine or heroin use (4) Relationships • 14% of females are currently married or in a union (3) Domestic Violence • 18% of females ages 15‐49 currently married or in a union have accepting attitudes towards domestic violence (3) • 1 in 5 females in Guyana ages 15‐49 (18%)—39% interior, 20% rural coast, 8% urban coast believed that a husband/partner is justified in beating his wife or partner. The more educated the woman and richer the household the less likely she is to agree that a husband is justified in beating his wife/partner (3) Sources (1) Epidemiological Fact Sheet on HIV and AIDS: Guyana 2008 Update. WHO, UNAIDS, UNICEF. December 2008 (2)UNGASS Country Progress Report 22: Republic of Guyana January 2006 – December 2007. Presidential Commission on HIV and AIDS. (3) Guyana Multiple Indicator Cluster Survey Summary Report 2006. United Nations Children’s Fund and Guyana Bureau of Statistics. (4) Behavioral Surveillance Survey. Round 1: 2003‐2004. Family Health International and The Guyana Ministry of Health.

13 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

ISY KAB Pre‐test Results Demographics Schools Completing ISY KAB Pre‐test Brickdam SS Central SS Dolphin SS Queenstown SS Tutorial SS TOTALS

Total number students 52 117 127 59 29 384

Total female students 25 64 74 31 10 204

Ages of Female Students

30%

13yr 3%

72%

Ages of Male Students 12yr

16%

Total male students 27 53 53 28 19 180

1% 8% 0%

12%

14yr

15yr

16yr

48%

17yr

Tutorial Secondary School Students completing ISY KAB pre‐test

14 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

K E Y

SUMMARY by MODULE TOPIC January 2010 ISY KAB Pre‐test Results

Br= Brickdam Qu=Queenstown Tu= Tutorial F= females Ce= Central M=malesA Do= Dolphin Ave= average

Desired % Desired Answer Answer Br F Br M Tu F Tu M Ce F Ce M Do F Do M Qu F Qu M Ave F Ave M Ave All 43 1) A person with good self‐esteem may be easily False 88 67 80 63 75 78 58 60 65 73 62 68 influenced by others. 82 2) A person with good self‐esteem is confident True 88 78 40 47 73 61 74 66 87 72 67 70 but not aggressive. 29 7) Sometimes I feel I have no choices or options False 36 48 50 74 42 52 35 45 23 37 50 44 in life. 89 9) I have several goals I want to reach in my life. True 96 89 90 79 100 98 92 85 97 77 88 83 Comments‐ Students recognize the characteristics of a person of self‐esteem. Tutorial students need to be reminded that aggression is a sign of insecurity and not good self‐ esteem. Students have goals but frequently feel they have no choices in life, especially females.

Self‐esteem Items

Desired Answer True

Br F 100

Br M 89

Tu F 100

Tu M 100

Ce F 98

Ce M 93

Do F 97

Do M 94

Qu F 77

Qu M 96

Ave F 94

Ave M 94

Ave All 94

4) My personal values help me make important decisions.

True

100

5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision.

True

Values Items 3) I know what my personal values are.

% Desired Answer

Comments‐ Students are aware of their personal values and the part they play in making decisions. Students value the opinions of family over friends. Students confiding in teachers or seeking their advice varies widely from school to school. Central students are the least likely to discuss difficult decisions with a teacher while Tutorial students are the most likely.

Desired Answer 4) My personal values help me make important True decisions. 5) I value the opinions of my family more than True the opinions of my friends. 6) Sometimes I talk to my teachers when I have True to make a difficult decision. 7) Sometimes I feel I have no choices or options False in life.

% Desired Answer

Decision‐making Items

8) I usually make decisions alone without talking to others first.

False

Br F 100

Br M 93

Tu F 100

Tu M 95

Ce F 95

Ce M 94

Do F 95

Do M 92

Qu F 87

Qu M 89

Ave F 95

Ave M 93

Ave All 94

Comments‐ Students rely on their personal values to help in decision making and they value the opinions of family over friends. Less than half of students would go to a teacher to discuss a difficult decision. Females are more likely to discuss options with others before making a decision, especially those from Brickdam. Desired Answer 9) I have several goals I want to reach in my life. True

% Desired Answer

Goal‐Setting Items

Br F 96

Br M 89

Tu F 90

Tu M 79

Ce F 100

Ce M 98

Do F 92

Do M 85

Qu F 97

Qu M 89

Ave F 95

Ave M 88

Ave All 92

10) Making goals can help me become the True 100 100 90 100 98 100 92 98 90 100 94 100 97 person I want to be. 49) If I had HIV I could still reach my goals in life. True 88 89 70 84 81 78 92 81 81 82 82 83 83 Comments‐ Nearly all students have several goals they want to achieve in life and understand the importance of goal setting in order to become the person they want to be. The majority of students also believe that being HIV positive would not prevent them from reaching their life goals. Desired % Desired Answer Answer Br F Br M Tu F Tu M Ce F Ce M Do F Do M Qu F Qu M Ave F Ave M Ave All 15) I have learned about sexuality from media— True 60 96 90 89 86 76 84 79 84 89 81 86 84 movies, songs, television, magazines. 43) Music and music videos often show healthy, False 76 63 70 74 100 94 39 30 74 43 72 61 67 loving relationships. Comments‐ Most students are aware of sexual images and messages in the media. Nearly all students at Central recognize that music and music videos do not depict healthy relationships compared to only one‐third of Dolphin students. All students must be taught to analyze media to understand how it is used as a sexuality socializing force.

Media Items

Desired Answer True

Br F 92

Br M 81

Tu F 90

Tu M 95

Ce F 86

Ce M 87

Do F 92

Do M 94

Qu F 84

Qu M 93

Ave F 89

Ave M 90

Ave All 90

True

True True False

84 80 16

74 63 37

50 80 30

68 58 16

52 69 20

52 59 37

65 78 15

60 58 38

55 74 3

50 93 25

61 76 17

61 66 31

61 71 24

43) Music and music videos often show healthy, loving relationships.

False

100

46) I feel I can talk to a parent or older relative about sex.

True

Relationships Items 5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision. 11) I feel I can trust the adults in my life. 12) I feel cared for in most of my relationships. 13) It is more important for girls to abstain from sex than it is for boys to abstain from sex.

% Desired Answer

Comments‐ Family opinions are valued over friends and less than half of students seek the opinions of teachers on difficult decisions. About two‐thirds of students feel they can trust adults in their lives. Most students are aware of unhealthy relationships depicted in music videos except those attending Dolphin. Most students feel they can talk to a parent or older relative about sex. There is a clear gender distinction when it comes to sexual abstinence expectations; more that 75% of students believe it is more important for a girl to abstain from sex than for a boy. The module lessons should include more activities and discussion of gender roles and expectations or an additional module on gender and sexuality should be facilitated. An example of such a module can be found in the ISY Program Enrichment Guidebook (January 2010). Desired % Desired Answer Answer Br F Br M Tu F Tu M Ce F Ce M Do F Do M Qu F Qu M Ave F Ave M Ave All 13) It is more important for girls to abstain from False 16 37 30 16 20 37 15 38 3 25 17 31 24 sex than it is for boys to abstain from sex. 19) The best way to prevent STIs is to abstain True 96 89 80 100 100 91 86 75 94 75 91 86 89 from sex. 31) Abstaining from sex is the only 100% sure True 64 78 50 84 89 76 84 64 81 68 74 74 74 way to not get HIV. 33) People can abstain from many things True 80 85 90 68 67 74 77 70 90 93 81 78 80 besides sex. 45) One way young people can stay healthy is to True 92 78 60 84 86 89 74 72 65 54 75 75 75 abstain from sex. Comments‐ Students understand the concept of abstinence and that a person can abstain from many behaviors. Abstaining from sex is a ‘gendered’ behavior expectation for students. More females than males feel that abstinence is especially important for girls and less so for boys reflecting a more permissive expectation for males. The large majority of students are aware that abstaining from sex is an effective means of preventing STIs, but the number falls to three‐quarters of students who associate abstaining from sex with being the best way to prevent HIV or be healthy.

Abstinence Items

Sex Items

Desired Answer False

14) Sexuality is the same as physical sexual activity or sexual intercourse. 15) I have learned about sexuality from media— True movies, songs, television, magazines. 27) You can increase your chances of getting HIV True if you have sex with many people. 34) Having sex is the only way to show I have False feelings for a boy or girl.

% Desired Answer Br F 56

Br M 81

Tu F 40

Tu M 32

Ce F 48

Ce M 57

Do F 41

Do M 30

Qu F 52

Qu M 75

Ave F 47

Ave M 55

Ave All 51

100

46) I feel I can talk to a parent or older relative about sex.

True

47) Most people my age have already had sex. 48) People my age usually have sex with others who are older.

True True

80 88

89 93

90 80

84 100

83 89

72 87

96 96

87 83

100 100

96 100

90 91

86 93

88 92

Comments‐ Only half of students understand there is a difference between sexuality and sexual intercourse. The large majority of students are aware of sexual images and messages in the media. Most students know having multiple sexual partners puts them at risk for HIV. More females than males feel that having sex is not the only way to show affection. More than two‐thirds of students feel they can talk about sex with a parent or relative. Most students believe their peers have already had sex and both females and males think their peers usually have sex with someone older. Just how much older is unknown.

STIs Items

Desired Answer False

% Desired Answer Br F 96

Br M 89

Tu F 80

Tu M 100

Ce F 100

Ce M 96

Do F Do M Qu F Qu M Ave F Ave M Ave All 16) Sexually transmitted infections or STIs are 89 75 84 93 90 91 91 not a problem for young people. 17) It is easy for young people to know they False 56 67 20 68 67 61 42 51 65 43 50 58 54 have an STI. 18) Having an STI puts people at greater risk for True 88 81 70 89 95 76 89 74 81 82 85 80 83 getting HIV. 19) The best way to prevent STIs is to abstain True 96 89 80 100 100 91 86 75 94 75 91 86 89 from sex. Comments‐ Nearly all students realize STIs are a problem for youth. But only half of students feel it is easy to know if you have an STI. Most students understand that having an STI puts them at risk for HIV and that abstaining from sex is the best way to prevent STIs.

Abuse Items

Desired Answer True

Br F 100

Br M 96

Tu F 90

Tu M 95

Ce F 98

Ce M 95

Desired Answer True

Br F 100

Br M 93

Tu F 90

Tu M 95

Ce F 100

Ce M 96

Br F 96

Br M 100

Tu F 100

Tu M 95

Ce F 100

Ce M 94

% Desired Answer

Do F Do M Qu F Qu M Ave F Ave M Ave All 35) Young people can be victims of sexual 100 92 100 96 98 95 97 abuse. 36) Child abuse is the child’s fault. False 100 93 80 100 97 93 91 79 100 89 94 91 93 37) Young people can do things to reduce their True 80 81 90 74 84 81 92 87 94 93 88 83 84 risk of being abused. 38) If an adult does not believe you that you or False 92 85 80 84 95 72 86 62 81 82 87 77 82 someone you know is being abused, you should not tell anyone else. Comments‐ Nearly all students agree that young people can be victims of sexual abuse and the abuse is not the fault of the child. Fewer students, but still a large majority feel students can do things to reduce abuse risk and abuse needs to be reported to a trusted adult. Males are somewhat less likely to seek out an adult confidant after abuse than are females.

Alcohol & Drugs Items

% Desired Answer

Do F Do M Qu F Qu M Ave F Ave M Ave All 39) Using drugs or alcohol can put you more at 91 89 84 100 93 95 94 risk to make unhealthy decisions. 40) Young people are more affected by alcohol True 76 78 60 74 75 78 84 64 81 79 75 75 75 and drugs than adults. 41) Smoking marijuana makes you more likely to True 88 96 80 79 97 83 93 87 94 71 90 83 87 try other drugs. 42) Alcohol and drugs damage the body and can True 96 100 100 95 100 94 96 89 97 100 98 96 97 cause many health problems. Comments‐ Students are well aware of the physical damage and health problems potentially caused by alcohol and/or drug use. More females than males feel marijuana use leads to other drug use. Three‐quarters of students think young people are more affected by substance use than adults.

Health Items

Desired Answer

% Desired Answer Do F 96

Do M 89

Qu F 97

Qu M 100

Ave F 98

Ave M 96

Ave All 97

42) Alcohol and drugs damage the body and can True cause many health problems. 44) Young people can do things to improve their True 100 96 100 100 100 96 97 94 100 100 99 97 98 health. 45) One way young people can stay healthy is to True 92 78 60 84 86 89 74 72 65 54 75 75 75 abstain from sex. Comments‐ Almost all students recognize the potential negative effects of alcohol and drugs health and that students can do things to improve their personal health. But one‐ quarter of students do not see abstaining from sex as a way to stay healthy.

HIV/AIDS Items

Desired Answer

% Desired Answer

True

Br F 88

Br M 81

Tu F 70

Tu M 89

Ce F 95

Ce M 76

Do F 89

Do M 74

Qu F 81

Qu M 82

Ave F 85

Ave M 81

Ave All 83

False True False

80 80 96

81 81 100

100 80 70

95 95 89

98 92 97

83 79 98

69 85 95

49 85 87

71 87 97

68 86 93

84 85 91

75 85 93

80 85 92

23) HIV can be cured.

False

100

24) If a pregnant woman is HIV positive, her baby can contract the disease.

True

25) You can tell if a person has HIV because they look unhealthy.

False

100

26) You can contract HIV from mosquitoes. False 27) You can increase your chances of getting HIV True if you have sex with many people.

72 88

63 93

90 90

95 95

86 92

94 91

65 78

64 79

81 90

64 86

79 88

76 88

78 88

28) You can get HIV from kissing. 29) You can get HIV by sharing a needle (for drugs or tattoos) with some who is infected.

False True

56 96

67 100

50 100

63 95

77 100

65 100

53 96

55 89

52 100

45 100

58 98

59 97

59 98

30) People with HIV should be treated the same as people who do not have the disease.

True

100

31) Abstaining from sex is the only 100 sure way to not get HIV.

True

18) Having an STI puts people at greater risk for getting HIV. 20) HIV is the same thing as AIDS. 21) HIV is spread through body fluids. 22) HIV can be spread by touching a person with the disease.

32) If I had HIV, I would keep it a secret. False 76 63 60 58 59 52 81 60 48 36 65 54 60 49) If I had HIV I could still reach my goals in life. True 88 89 70 84 81 78 92 81 81 82 82 83 83 50) I know a person or family who has been True 60 19 70 21 47 44 61 58 42 32 56 35 46 affected by HIV. Comments‐ Overall students have a high level of HIV knowledge. Some myths and misconceptions still need clarification regarding modes of HIV transmission. One quarter of students believe HIV can be cured. A similar percentage believe mosquitoes can spread HIV. One third of students believe kissing puts a person at risk for contracting HIV. And one‐quarter of students disagree that abstaining from sex is the best way to prevent HIV. This could possibly reflect knowledge of other modes of transmission such as infected needles which nearly all students are aware of as an HIV risk. Almost half of students know a person or family affected by HIV, but this is more common for females. And about two‐thirds of students would not keep an HIV positive status a secret. This could be an indicator of low levels of stigma towards people living with HIV/AIDS amongst students.

Using Pre‐/Post‐test Data The following test items deserve special attention. Items that had half or less than half of students providing the desired answer should be discussed thoroughly with students before the Post‐test is given. ISY facilitators should be aware of the gender roles and expectations students’ perceive and the needs of both genders as evident in the top 5 items girls and boys answers differed the most. Gender equality should be stressed. Items most frequently unanswered by students will need through teaching and discussion/activities.

Top 5 Pre‐test Items most Desired % All Students Divergent from Desired Answers Answer Desired Answer 7‐ Sometimes I feel I have no choices or options in life. False 44% 6‐ Sometimes I talk to my teachers when I have to make a difficult decision. True 43% 13‐ It is more important for girls to abstain from sex than it is for boys to False 24% abstain from sex. 14‐ Sexuality is the same as physical sexual activity or sexual intercourse. False 51% 17‐ It is easy for young people to know they have an STI. False 54% Top 5 Pre‐test Items most Desired Answer % Desired Answer % Divergent between Genders Females Males Different 7) Sometimes I feel I have no choices or options in False 37% 50% 13% life. 8) I usually make decisions alone without talking to False 51% 39% 12% others first. 13) It is more important for girls to abstain from False 17% 31% 14% sex than it is for boys to abstain from sex. 34) Having sex is the only way to show I have False 93 79 14% feelings for a boy or girl. 50) I know a person or family who has been *True 56 35 21% affected by HIV. *True was the decided “Desired Answer” because it was felt that knowing someone or a family affected by HIV would motivating force for personal HIV risk behavior change.

Top 5 Most Skipped Test Items ( No Response Given) 14‐ Sexuality is the same as physical sexual activity or sexual intercourse. 23‐ HIV can be cured. 32‐ If I had HIV, I would keep it a secret. 49‐ If I had HIV I could still reach my goals in life. 17‐ It is easy for young people to know they have an STI.

# All Students Skipped Item 15

% All Students Skipped Item 4%

11 10 9 9

3% 3% 2% 2%

21 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

Data from the pre‐test can be used several ways to strengthen the ISY Program 1. Compare student responses to the baseline data found in this report. 2. Use student data to revise the success indicators in the ISY Program Plan. 3. Tailor facilitation of the ISY Modules to the particular needs of the school or to female or male students. 4. Share this report with donors and other organizations conducting ISY Programs. 5. Share results with students as a way to open up discussion. 6. Share results with parents, teachers and school administrators and ask for their feedback.

Conducting the ISY KAB Post‐test Any survey can be improved and facilitators may find that some pre‐test questions could be written more clearly and specifically. Rewrite these questions just enough to be more clear and specific but not so much as to void comparison between pre‐test and post‐test scores. The following are suggested changes to ISY KAB test items before the post‐test is done. Suggested Suggest Revised Test Item Desired Answer 1) A person with good self‐esteem may find it difficult to stand up to peer False pressure. 2) A person with good self‐esteem is confident but not aggressive or violent. True 8) I usually make important or difficult decisions alone without talking to others False first. 29) You can get HIV by using an infected needle. True 30) People with HIV should be respected the same as people who do not have True the disease. 31) Abstaining from sex is the only way to protect myself from HIV. False 38) If I was being abused, I would tell a trusted adult. True 40) Young people’s bodies are more affected by alcohol and drugs than adults. True 48) People my age usually have sex with others who are at least 3 years older. ? After students have participated in all ISY Modules, conduct a KAB Post‐test using the same methods as the Pre‐test with the revised questions above. Compare pre‐test and post‐test results for each school and for females and males. The aim is to have more students providing the “Desired Answer.” Share Post‐test data the same ways outlined above.

22 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

Brickdam Secondary School Profile Pre‐test month: January 2010 Classes receiving ISY curriculum: 3A, 3B Classes completing pre‐test: 3A, 3B (100%) Prior ISY Modules: None

SUMMARY January 2010 ISY KAB Pre‐test Results Brickdam Secondary School ‐ Classes 3A, 3B Total Number Students Completing Test= 52 25 Females, 27 Males Test Item

Desired Answer

1) A person with good self‐esteem may be easily influenced by others. 2) A person with good self‐esteem is confident but not aggressive. 3) I know what my personal values are. 4) My personal values help me make important decisions.

False True True True

# and % Desired Answer Females Males 22, 88% 18, 67% 22, 88% 21, 78% 25, 100% 24, 89% 25, 100% 25, 93%

5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision. 7) Sometimes I feel I have no choices or options in life. 8) I usually make decisions alone without talking to others first. 9) I have several goals I want to reach in my life.

True True False False True

23, 92% 11, 44% 9, 36% 19, 76% 24, 96%

22, 81% 10, 37% 13, 48% 10, 37% 24, 89%

10) Making goals can help me become the person I want to be. 11) I feel I can trust the adults in my life. 12) I feel cared for in most of my relationships. 13) It is more important for girls to abstain from sex than it is for boys to abstain from sex. 14) Sexuality is the same as physical sexual activity or sexual intercourse.

True True True False False

25, 100% 21, 84% 20, 80% 4, 16% 14, 56%

27, 100% 20, 74% 17, 63% 10, 37% 22, 81%

15) I have learned about sexuality from media—movies, songs, television, magazines. 16) Sexually transmitted infections or STIs are not a problem for young people. 17) It is easy for young people to know they have an STI.

True False False

15, 60% 24, 96% 14, 56%

26, 96% 24, 89% 18, 67%

18) Having an STI puts people at greater risk for getting HIV. 19) The best way to prevent STIs is to abstain from sex. 20) HIV is the same thing as AIDS. 21) HIV is spread through body fluids. 22) HIV can be spread by touching a person with the disease.

True True False True False

22, 88% 24, 96% 20, 80% 20, 80% 24, 96%

22, 81% 24, 89% 22, 81% 22, 81% 27, 100%

23) HIV can be cured. 24) If a pregnant woman is HIV positive, her baby can contract the disease. 25) You can tell if a person has HIV because they look unhealthy.

False True False

23, 92% 21, 84% 23, 92%

24, 89% 24, 89% 24, 89%

26) You can contract HIV from mosquitoes. 27) You can increase your chances of getting HIV if you have sex with many people. 28) You can get HIV from kissing. 29) You can get HIV by sharing a needle (for drugs or tattoos) with some who is infected. 30) People with HIV should be treated the same as people who do not have the disease.

False True False True True

18, 72% 22, 88% 14, 56% 24, 96% 25, 100%

17, 63% 25, 93% 18, 67% 27, 100% 26, 96%

31) Abstaining from sex is the only 100% sure way to not get HIV. 32) If I had HIV, I would keep it a secret. 33) People can abstain from many things besides sex.

True False True

16, 64% 19, 76% 20, 80%

21, 78% 17, 63% 23, 85%

34) Having sex is the only way to show I have feelings for a boy or girl.

False

25, 100%

24, 89%

23 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

35) Young people can be victims of sexual abuse. 36) Child abuse is the child’s fault. 37) Young people can do things to reduce their risk of being abused. 38) If an adult does not believe you that you or someone you know is being abused, you should not tell anyone else. 39) Using drugs or alcohol can put you more at risk to make unhealthy decisions. 40) Young people are more affected by alcohol and drugs than adults. 41) Smoking marijuana makes you more likely to try other drugs. 42) Alcohol and drugs damage the body and can cause many health problems. 43) Music and music videos often show healthy, loving relationships. 44) Young people can do things to improve their health. 45) One way young people can stay healthy is to abstain from sex. 46) I feel I can talk to a parent or older relative about sex. 47) Most people my age have already had sex. 48) People my age usually have sex with others who are older. 49) If I had HIV I could still reach my goals in life. 50) I know a person or family who has been affected by HIV.

True False True False

25, 100% 25, 100% 20, 80% 23, 92%

26, 96% 25, 93% 22, 81% 23, 85%

True True True True False True True True True True True True

25, 100% 19, 76% 22, 88% 24, 96% 19, 76% 25, 100% 23, 92% 20, 80% 20, 80% 22, 88% 22, 88% 15, 60%

25, 93% 21, 78% 26, 96% 27, 100% 17, 63% 26, 96% 21, 78% 16, 59% 24, 89% 25, 93% 24, 89% 5, 19%

ANALYSIS by MODULE TOPIC January 2010 ISY KAB Pre‐test Results Brickdam Secondary School ‐ Classes 3A, 3B Total Number Students Completing Test= 52 25 Females, 27 Males Desired Test Items by Module Topic Answer Self‐esteem Items 1) A person with good self‐esteem may be easily influenced by others. False 2) A person with good self‐esteem is confident but not aggressive. True 7) Sometimes I feel I have no choices or options in life. False 9) I have several goals I want to reach in my life. True Desired Answer Values Items 3) I know what my personal values are. True 4) My personal values help me make important decisions. True 5) I value the opinions of my family more than the opinions of my friends. True 6) Sometimes I talk to my teachers when I have to make a difficult decision. True Desired Decisions Items Answer

4) My personal values help me make important decisions. 5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision. 7) Sometimes I feel I have no choices or options in life. 8) I usually make decisions alone without talking to others first. Goals Items 9) I have several goals I want to reach in my life. 10) Making goals can help me become the person I want to be. 49) If I had HIV I could still reach my goals in life. Relationships Items 5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision.

True True True False False Desired Answer

True True True Desired Answer

True True

% Desired Answer Females

Males

88% 88% 36% 96%

67% 78% 48% 89%

% Desired Answer Females

Males

100% 100% 92% 44%

89% 93% 81% 37%

% Desired Answer Females Males

100% 92% 44% 36% 76%

% Desired Answer Females Males

96% 100% 88%

89% 100% 89%

% Desired Answer Females Males

92% 44%

24 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

93% 81% 37% 48% 37%

81% 37%

11) I feel I can trust the adults in my life. 12) I feel cared for in most of my relationships. 13) It is more important for girls to abstain from sex than it is for boys to abstain from sex. 43) Music and music videos often show healthy, loving relationships. 46) I feel I can talk to a parent or older relative about sex. Abstinence Items 13) It is more important for girls to abstain from sex than it is for boys to abstain from sex. 19) The best way to prevent STIs is to abstain from sex. 31) Abstaining from sex is the only 100% sure way to not get HIV. 33) People can abstain from many things besides sex. 45) One way young people can stay healthy is to abstain from sex. Sex Items 14) Sexuality is the same as physical sexual activity or sexual intercourse. 15) I have learned about sexuality from media—movies, songs, television, magazines. 27) You can increase your chances of getting HIV if you have sex with many people. 34) Having sex is the only way to show I have feelings for a boy or girl. 46) I feel I can talk to a parent or older relative about sex. 47) Most people my age have already had sex. 48) People my age usually have sex with others who are older. Media Items 15) I have learned about sexuality from media—movies, songs, television, magazines. 43) Music and music videos often show healthy, loving relationships. STIs Items 16) Sexually transmitted infections or STIs are not a problem for young people. 17) It is easy for young people to know they have an STI. 18) Having an STI puts people at greater risk for getting HIV. 19) The best way to prevent STIs is to abstain from sex. HIV Items 18) Having an STI puts people at greater risk for getting HIV. 20) HIV is the same thing as AIDS. 21) HIV is spread through body fluids. 22) HIV can be spread by touching a person with the disease. 23) HIV can be cured. 24) If a pregnant woman is HIV positive, her baby can contract the disease. 25) You can tell if a person has HIV because they look unhealthy. 26) You can contract HIV from mosquitoes. 27) You can increase your chances of getting HIV if you have sex with many people. 28) You can get HIV from kissing. 29) You can get HIV by sharing a needle (for drugs or tattoos) with some who is infected. 30) People with HIV should be treated the same as people who do not have the disease.

True True False

84% 80% 16%

74% 63% 37%

False True

76% 80%

63% 59%

Desired Answer

% Desired Answer Females Males

False

16%

37%

True True True True

96% 64% 80% 92%

89% 78% 85% 78%

Desired Answer

% Desired Answer Females Males

False True

56% 60%

81% 96%

True False True True True

88% 100% 80% 80% 88%

93% 89% 59% 89% 93%

Desired Answer

% Desired Answer Females Males

True

60%

96%

False

76%

63%

Desired Answer

False False True True Desired Answer

% Desired Answer Females Males

96%

89%

56%

67%

88% 96%

81% 89%

% Desired Answer Females Males

True False True False False True False False True False True

88% 80% 80% 96%

81% 81% 81% 100%

92% 84% 92%

89% 89% 89%

72% 88% 56% 96%

63% 93% 67% 100%

True

100%

96%

25 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

31) Abstaining from sex is the only 100% sure way to not get HIV. 32) If I had HIV, I would keep it a secret. 49) If I had HIV I could still reach my goals in life. 50) I know a person or family who has been affected by HIV. Abuse Items 35) Young people can be victims of sexual abuse. 36) Child abuse is the child’s fault. 37) Young people can do things to reduce their risk of being abused. 38) If an adult does not believe you that you or someone you know is being abused, you should not tell anyone else. Alcohol & Drugs Items 39) Using drugs or alcohol can put you more at risk to make unhealthy decisions. 40) Young people are more affected by alcohol and drugs than adults. 41) Smoking marijuana makes you more likely to try other drugs. 42) Alcohol and drugs damage the body and can cause many health problems. Health Items 42) Alcohol and drugs damage the body and can cause many health problems. 44) Young people can do things to improve their health. 45) One way young people can stay healthy is to abstain from sex.

True False True True Desired Answer

True False True False Desired Answer

True True True True Desired Answer

True True True

64% 76% 88%

78% 63% 89%

60%

19%

% Desired Answer Females Males

100% 100% 80% 92%

% Desired Answer Females Males

100% 76% 88% 96%

93% 78% 96% 100%

% Desired Answer Females Males

96% 100% 92%

26 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

96% 93% 81% 85%

100% 96% 78%

Central Secondary School Profile Pre‐test month: January 2010 Classes receiving ISY curriculum: 3A, B, C, D Classes completing pre‐test: 3A, B, C, D (100%) Prior ISY Modules: None

SUMMARY January 2010 ISY KAB Pre‐test Results Central Secondary School ‐ Classes Total Number Students tested= 117 64 Females, 53Males Test Item

Desired Answer

False True True True

# and % Desired Answer Females Males 48, 75% 42, 78% 47, 73% 33, 61% 63, 98% 50, 93% 61, 95% 51, 94%

True True False False True

55, 86% 6, 9% 27, 42% 29, 45% 64, 100%

47, 87% 7, 13% 28, 52% 16, 30% 53, 98%

True True True False False

63, 98% 33, 52% 44, 69% 13, 20% 31, 48%

54, 100% 28, 52% 32, 59% 20, 37% 31, 57%

True False False

55, 86% 64, 100% 42, 67%

41, 76% 52, 96% 33, 61%

True True False True False

61, 95% 64, 100% 63, 98% 59, 92% 62, 97%

41, 76% 49, 91% 45, 83% 42, 79% 53, 98%

23) HIV can be cured. 24) If a pregnant woman is HIV positive, her baby can contract the disease. 25) You can tell if a person has HIV because they look unhealthy.

False True False

49, 77% 52, 81% 59, 92%

40, 74% 48, 89% 50, 93%

False True False True True

55, 86% 59, 92% 49, 77% 64, 100% 63, 98%

51, 94% 49, 91% 35, 65% 54, 100% 50, 93%

31) Abstaining from sex is the only 100% sure way to not get HIV. 32) If I had HIV, I would keep it a secret. 33) People can abstain from many things besides sex.

True False True

54, 89% 38, 59% 43, 67%

41, 76% 28, 52% 40, 74%

34) Having sex is the only way to show I have feelings for a boy or girl.

False

64, 100%

43, 80%

27 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

True False True False

63, 98% 62, 97% 54, 84% 61, 95%

50, 95% 50, 93% 44, 81% 39, 72%

True True True True False True True True True True True True

64, 100% 48, 75% 62, 97% 64, 100% 51, 80% 64, 100% 55, 86% 41, 64% 53, 83% 57, 89% 52, 81% 30, 47%

52, 96% 42, ,78% 45, 83% 51, 94% 39, 72% 52, 96% 48, 89% 39, 72% 39, 72% 47, 87% 42, 78% 24, 44%

ANALYSIS by MODULE TOPIC January 2010 ISY KAB Pre‐test Results Central Secondary School ‐ Classes Total Number Students tested=117 64 Females, 53 Males Desired Test Items by Module Topic Answer Self‐esteem Items 1) A person with good self‐esteem may be easily influenced by others. False 2) A person with good self‐esteem is confident but not aggressive. True 7) Sometimes I feel I have no choices or options in life. False 9) I have several goals I want to reach in my life. True Desired Answer Values Items 3) I know what my personal values are. True 4) My personal values help me make important decisions. True 5) I value the opinions of my family more than the opinions of my friends. True 6) Sometimes I talk to my teachers when I have to make a difficult decision. True Desired Decisions Items Answer

True True True False False Desired Answer

True True True Desired Answer

True True

% Desired Answer Females

Males

75% 73% 42% 100%

78% 61% 52% 98%

% Desired Answer Females

Males

98% 95% 86% 9%

93% 94% 87% 13%

% Desired Answer Females Males

95% 86% 9% 42% 45%

% Desired Answer Females Males

100% 98% 81%

98% 100% 78%

% Desired Answer Females Males

86% 9%

28 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

94% 87% 13% 52% 30%

87% 13%

True True False

52% 69% 20%

52% 59% 37%

False True

80% 64%

72% 72%

Desired Answer

% Desired Answer Females Males

False

20%

37%

True True True True

100% 89% 67% 86%

91% 76% 74% 89%

Desired Answer

% Desired Answer Females Males

False True

48% 86%

57% 76%

True False True True True

92% 100% 64% 83% 89%

91% 80% 72% 72% 87%

Desired Answer

% Desired Answer Females Males

True

86%

76%

False

100%

94%

Desired Answer

False False True True Desired Answer

True False True False False True False False True False True True

% Desired Answer Females Males

100%

96%

67%

61%

95% 100%

76% 91%

% Desired Answer Females Males

95% 98% 92% 97%

76% 83% 79% 98%

77% 81% 92%

74% 89% 93%

86% 92% 77% 100%

94% 91% 65% 100%

98%

93%

29 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

True False True True Desired Answer

True False True False Desired Answer

True True True True Desired Answer

True True True

89% 59% 81%

76% 52% 78%

47%

44%

% Desired Answer Females Males

98% 97% 84% 95%

% Desired Answer Females Males

100% 75% 97% 100%

96% 78% 83% 94%

% Desired Answer Females Males

100% 100% 86%

30 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

95% 93% 81% 72%

94% 96% 89%

Dolphin Secondary School Profile Pre‐test month: January 2010 Classes receiving ISY curriculum: 3A, 3B, 3C, 3D, 3E, 168 students; 103 females, 65 males Classes completing pre‐test: 3A, 3B, 3C, 3E [76% of all; 74 females (72%), 53 males (82%)] Prior ISY Modules: M1‐Self‐esteem, M2‐Values, M3‐Decision‐making, M4‐ Goal‐setting SUMMARY January 2010 ISY KAB Pre‐test Results Dolphin Secondary School ‐ Classes 3A, 3B, 3C, 3E Total Number Students tested= 127 74 Females, 53 Males Test Item

Desired Answer

False True True True

# and % Desired Answer Females Males 43, 58% 32, 60% 55, 74% 35, 66% 72, 97% 50, 94% 70, 95% 49, 92%

True True False False True

68, 92% 36, 49% 26, 35% 30, 41% 68, 92%

50, 94% 31, 58% 24, 45% 18, 34% 45, 85%

True True True False False

68, 92% 48, 65% 58, 78% 11, 15% 30, 41%

52, 98% 32, 60% 31, 58% 20, 38% 16, 30%

True False False

62, 84% 66, 89% 31, 42%

42, 79% 40, 75% 27, 51%

True True False True False

66, 89% 64, 86% 51, 69% 63, 85% 70, 95%

39, 74% 40, 75% 26, 49% 45, 85% 46, 87%

23) HIV can be cured. 24) If a pregnant woman is HIV positive, her baby can contract the disease. 25) You can tell if a person has HIV because they look unhealthy.

False True False

53, 72% 56, 76% 64, 86%

36, 68% 39, 74% 44, 83%

False True False True True

48, 65% 58, 78% 39, 53% 71, 96% 66, 89%

34, 64% 42, 79% 29, 55% 47, 89% 45, 85%

31) Abstaining from sex is the only 100% sure way to not get HIV. 32) If I had HIV, I would keep it a secret. 33) People can abstain from many things besides sex.

True False True

62, 84% 60, 81% 57, 77%

34, 64% 32, 60% 37, 70%

34) Having sex is the only way to show I have feelings for a boy or girl.

False

70, 95%

37, 70%

31 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

True False True False

74, 100% 67, 91% 68, 92% 64, 86%

49, 92% 42, 79% 46, 87% 33, 62%

True True True True False True True True True True True True

67, 91% 62, 84% 69, 93% 71, 96% 29, 39% 72, 97% 55, 74% 55, 74% 71, 96% 71, 96% 68, 92% 45, 61%

47, 89% 34, 64% 46, 87% 47, 89% 16, 30% 50, 94% 38, 72% 37, 70% 46, 87% 44, 83% 43, 81% 31, 58%

ANALYSIS by MODULE TOPIC January 2010 ISY KAB Pre‐test Results Dolphin Secondary School ‐ Classes 3A, 3B, 3C, 3E Total Number Students tested= 127 74 Females, 53 Males Desired Test Items by Module Topic Answer Self‐esteem Items 1) A person with good self‐esteem may be easily influenced by others. False 2) A person with good self‐esteem is confident but not aggressive. True 7) Sometimes I feel I have no choices or options in life. False 9) I have several goals I want to reach in my life. True Desired Answer Values Items 3) I know what my personal values are. True 4) My personal values help me make important decisions. True 5) I value the opinions of my family more than the opinions of my friends. True 6) Sometimes I talk to my teachers when I have to make a difficult decision. True Desired Decisions Items Answer

True True True False False Desired Answer

True True True Desired Answer

True True

% Desired Answer Females

Males

58% 74% 35% 92%

60% 66% 45% 85%

% Desired Answer Females

Males

97% 95% 92% 49%

94% 92% 94% 58%

% Desired Answer Females Males

95% 92% 49% 35% 41%

% Desired Answer Females Males

92% 92% 92%

85% 98% 81%

% Desired Answer Females Males

92% 49%

32 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

92% 94% 58% 45% 34%

94% 58%

True True False

65% 78% 15%

60% 58% 38%

False True

39% 74%

30% 70%

Desired Answer

% Desired Answer Females Males

False

15%

38%

True True True True

86% 84% 77% 74%

75% 64% 70% 72%

Desired Answer

% Desired Answer Females Males

False True

41% 84%

30% 79%

True False True True True

78% 95% 74% 96% 96%

79% 70% 70% 87% 83%

Desired Answer

% Desired Answer Females Males

True

84%

79%

False

39%

30%

Desired Answer

False False True True Desired Answer

% Desired Answer Females Males

89%

75%

42%

51%

89% 86%

74% 75%

% Desired Answer Females Males

True False True False False True False False True False True

89% 69% 85% 95%

74% 49% 85% 87%

72% 76% 86%

68% 74% 83%

65% 78% 53% 96%

64% 79% 55% 89%

True

89%

85%

33 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

True False True True Desired Answer

True False True False Desired Answer

True True True True Desired Answer

True True True

84% 81% 92%

64% 60% 81%

61%

58%

% Desired Answer Females Males

100% 91% 92% 86%

% Desired Answer Females Males

91% 84% 93% 96%

89% 64% 87% 89%

% Desired Answer Females Males

96% 97% 74%

34 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

92% 79% 87% 62%

89% 94% 72%

Queenstown Secondary School Profile Pre‐test month: January 2010 Classes receiving ISY curriculum: 3A1, A2 Classes completing pre‐test: 3A1, A2 (100% Prior ISY Modules: None SUMMARY January 2010 ISY KAB Pre‐test Results Queenstown Secondary School ‐ Classes 3A1, 3A2 Total Number Students Tested=59 31 Females, 28 Males Test Item

Desired Answer

False True True True

# and % Desired Answer Females Males 20, 65% 12, 43% 27, 87% 23, 82% 24, 77% 27, 96% 27, 87% 25, 89%

True True False False True

26, 84% 14, 45% 7, 23% 11, 35% 30, 97%

26, 93% 10, 36% 8, 29% 10, 36% 25, 89%

True True True False False

28, 90% 17, 55% 23, 74% 1, 3% 16, 52%

28, 100% 14, 50% 26, 93% 7, 25% 21, 75%

True False False

26, 84% 26, 84% 20, 65%

25, 89% 26, 93% 12, 43%

True True False True False

25, 81% 29, 94% 22, 71% 27, 87% 30, 97%

23, 82% 21, 75% 19, 68% 24, 86% 26, 93%

23) HIV can be cured. 24) If a pregnant woman is HIV positive, her baby can contract the disease. 25) You can tell if a person has HIV because they look unhealthy.

False True False

31, 100% 26, 84% 31, 100%

25, 89% 22, 79% 23, 82%

False True False True True

25, 81% 28, 90% 16, 52% 31, 100% 31, 100%

18, 64% 24, 86% 15, 45% 28, 100% 23, 82%

31) Abstaining from sex is the only 100% sure way to not get HIV. 32) If I had HIV, I would keep it a secret. 33) People can abstain from many things besides sex.

True False True

25, 81% 15, 48% 28, 90%

16, 68% 10, 36% 26, 93%

34) Having sex is the only way to show I have feelings for a boy or girl.

False

31, 100%

25, 89%

35 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

True False True False

31, 100% 31, 100% 29, 94% 25, 81%

27, 96% 25, 89% 26, 93% 23, 82%

True True True True False True True True True True True True

26, 84% 25, 81% 29, 94% 30, 97% 23, 74% 31, 100% 20, 65% 22, 71% 31, 100% 31, 100% 25, 81% 13, 42%

28, 100% 22, 79% 20, 71% 28, 100% 12, 43% 28, 100% 15, 54% 24, 86% 27, 96% 28, 100% 23, 82% 9, 32%

ANALYSIS by MODULE TOPIC January 2010 ISY KAB Pre‐test Results Queenstown Secondary School ‐ Classes Total Number Students tested= Females, Males Test Items by Module Topic Self‐esteem Items 1) A person with good self‐esteem may be easily influenced by others. 2) A person with good self‐esteem is confident but not aggressive. 7) Sometimes I feel I have no choices or options in life. 9) I have several goals I want to reach in my life. Values Items 3) I know what my personal values are. 4) My personal values help me make important decisions. 5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision. Decisions Items 4) My personal values help me make important decisions. 5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision. 7) Sometimes I feel I have no choices or options in life. 8) I usually make decisions alone without talking to others first. Goals Items 9) I have several goals I want to reach in my life. 10) Making goals can help me become the person I want to be. 49) If I had HIV I could still reach my goals in life. Relationships Items 5) I value the opinions of my family more than the opinions of my friends. 6) Sometimes I talk to my teachers when I have to make a difficult decision.

Desired Answer

Females

Males

False True False True

65% 87% 23% 97%

43% 82% 29% 89%

Desired Answer

Females

Males

True True True True

77% 87% 84% 45%

96% 89% 93% 36%

Desired Answer

True True True False False Desired Answer

True True True Desired Answer

True True

% Desired Answer

% Desired Answer Females Males

87% 84% 45% 23% 35%

% Desired Answer Females Males

97% 90% 81%

89% 100% 82%

% Desired Answer Females Males

84% 45%

36 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

89% 93% 36% 29% 36%

93% 36%

True True False

55% 74% 3%

50% 93% 25%

False True

100% 71%

100% 86%

Desired Answer

% Desired Answer Females Males

False

25%

True True True True

94% 81% 90% 65%

75% 68% 93% 54%

Desired Answer

% Desired Answer Females Males

False True

52% 84%

75% 89%

True False True True True

90% 100% 71% 100% 100%

86% 89% 86% 96% 100%

Desired Answer

% Desired Answer Females Males

True

84%

89%

False

74%

43%

Desired Answer

False False True True Desired Answer

% Desired Answer Females Males

84%

93%

65%

43%

81% 94%

82% 75%

% Desired Answer Females Males

True False True False False True False False True False True

81% 71% 87% 97%

82% 68% 86% 93%

100% 84% 100%

89% 79% 82%

81% 90% 52% 100%

64% 86% 45% 100%

True

100%

82%

37 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

True False True True Desired Answer

True False True False Desired Answer

True True True True Desired Answer

True True True

81% 48% 81%

68% 36% 82%

42%

32%

% Desired Answer Females Males

100% 100% 94% 81%

% Desired Answer Females Males

84% 81% 94% 97%

100% 79% 71% 100%

% Desired Answer Females Males

97% 100% 65%

38 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

96% 89% 93% 82%

100% 100% 54%

Tutorial Secondary School Profile Pre‐test month: January 2010 Classes receiving ISY curriculum: 3H Classes completing pre‐test: 3H (100%) Prior ISY Modules: M1‐ Self‐esteem, M2‐ Values, M3 Decision‐making, M4‐ Goal‐setting, M5‐ Building Healthy Relationships, M6‐ Sexuality, M7‐ HIV/AIDS & STIs, M8‐Abstinence & Refusal Skills SUMMARY January 2010 ISY KAB Pre‐test Results Tutorial Secondary School ‐ Class 3H Total Number Students Tested=29 10 Females, 19 Males Test Item

Desired Answer

# and % Desired Answer Females Males 8, 80% 12, 63% 4, 40% 9,47% 10, 100% 19, 100% 10, 100% 18, 95%

False True True True

True True False False True

9, 90% 8, 80% 5, 50% 6, 60% 9, 90%

18, 95% 12, 63% 14, 74% 8, 42% 15, 79%

True True True False False

9, 90% 5, 50% 8, 80% 3, 30% 4, 40%

19, 100% 13, 68% 11, 58% 3, 16% 6, 32%

True False False

9, 90% 8, 80% 2, 20%

17, 89% 19, 100% 13, 68%

True True False True False

7, 70% 8, 80% 10, 100% 8, 80% 7, 70%

17, 89% 19, 100% 18, 95% 18, 95% 17, 89%

23) HIV can be cured. 24) If a pregnant woman is HIV positive, her baby can contract the disease. 25) You can tell if a person has HIV because they look unhealthy.

False True False

3, 30% 6, 60% 7, 70%

15, 79% 16, 84% 15, 79%

False True False True True

9, 90% 9, 90% 5, 50% 10, 100% 10, 100%

18, 95% 18, 95% 12, 63% 18, 95% 14, 74%

31) Abstaining from sex is the only 100% sure way to not get HIV. 32) If I had HIV, I would keep it a secret. 33) People can abstain from many things besides sex.

True False True

5, 50% 6, 60% 9, 90%

16, 84% 11, 58% 13, 68%

39 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

34) Having sex is the only way to show I have feelings for a boy or girl. 35) Young people can be victims of sexual abuse. 36) Child abuse is the child’s fault. 37) Young people can do things to reduce their risk of being abused. 38) If an adult does not believe you that you or someone you know is being abused, you should not tell anyone else. 39) Using drugs or alcohol can put you more at risk to make unhealthy decisions. 40) Young people are more affected by alcohol and drugs than adults. 41) Smoking marijuana makes you more likely to try other drugs. 42) Alcohol and drugs damage the body and can cause many health problems. 43) Music and music videos often show healthy, loving relationships. 44) Young people can do things to improve their health. 45) One way young people can stay healthy is to abstain from sex. 46) I feel I can talk to a parent or older relative about sex. 47) Most people my age have already had sex. 48) People my age usually have sex with others who are older. 49) If I had HIV I could still reach my goals in life. 50) I know a person or family who has been affected by HIV.

False True False True False

7, 70% 9, 90% 8, 80% 9, 90% 8, 80%

13, 68% 18, 95% 19, 100% 14, 74% 16, 84%

True True True True False True True True True True True True

9, 90% 6, 60% 8, 80% 10, 100% 7, 70% 10, 100% 6, 60% 7, 70% 9, 90% 8, 80% 7, 70% 7, 70%

18, 95% 14, 74% 15, 79% 18, 95% 14, 74% 19, 100% 16, 84% 11, 58% 16, 84% 19, 100% 16, 84% 4, 21%

ANALYSIS by MODULE TOPIC January 2010 ISY KAB Pre‐test Results Tutorial Secondary School ‐ Classes Total Number Students tested=29 10 Females, 19 Males Desired Test Items by Module Topic Answer Self‐esteem Items 1) A person with good self‐esteem may be easily influenced by others. False 2) A person with good self‐esteem is confident but not aggressive. True 7) Sometimes I feel I have no choices or options in life. False 9) I have several goals I want to reach in my life. True Desired Answer Values Items 3) I know what my personal values are. True 4) My personal values help me make important decisions. True 5) I value the opinions of my family more than the opinions of my friends. True 6) Sometimes I talk to my teachers when I have to make a difficult decision. True Desired Decisions Items Answer

True True True False False Desired Answer

True True True Desired Answer

True

% Desired Answer Females

Males

80% 40% 50% 90%

63% 47% 74% 79%

% Desired Answer Females

Males

100% 100% 90% 80%

100% 95% 95% 63%

% Desired Answer Females Males

100% 90% 80% 50% 60%

% Desired Answer Females Males

90% 90% 70%

79% 100% 84%

% Desired Answer Females Males

90%

40 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

95% 95% 63% 74% 42%

95%

6) Sometimes I talk to my teachers when I have to make a difficult decision. 11) I feel I can trust the adults in my life. 12) I feel cared for in most of my relationships. 13) It is more important for girls to abstain from sex than it is for boys to abstain from sex. 43) Music and music videos often show healthy, loving relationships. 46) I feel I can talk to a parent or older relative about sex. Abstinence Items 13) It is more important for girls to abstain from sex than it is for boys to abstain from sex. 19) The best way to prevent STIs is to abstain from sex. 31) Abstaining from sex is the only 100% sure way to not get HIV. 33) People can abstain from many things besides sex. 45) One way young people can stay healthy is to abstain from sex. Sex Items 14) Sexuality is the same as physical sexual activity or sexual intercourse. 15) I have learned about sexuality from media—movies, songs, television, magazines. 27) You can increase your chances of getting HIV if you have sex with many people. 34) Having sex is the only way to show I have feelings for a boy or girl. 46) I feel I can talk to a parent or older relative about sex. 47) Most people my age have already had sex. 48) People my age usually have sex with others who are older. Media Items 15) I have learned about sexuality from media—movies, songs, television, magazines. 43) Music and music videos often show healthy, loving relationships. STIs Items 16) Sexually transmitted infections or STIs are not a problem for young people. 17) It is easy for young people to know they have an STI. 18) Having an STI puts people at greater risk for getting HIV. 19) The best way to prevent STIs is to abstain from sex. HIV Items 18) Having an STI puts people at greater risk for getting HIV. 20) HIV is the same thing as AIDS. 21) HIV is spread through body fluids. 22) HIV can be spread by touching a person with the disease. 23) HIV can be cured. 24) If a pregnant woman is HIV positive, her baby can contract the disease. 25) You can tell if a person has HIV because they look unhealthy. 26) You can contract HIV from mosquitoes. 27) You can increase your chances of getting HIV if you have sex with many people. 28) You can get HIV from kissing. 29) You can get HIV by sharing a needle (for drugs or tattoos) with some who is infected. 30) People with HIV should be treated the same as people who do not have the

True True True False

80% 50% 80% 30%

63% 68% 58% 16%

False True

70% 70%

74% 58%

Desired Answer

% Desired Answer Females Males

False

30%

16%

True True True True

80% 50% 90% 60%

100% 84% 68% 84%

Desired Answer

% Desired Answer Females Males

False True

40% 90%

32% 89%

True False True True True

90% 70% 70% 90% 80%

95% 68% 58% 84% 100%

Desired Answer

% Desired Answer Females Males

True

90%

89%

False

70%

74%

Desired Answer

False False True True Desired Answer

% Desired Answer Females Males

80%

100%

20%

68%

70% 80%

89% 100%

% Desired Answer Females Males

True False True False False True False False True False True

70% 100% 80% 70%

89% 95% 95% 89%

30% 60% 70%

79% 84% 79%

90% 90% 50% 100%

95% 95% 63% 95%

True

100%

74%

41 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

disease. 31) Abstaining from sex is the only 100% sure way to not get HIV. 32) If I had HIV, I would keep it a secret. 49) If I had HIV I could still reach my goals in life. 50) I know a person or family who has been affected by HIV. Abuse Items 35) Young people can be victims of sexual abuse. 36) Child abuse is the child’s fault. 37) Young people can do things to reduce their risk of being abused. 38) If an adult does not believe you that you or someone you know is being abused, you should not tell anyone else. Alcohol & Drugs Items 39) Using drugs or alcohol can put you more at risk to make unhealthy decisions. 40) Young people are more affected by alcohol and drugs than adults. 41) Smoking marijuana makes you more likely to try other drugs. 42) Alcohol and drugs damage the body and can cause many health problems. Health Items 42) Alcohol and drugs damage the body and can cause many health problems. 44) Young people can do things to improve their health. 45) One way young people can stay healthy is to abstain from sex.

True False True True Desired Answer

True False True False Desired Answer

True True True True Desired Answer

True True True

50% 60% 70%

84% 58% 84%

70%

21%

% Desired Answer Females Males

90% 80% 90% 80%

% Desired Answer Females Males

90% 60% 80% 100%

95% 74% 79% 95%

% Desired Answer Females Males

100% 100% 60%

42 Artistes in Direct Support ISY HIV Prevention Program Student KAB Pre‐test Results January 2010 Sara Krosch www.sarakrosch.com

95% 100% 74% 84%

95% 100% 84%