Can Church Schools Reduce Risk of HIV Infection for Orphan Girls in Zimbabwe?

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DESCRIPTION (provided by applicant): The AIDS pandemic has led to the illness and death of millions of adults, and has also resulted in millions of orphans. This study examines the context of schooling and sexual debut among a particularly vulnerable group, adolescent orphan girls in Zimbabwe. The study uses a rigorous randomized controlled trial design to test whether modest support can retain orphan girls in school through the transition to high school and whether religious schooling adds greater protection than secular schooling for HIV risk behaviors. The Methodist Church provides an important infrastructure for education, as well as services for orphans, in Zimbabwe. The study specifically focuses on young female orphans because of their greater likelihood of HIV infection, greater likelihood of school dropout, and greater vulnerability to sexual abuse due to loss of parental protection. Specific aims for the proposed study are: 1) To test experimentally whether modest assistance can help orphan girls stay in school through the transition to high school, and whether attending a church-run high school is more protective against HIV risk behaviors than attending a secular school; 2) To compare the content and consistency of sex and HIV-related messages taught through church-sponsored versus secular secondary schools; and 3) To examine how female orphans perceive HIV messages from church-sponsored compared to secular secondary schools, and to explore the context in which the girls make decisions about sexual behavior. For Aim 1, methods include use of an experimental design and self- administered surveys completed by orphan adolescent girls in Manicaland Province, Zimbabwe. For Aims 2 and 3, concept mapping techniques are used to gather and analyze information from adults (church personnel, teachers and administrators) and orphan teen girls. Research activities will be jointly conducted by U.S. and Zimbabwean collaborators. The research addresses a problem of the highest public health significance. HIV prevalence in Zimbabwe is among the highest in the world, as is the proportion of AIDS orphans. The study will contribute to the knowledge base concerning the extent and nature of religious organizations' involvement in HIV-related activities, mechanisms by which the United Methodist Church and its schools influence orphan risk and protective factors, and the context in which young Zimbabwean women make decisions about sex.