With an average annual per capita gross national product of US$2000, biomedical prevention and treatment methods in Namibia are simply not affordable to most citizens or to the government.
Significance. The study is significant in that in 1996, the Government of Namibia in partnership with UNICEF and the University of Maryland, elected to adapt an adolescent AIDS risk-reduction curriculum that had been successful in the United States. The resulting curriculum, 'My Future is My Choice' (MFMC), included 14 sessions, each 2 hours in length, to be administered over 7 weeks. The MFMC intervention was administered to adolescents throughout Namibia. Before its widespread implementation, the programme was assessed in 1996-1997 through a randomized, controlled longitudinal trial of 515 youths from 10 schools in two of Namibia's 11 districts, Caprivi and Omusati. The primary outcome measures of the intervention were abstinence and condom use. Additional risk behaviors, as well as HIV risk intentions and perceptions, were also assessed. This study reported the results of this evaluation.
Theoretical model. Although no theoretical model is described as used in the study, a conceptual framework can be discerned. The study acknowledges the abundance of literature indicating behavioral interventions in Western settings that share certain common features said to change self-reported risk behaviors among targeted audiences, including adolescents. The framework of this study is that of behavioral change that involves training and practice in specific skills such as the acquisition and use of condoms, redounding to an increase of protected sex.
Research design and methods. A randomized trial of a 14-session face-to-face intervention emphasizing abstinence and safer sexual practices was conducted among 515 youths (median age 17 years and median grade 11) attending 10 secondary schools located in two districts in Namibia. Youths were randomly assigned to the intervention or control condition at the level of the individual. HIV risk behaviors; intentions and perceptions were assessed at baseline; and immediately post-intervention at 6 and 12 months post-intervention.
Sample characteristics and sampling. Youths from 10 schools, randomly selected from among the 161 upper/high schools in Omusati and Caprivi who were in grades 9 or 11 between ages 15 and 18 were invited to enroll. Over 80% of eligible youths enrolled. After enrolment, students attended a preliminary session to complete baseline questionnaires. They were then randomly assigned at the level of the individual based on random numbers table, to the intervention condition (e.g. participate in the MFMC programme in late 1996) or to the delay-control condition (e.g. would not receive the intervention until after the 12-month follow-up had been completed). The protocol received ethical clearance from institutional review boards at