Cluster-randomized controlled trials were carried out to examine effects on sexual practices of school-based interventions among adolescents in three sites in sub-Saharan Africa. In this publication, effects on communication about sexuality with significant adults (including parents) and such communication as a mediator of other outcomes were examined. Belonging to the intervention group was significantly associated with fewer reported sexual debuts in Dar es Salaam only (OR 0.648). Effects on communication with adults about sexuality issues were stronger for Dar es Salaam than for the other sites. In Dar, increase in communication with adults proved to partially mediate associations between intervention and a number of social cognition outcomes. The hypothesized mediational effect of communication on sexual debut was not confirmed. Promoting intergenerational communication on sexuality issues is associated with several positive outcomes and therefore important. Future research should search for mediating factors influencing behavior beyond those examined in the present study.
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The partners and principal investigators of the study included the University of Cape Town (Alan John Flisher), Muhimbili University of Health and Allied Sciences (Sylvia Kaaya), University of Limpopo (Hans Onya), Karolinska Institutet (Minou Fuglesang), University of Maastricht (Herman Schaalma), University of Oslo (Knut-Inge Klepp), World Population Foundation (Jo Reinders), and University of Bergen (Leif Edvard Aarø; co-ordinator). The study was carried out as part of a European Union-funded research project. The full title is ‘Promoting sexual and reproductive health. School-based HIV/AIDS prevention in sub-Saharan Africa’. The acronym for the project is ‘SATZ’, which stands for South Africa Tanzania. The authors thank the teachers and students who participated in this study. This study was funded by the European Commission – International Cooperation Activities Research Programme (Fifth Framework Programme-ICA4-CT-2002-10038).
Conflict of interest
Ethical clearance was provided by the Western Norway Regional Committee for Medical Research Ethics, the Research Ethics Committee of the University of Cape Town (South Africa), the Senate Research and Publications Committee of the Muhimbili University of Health and Allied Sciences in Dar es Salaam (Tanzania) and The Ethics Committee of the Faculty of Health Sciences, University of the North (South Africa). Participating students signed assent forms.
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Namisi, F., Aarø, L.E., Kaaya, S. et al. Adolescents’ Communication with Parents, Other Adult Family Members and Teachers on Sexuality: Effects of School-Based Interventions in South Africa and Tanzania. AIDS Behav 19, 2162–2176 (2015). https://doi.org/10.1007/s10461-015-1019-9
- Interpersonal communication
- Statistical mediation