Impact Evaluation of a School-Based Sexuality and HIV-Prevention Education Activity in South Africa

The impact evaluation of a school-based sexuality and HIV prevention education activity in South Africa was conducted by MEASURE Evaluation with support from the United States Agency for International Development, and in partnership with the South Africa Department of Basic Education. The evaluation employs a two-arm, stratified cluster-randomized trial, where a secondary school is a cluster and a learner is the unit of observation/analysis. A sample of schools was randomly selected and assigned to intervention and control arms for a longitudinal observation of Grade-8 female learners (data collected at baseline in year 2016, midline in 2017, and endline in 2018). The impact (at the end of 2018) of the new program is measured by comparing the incidence of HSV-2, or pregnancy, among the cohort of Grade-8 female learners enrolled in the selected schools in 2016 (hereafter referred to as “the cohort of female learners”), in the intervention and control arms. The cohort of female learners in the intervention and control arms took part in an annual panel survey from 2016 to 2018. Biomarkers for HSV-2 were collected from the cohort of female learners at baselinein 2016 and again at endline in 2018. All biomarker samples collected in 2018 were tested for HSV-2. Additionally, all the biomarkers were tested for HIV at endline, which permites assessment of HIV prevalence among the cohort of female learners at endline. The cohort of female learners were followed even if they dropped out of school after baseline, to ensure a complete picture of intervention effects. Additionally, cross-sectional samples of male learners in Grade-8 at baseline, Grade-9 at midline, and Grade-10 at endline in the same schools participated in the baseline, midline, and endline surveys, respectively; no effort was made to link the male learners over time. Likewise, cross-sectional samples of female learners in Grade-9 at midline and Grade-10 at endline in the same schools participated in the midline and endline surveys, respectively. Again, no effort was made to link the male learnrs over time. Likewise, a cross-sectional sample of Grade-10 female learners at baseline in the same schools participated in the baseline survey.