This article reports on the implementation of a schoolbased HIV/AIDS and life-skills training program to prevent the spread of HIV/AIDS among the young people in secondary schools in South Africa. The implementation of the program was evaluated for a period of two years, using process and outcome evaluation and a systems approach to understand the higher-order feedback processes that obstructed the implementation and effectiveness of the intervention. Although HIV/AIDS is a medical condition, this article emphasizes that HIV/AIDS prevention is interrelated with the psychosocial context within the community. Interventions should therefore be conceptualized and implemented in terms of the various levels of interaction in the community.
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References
1.
Abdool Karim, Q. (1998). Women and AIDS, the imperative for a gendered prognosis and preventive policy . Agenda, 39, 15–25 .
2.
Abdool Karim, S. S., Abdool Karim, Q., Preston-White, E., & Sankar, N. (1992). Reasons for lack of condom use among high school students . South African Medical Journal, 82, 107–110 .
3.
Banyard, V. L., & Miller, K. E. (1998). The powerful potential of qualitative research for community psychology . American Journal of Community Psychology, 26(4), 485–505 .
4.
Bateson, G. (1979). Mind and nature: A necessary unity. New York: E. P. Dutton .
5.
Beyond Awareness Campaign. (1998). Health Systems Trust Update, 30, 16-16 .
6.
Booyse, J., & Swanepoel, C. (1999). Die impak van onderwysverandering op die arbeidslewe van die Suid-Afrikaanse onderwysers (The impact of educational change on the working life of the South African teachers) . South African Journal of Education, 19(3), 214–221 .
7.
Calder, J. (1994). Programme evaluation and quality, a comprehensive guide to setting up an evaluation system. London: Kogan Page .
8.
Campbell, C., & Williams, B. (1998). Evaluating HIVprevention programmes: Conceptual challenges . Psychology in Society, 24, 57–68 .
9.
Capra, F. (1997). The Web of Life, a new synthesis of mind and matter. London: Flamingo .
10.
Cassimjee, N. (1998). The role of gender in black adolescent sexuality: An ecosystemic approach. Unpublished Master’s dissertation, University of Pretoria, Pretoria.
11.
Catania, J. A., Gibson, D. R., Chitwood, D. D., & Coats, T. J. (1990). Methodological problems in AIDS behavioural research: Influences on measurement error and participation bias in studies of sexual behavior . Psychological Bulletin, 108(3), 339–362 .
12.
Dalton, J. H., Elias, M. J., & Wandersman, A. (2001). Community psychology, linking individuals and communities. Belmont, CA: Wadsworth/Thomson Learning .
13.
Davidoff, S. (1997). School organization development in a changing political environment. In S. Hollingsworth (Ed.), International action research: A casebook for educational reform(pp. 100–111). London: The Falmer Press .
14.
Decosas, J. (1998/1999). Preventing HIV transmission through social policy . AIDS Analysis Africa, 9(4), 1–3 .
15.
De Jong, T. (1996). The educational psychologist and school organization development in the reconstruction of education in South Africa: Issues and challenges . South African Journal of Psychology, 26(2), 114–119 .
16.
De la Rey, R. P. (2002). Spiralling HIV/AIDS but bewildering disease management: A South African perspective in an African context . Paper presented at the APA Symposium ‘Psychology’s response to global health problems’, Chicago, 22–25 August.
17.
Department of Education. (1997). Quality education for all, overcoming barriers to learning and development. Report of the National Commission on Special Needs in Education and Training and National Committee on Education Support Services. Pretoria: Department of Education .
18.
Department of Health. (2000). HIV/AIDS/STD strategic plan for South Africa 2000–2005. Pretoria: Department of Health .
19.
Department of Health. (2002). National HIV and syphilis sero-prevalence survey of women attending public antenatal clinics in South Africa 2001. Pretoria: Department of Health .
20.
DiClemente, R. J. (1992). Adolescents and AIDS, a generation in jeopardy. Newbury Park, CA: Sage Publications .
21.
Edelston, K. (1988). AIDS. Countdown to doomsday. Johannesburg: Media House Publications .
22.
Edwards, R. W., Jumper-Thurman, P., Plested, B. A., Oetting, E. R., & Swanson, L. (2000). Community readiness: Research to practice . Journal of Community Psychology, 28(3), 291–307 .
23.
Evian, C. (1992). AIDS and the cycle of poverty . AIDS Scan, 4(4), 3-3 .
24.
Fiedeldey, A. C. (1995). Qualitative research methods: A systems theoretical application . Advances in systems science and application, inaugural issue, 160–167 .
25.
Flisher, A. J., Ziervogel, C. F., Chalton, D. O., Leger, P. H., & Robertson, B. A. (1993). Risk-taking behaviour of Cape Peninsula high-school students. Part VIII: Sexual behaviour . South African Medical Journal, 83, 495–497 .
26.
Flisher, A. J., Ziervogel, C. F., Chalton, D. O., Leger, P. H., & Robertson, B. A. (1996). Risk-taking behaviour of Cape Peninsula high-school students. Part IX: Evidence for a syndrome of adolescent risk behaviour . South African Medical Journal, 86, 1090–1093 .
27.
Gilgen, D., Williams, B. G., MacPhail, C., van Dam, C. J., Campbell, C., Ballard, R. C., & Taljaard, D. (2001). The natural history of HIV/AIDS in a major goldmining centre in South Africa: Results of a biomedical and social survey . South African Journal of Science, 97, 387–392 .
28.
Gillies, P., Tolley, K., & Wolstenholme, J. (1996). Is AIDS a disease of poverty? AIDS Care, 8(3), 351–363 .
29.
Goodman, R. M. (2000). Bridging the gap in effective program implementation: From concept to application . Journal of Community Psychology, 28(3), 309–321 .
30.
Hanson, B. G. (1995). General systems theory beginning with wholes. Toronto: Taylor & Francis .
31.
Hickson, J., & Mokhobo, D. (1992). Combatting AIDS in Africa: Cultural barriers to effective prevention and treatment . Journal of Multicultural Counseling and Development, 20, 11–22 .
32.
Hobfoll, S. E. (1998). Ecology, community and AIDS prevention . American Journal of Community Psychology, 26(1), 133–144 .
33.
Hunter, D. J., & Chen, L. C. (1992). The impact of AIDS and AIDS education, in the context of health problems of the developing world. In J. Sepulveda, H. Fineberg, & J. Mann (Eds.), AIDS prevention through education: A world view(pp. 323–342). New York: Oxford University Press .
34.
Jeevanantham, L. S. (1999). Towards 2005: Proposals for curriculum change . South African Journal of Education, 19(1), 49–54 .
35.
Keeney, B. P. (1983). Aesthetics of change. New York: Guilford Press .
36.
Kelly, J. A., Murphy, D. A., Sikkema, K. J., & Kalichma, S. C. (1993). Psychological interventions to prevent HIV infection are urgently needed: New priorities for behavioral research in the second decade of AIDS . American Psychologist, 48, 1023–1034 .
37.
Kerlinger, F. N., & Lee, H. B. (2000). Foundations of behavioral research, 4th edn. Fort Worth, TX: Harcourt College Publishers .
38.
Kushlick, A., & Rapholo, G. (1998). Baseline survey into HIV/AIDS knowledge, attitudes and related life skills. Researched for the National Life Skills Task Team. Braamfontein: Community Agency for Social Enquiry .
39.
Lamptey, P. (2000). Prevention does work! Keynote address at the XIII International AIDS Conference, Durban, 9–14 July.
40.
Levine, M. (1998). Prevention and community . American Journal of Community Psychology, 26(2), 189–206 .
41.
Levine, R. L., van Sell, M., & Rubin, B. (1992). System dynamics and the analysis of feedback processes in social and behavioral systems. In R. L. Levine & H. E. Fitzgerald (Eds.), Analysis of dynamic psychological systems. Vol. 1: Basic approaches to general systems, dynamic systems and cybernetics(pp. 145–261). New York: Plenum Press .
42.
Lindegger, G., & Wood, G. (1995). The AIDS crisis: Review of psychological issues and implementations, with special reference to the South African situation . South African Journal of Psychology, 25(1), 1–11 .
43.
Mabeba, M. Z., & Prinsloo, E. (2000). Perceptions of discipline and ensuing discipline problems in secondary education . South African Journal of Education, 20(1), 34–41 .
44.
Macheke, C., & Campbell, C. (1998). Perceptions of HIV/AIDS on a Johannesburg gold mine . South African Journal of Psychology, 28(3), 146–153 .
45.
Maclachlan, M., Namangala, J. J., & Kabambe, S. (1995). Towards AIDS prevention and education at the University of Malawi . The Central African Journal of Medicine, 41(6), 174–178 .
46.
MacPhail, C., & Campbell, C. (1999). Evaluating HIV/STD interventions in developing countries: Do current indicators do justice to advances in intervention approaches? South African Journal of Psychology, 29(4), 149–165 .
47.
Mathews, C., Everett, K., Binedell, J., & Steinberg, M. (1995). Learning to listen: Formative research in the development of AIDS education for secondary school students . Social Sciences Medicine, 12, 1715–1724 .
48.
Mathews, C., Kuhn, L., Metcalf, C. A., Joubert, G., & Cameron, N. A. (1990). Knowledge, attitudes and beliefs about AIDS in township school students in Cape Town . South African Medical Journal, 78(3), 511–516 .
49.
Mayekiso, T. V., & Twaise, N. (1993). Assessment of parental involvement in imparting sexual knowledge to adolescents . South African Journal of Psychology, 23(1), 21–23 .
50.
McNiff, J. (1988). Action research: Principles and practice. Hong Kong: MacMillan Education .
51.
Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis, an expanded sourcebook, 2nd edn. Thousand Oaks, CA: Sage Publications .
52.
Miller, H. G., Turner, C. F., & Moses, L. E. (1991). Methodological issues in AIDS surveys. In S. L. Coyle, R. F. Boruch, & C. F. Turner (Eds.), Evaluating AIDS prevention programs, expanded edition. Panel on the Evaluation of AIDS interventions of the National Research Council (pp. 207–315). Washington, DC: National Academy Press .
53.
Mogotsi, M. (1997). Knowledge and attitudes of school girls with regard to AIDS and sexual practices . Health Systems Trust Update, 27, 20-20 .
54.
O’Grady, M. (2000). Priorities in AIDS prevention and research . Presentation at the Third International HIV Prevention Works Symposium, Durban, 8–9 July.
55.
Parker, W., Dalrymple, L., & Durden, E. (1998). Communicating beyond AIDS awareness, a manual for South Africa.Commissioned by the HIV/AIDS and STD Directorate of the Department of Health as part of the 1997/1998 Beyond Awareness campaign. Pretoria: Department of Health .
56.
Patton, M. Q. (1997). Utilization-focused evaluation, the new century text, 3rd edn. Thousand Oaks, CA: Sage Publications .
57.
Perkel, A. K., Strebel, A., & Joubert, G. (1991). The psychology of AIDS transmission: Issues for intervention . South African Journal of Psychology, 21(3), 148–152 .
58.
Ratsaka, M. H., & Hirschowitz, R. (1993). Knowledge, attitudes, beliefs and general sexual behaviour patterns/practices amongst inhabitants of high density informal settlements with regard to sexuality and AIDS related issues in Alexandra township. AIDS Research Feedback session. Pretoria: Report of the Department of National Health and Population Development .
59.
Reddy, P., Everett, K., & Steinberg, M. (1992). Appraisal of the AIDS and lifestyle education of the Department of National Health and Population Development. Cape Town: National AIDS Programme, Medical Research Council .
60.
Schoub, B. (1992). AIDS in South Africa—into the second decade . South African Medical Journal, 81, 55–56 .
61.
Sepulveda, J., Fineberg, H., & Mann, J. (1992). AIDS prevention through education: A world view. New York: Oxford University Press .
62.
Sherriffs, P. (1997). A time for review—HIV in a democratic South Africa . Positive Outlook, 4(3), 10–12 .
63.
Siegel, S. (1956). Nonparametric statistics for the behavioral sciences. Tokyo: Kogakusha Company .
64.
Steyn, A. G. W. (1998). Learner growth in the South African school system . South African Journal of Education, 18(3), 182–193 .
65.
Steyn, A. G. W. (1999). The elimination of inequalities in the provision of school education in South Africa . South African Journal of Education, 19(1), 66–73 .
66.
St Lawrence, J. S., Eldridge, G. D., Reitman, D., Little, C. E., Shelby, M. C., & Brasfield, T. L. (1998). Factors influencing condom use among African American women: Implications for risk-reduction interventions . American Journal of Community Psychology, 26(1), 7–28 .
67.
Sunday Times. (2001). Be afraid. Be very afraid. Newspaper article , 4 March, p. 4-4 .
68.
Swart, K. (Ed.). (1998). Life skills and HIV/AIDS education programme. Project report of the joint venture of the South African Departments of Health and Education. Pretoria: Department of Education .
69.
Van Dyk, A. C. (1991). Voorkoming van VIGS: Psigososiale voorspellers van houdings, gedrag en gedragsverandering(Prevention of AIDS: Psychosocial predictors of attitude, behaviour and behaviour change). Unpublished dissertation, University of South Africa, Pretoria.
70.
Visser, M. J. (1995). The need for AIDS education in schools: An analysis of knowledge, attitude and behavioural intentions of students . South African Journal of Education, 15(3), 130–138 .
71.
Visser, M. (1996). Evaluation of the First AIDS Kit, the AIDS and lifestyle education programme for teenagers . South African Journal of Psychology, 26(2), 103–113 .
72.
Visser, M. J., Korf, L., & Roos, J. L. (1995). AIDS prevention on the campus . South African Journal of Higher Education, 9(2), 165–174 .
73.
Visser, M., & Moleko, A.-G. (1999). High-risk behaviour of primary school learners . Urban Health and Development Bulletin, 2(1), 9–15 .
74.
Walker, M. (1997). Transgressing boundaries: Everyday/Academic discourses. In S. Hollingsworth (Ed.), International action research: A casebook for educational reform(pp. 136–146). London: The Falmer Press .
75.
World Health Organization. (1992). School health education to prevent AIDS and sexually transmitted diseases. WHO AIDS Series 10. Geneva: World Health Organization .
76.
World Health Organization/Global programme on AIDS. (1993). School health education to prevent AIDS and STD: A resource package for curriculum planners. Geneva: WHO/GPA .
77.
World Health Organization. (1999). Preventing HIV/AIDS/STI and related discrimination: An important responsibility of health-promoting schools. WHO Information Series on School Health. Geneva: World Health Organization .
