Impact of abstinence only education in areas with high literacy rate and low prevalence (AIDS) in Shimla, Himachal Pradesh, India
METHODS: A cross sectional school based study, in a study population of 853 adolescent girls selected by 2 stage stratified random sampling with sampling unit being secondary school girls. A pretested, self-administered study tool applied after consent from parents and assent from participants in the local language (modified standard questionnaire by WHO).
RESULTS: Overall 95% of study population as some knowledge about HIV and its routes of transmission. When coming to STDs/RTIs only 30% were found to be aware of signs and symptoms related to it and 80% of girls not aware that condom can protect from HIV/STDs. Though self-reported sexual activity was only 5.2% with response rate of 60% to this question; on adjusting for it, came out to be 12% (increasing trend compared to last decade). Significant low level of girls knowing fertile period (37.7%), >2 modern methods of contraception (45%), preferring no sex as the most appropriate contraception for their age (60.2%), >2 modes of HIV transmission (58.2%). Major factors contributing to misconceptions were: schools not giving any classes on SRH (RR-2.2, CI 1.6-2.9; p<0.001), not visited any health facility (RR 2.0, CI 1.0-2.3, p 0.04) and not having any elder siblings, low economic status, studying non science subjects. Eve teasing reported by 80% of girls.
CONCLUSIONS: HIV and condom awareness has increased significantly as well as abstinence message, at the cost that other integral part of AIDS awareness program are left behind as STD, menstruation hygiene, contraception and life skills to negotiate any untoward advances. At the same time penetrance of adolescent health programs is negligible even to the most educated and aware section of adolescents.