Changing adolescents" beliefs about protective sexual behavior : the Botswana tsa banana program

Data were obtained from the Botswana Tsa Banana Adolescent Reproductive Health Surveys in mid-1994 and October 1995. The sample included 2396 adolescents. The program was conducted by the Botswana Social Marketing Program, which was also promoting nationwide condom sales. About 40% of women attending prenatal clinics in Lobatse and Francistown tested positive for HIV. Health belief measures included the perceived severity, susceptibility, benefits of condom use and less risky sex behavior, and barriers to condom use and less risky sex behavior. This study demonstrated the need for a complex and sophisticated research design and gender-based programs. Program managers should be aware in designing interventions that there may be positive and negative consequences. The behavior change model should detect changes and potential causal relationships at multiple stages. AIDS prevention programs should consider issues such as creating awareness about unsafe sex practices and destigmatizing condom use. Most adolescents were aware that AIDS was not curable. Many females pre- and post-intervention did not believe sexually active persons were at risk. Post-intervention, over 80% of males in both locations increased their perception of increased risk due to sexual activity. Awareness of the benefits of abstinence improved for females only in the intervention location, but for males it increased five-fold in both locations. Findings suggest that adolescent women increasingly associated condom use with irresponsible behavior. Male adolescents in both locations strongly believed that sexual activity increased one"s status with peers. Both men and women were equally shy about buying condoms. (POPLINE abstract)