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Aims: To test the applicability of an extended version of the theory of planned behaviour for the study of condom use intentions among large samples of young people in South Africa and Tanzania. Methods: Baseline data of a randomized controlled trial of school-based HIV/AIDS prevention programmes were used. The setting comprised secondary schools in the regions of Cape Town, Polokwane and Dar es Salaam. Participants were 15,782 secondary school students. The main measures were scales for intentions, knowledge, risk perceptions, attitudes, perceived social norms and perceived self-efficacy regarding condom use. Results: Seven variables accounted for 77% of the variance in intentions to use condoms: attitudes (β=0.17), injunctive norms (β=0.27), self-efficacy (β=0.41), gender (lower condom use intentions among females), being a student at the Dar es Salaam site (lower scores than students in Cape Town and Polokwane), socioeconomic status (higher intentions with higher status), and access to condoms (higher intentions with higher access). Conclusions: Our results are comparable to those of studies conducted in Europe and the USA. Social cognition models such as the theory of planned behaviour are applicable in understanding the correlates of condom use intentions in African contexts. [ABSTRACT FROM AUTHOR]

Aims: To identify with whom in-school adolescents preferred to communicate about sexuality, and to study adolescents' communication on HIV/AIDS, abstinence and condoms with parents/guardians, other adult family members, and teachers. Methods: Data were obtained from a baseline questionnaire survey carried out in South Africa (Cape Town and Mankweng) and Tanzania (Dar es Salaam) in early 2004. We analysed data for 14,944 adolescents from 80 randomly selected schools. The mean ages were as follows: Cape Town, 13.38 years (standard deviation (SD) 1.15);Mankweng, 13.94 years (SD 1.35); and Dar es Salaam, 12.94 years (SD 1.31). Results: Adolescent females preferred to receive sexuality information from their mothers, while among males there was a higher preference for fathers in two sites. Thirty-seven per cent, 41% and 29% reported never or hardly ever communicating about sexuality with parents, other adult family members, and teachers, respectively. ''Silence'' was more prevalent in Dar es Salaam than in the other two sites. The odds of ''never or hardly ever'' communicating with parents in Dar es Salaam were higher among girls than among boys (p <0.01). For the two South African sites, boys had significantly higher odds of experiencing silence than did girls (both p <0.001), and socioeconomic status was positively associated with parent-adolescent sexuality communication. In the logistic regression models, explained variation (Nagelkerke's R2) across sites ranged from 0.013 to 0.032. Conclusions: In all three sites, a substantial proportion of adolescents reported not communicating with their parents about HIV/AIDS, abstinence, or condoms. The low proportion of explained variation in sexuality communication implies that silence is common across sociodemographic subgroups. [ABSTRACT FROM AUTHOR]

Aims: This article reports on the development and psychometric properties of an instrument to evaluate school-based HIV/ AIDS interventions aimed at adolescents in three African sites. Methods: The instrument was developed in a series of steps that involved a review of existing instruments; use of empirical data and secondary literature supporting an association between the variables of interest and sexual intercourse or condom use; operationalizing the constructs of the theoretical model employed; and using the objectives of the intervention. Test-retest reliability studies were conducted at each site. Results: The questionnaire demonstrated good internal consistency and adequate test-retest reliability. Cronbach's alpha was higher than 0.50 for all the 10 psychosocial scales, while Cohen's kappa showed poor to substantial test-retest reliability on the sexual behaviour items (κ=0.14 to 0.69). Conclusions: We conclude that the instrument had sufficient test-retest reliability and internal consistency. [ABSTRACT FROM AUTHOR]

Aims: Action to prevent the spread of HIV among young people in Sub-Saharan Africa is needed urgently. In order to be effective, such action should be theory and evidence based and carefully adapted to local cultures and contexts. The present article describes the organization, theoretical basis, and methodological approach of a project that aims at developing and evaluating school-based interventions targeting adolescents aged 12–14 years. Methods: Researchers from European and African universities have developed interventions that were conducted in three sites: Cape Town and Polokwane (South Africa) and Dar es Salaam (Tanzania). In each site the interventions were evaluated through large-scale field experiments with intervention schools and delayed intervention schools and with baseline and two follow-up data collections. Mimimum sample sizes were estimated for each site based on local data and taking into acount that the unit of allocation was schools and not individual students (the design effect). During the formative phase as well as within the field experiments, qualitative studies were also conducted. Discussion: The interventions were developed consistent with the Intervention Mapping approach, and the theoretical framework was based on a modified version of the Theory of Planned Behaviour. The limitations of Western social cognition models were recognized, and the theoretical framework has therefore been expanded in two directions: towards integrating cultural processes and towards taking societal factors and constraints into account. Conclusion: The project will throw light on the application of social cognition models as well as the usefulness of the Intervention Mapping approach to intervention development in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]