dc.description.abstract |
We conducted a 2-year pilot randomized controlled trial (N = 105) in a high HIV-prevalence area
in rural western Kenya to test whether providing young orphan adolescents with uniforms, school
fees, and community visitors improves school retention and reduces HIV risk factors. The trial
was a community intervention, limited to one community. In this paper, we examined intervention
implementation and its association with outcomes using longitudinal data. We used both
quantitative and qualitative methods to evaluate the community-based model for orphan HIV
prevention, with recommendations for future studies. Despite promising effects after 1 year, GEE
analyses showed null effects after 2 years. Volunteer community visitors, a key element of the
intervention, showed little of the expected effect although qualitative reports documented active
assistance to prevent orphans' school absence. For future research, we recommend capturing the
transition to high school, a larger sample size, and biomarker data to add strength to the research
design. We also recommend a school-based intervention approach to improve implementation and
reduce infrastructure costs. Finally, we recommend evaluating nurses as agents for improving
school attendance and preventing dropout because of their unique ability to address critical
biopsychosocial problems. |
en_US |