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Substance Use and Sexual Risk Prevention in Cape Town, South Africa: An Evaluation of the HealthWise Program

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Abstract

Sexual behavior and substance use represent major threats to the health and well-being of South African adolescents, especially in light of the high prevalence of HIV infection in this population. However, there is currently a lack of evidence-based school programs designed to address health risk behaviors. The current study details the evaluation of HealthWise South Africa, a leisure, life skills, and sexuality education intervention for eighth and ninth grade students. We hypothesized that, compared to controls, HealthWise participants would have delayed sexual initiation, reduced rates of current sexual activity, increased use of and perceived access to condoms, and lower rates of lifetime and past use of multiple substances. Longitudinal data were analyzed using logistic regression of multiply imputed data. Results indicate that HealthWise was effective in increasing the perception of condom availability for both genders (OR = 1.6). As compared to HealthWise participants, control participants also had steeper increases in recent and heavy use of alcohol (OR = 1.4 [95% C.I. = 1.1–1.8], 1.6 [1.2–2.2], respectively) and recent and heavy cigarette use (OR = 1.4 [1.1–1.7], 1.4 [1.1–1.8], respectively). There were also several significant gender by treatment interactions, which are discussed. These results suggest that HealthWise is a promising approach to reducing multiple health risk behaviors among the population of school-going South African adolescents.

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Acknowledgements

This research was funded by NIH Grants R01 DA01749 and T32 DA017629-01A1.

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Authors and Affiliations

  1. The Pennsylvania State University, State College, PA, USA

    Edward A. Smith, Lori-Ann Palen, Linda L. Caldwell & John W. Graham

  2. University of Cape Town, Cape Town, South Africa

    Alan J. Flisher & Catherine Mathews

  3. University of Bergen, Bergen, Norway

    Alan J. Flisher

  4. University of the Western Cape, Cape Town, South Africa

    Lisa Wegner & Tania Vergnani

  5. S-109 Henderson Building, University Park, PA, 16802, USA

    Edward A. Smith

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  1. Edward A. Smith
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  2. Lori-Ann Palen
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  8. Tania Vergnani
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Correspondence to Edward A. Smith.

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Smith, E.A., Palen, LA., Caldwell, L.L. et al. Substance Use and Sexual Risk Prevention in Cape Town, South Africa: An Evaluation of the HealthWise Program. Prev Sci 9, 311–321 (2008). https://doi.org/10.1007/s11121-008-0103-z

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  • DOI: https://doi.org/10.1007/s11121-008-0103-z

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