AIDS prevention and condom availability in an urban school system: facilitating factors and programme challenges

Abstract

This paper reports on a three-year evaluation of the implementation of the New York City AIDS Education and Condom Availability Program in the public high schools. Data were obtained in a sample of 12 representative high schools from surveys, interviews and focus groups with school administrators and students. The paper identifies and describes six key facilitating factors associated with variations in level of implementation: strength of the AIDS team, characteristics of AIDS team members, support of school principals, involvement of related school-based programmes, support of parents, and AIDS lessons. The paper also identifies and describes five major factors that inhibited programme use: programme quality, concerns about confidentiality, embarrassment, negative attitudes toward condoms, and relationship issues. Implications of these facilitating factors and programme challenges for con dom-availability programmes are discussed. Public high schools in cities with high HIV prevalence can play a key role in HIV prevention. By paying attention to the organisational factors that facilitate programme implementation, urban school and health officials may be able to increase the impact of these pro grammes.