Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya
A public health campaign warning about the increased risk of HIV associated with older partners decreased teen pregnancy (a proxy for unprotected sex), while abstinence-only education did not.
In sub-Saharan Africa, nearly two million people are infected with HIV/AIDS each year, most often through sexual transmission. One-fourth of those who contract the virus are under the age of 25, and teenage girls are three times more likely to be infected with HIV/AIDS than teenage boys. Research suggests this imbalance is due to unsafe sex between teenage girls and older men, who are more likely to be HIV positive than their teenage counterparts. This study examines whether abstinence-only campaigns or risk reduction campaigns that underscore a greater understanding of potential partners’ relative riskiness are more effective at reducing risky sexual behaviors and pregnancy among teenage girls.
The authors measured the effect of different educational information campaigns on the prevalence of teenage pregnancy, a proxy for risky sexual behavior. 164 primary schools were randomly chosen for the first treatment group, known as the Teacher Training program, which reinforced the nationally established HIV prevention curriculum by emphasizing abstinence until marriage. 71 primary schools were randomly chosen for the second treatment group known as the Relative Risk Information campaign which was an information campaign that presented the relative risks of acquiring HIV through potential partners of varying genders and ages.
Study participants provided information on pregnancy and birth history, age of their child’s father, and marital status. The study found that:
- The Teaching Training program had no effect on the incidence of unprotected sex. The relative risk education program led to a 28% decrease in the likelihood that girls started childbearing within a year.
- The Relative Risk Information led to a 61% decrease in the incidence of pregnancy between teenage girls and older men, thereby decreasing the incidence of unprotected sex.
- The number of girls in the relative risk campaign who reported using condoms at their last sexual intercourse increased by 11 percentage points compared to girls in the control program.
Overall, providing information about the relative risk of unprotected sex and HIV/AIDS led to an increase in self-reported sexual activity, but to a decrease in unsafe sex. This finding suggests that teenagers are not likely to abstain from sex even when presented with more information about the risks; however, they are more likely to modify their sexual behavior and engage in safer sex practices with less risky partners.
This study compared sexual health behaviors and outcomes in 328 primary schools in Western Kenya. Schools were randomly selected to receive one of the following four treatments: (1) a teacher training program that reinforced the nationally established HIV prevention curriculum by emphasizing abstinence until marriage; (2) an information campaign that presented the relative risks of acquiring HIV through potential partners of varying genders and ages; (3) neither campaign; or (4) both campaigns. Students were followed for over a year, and data on incidence of childbearing and sexual behavior was collected over the one year follow-up period.