Cognitive and Behavioral Effects of Participatory Sex Education on the Dual Prevention of STI/HIV/AIDS and Unwanted Pregnancies among Adolescents in Kinshasa High Schools, DR Congo


Context: With the view to reorient both STI/HIV/AIDS prevention and adolescents pregnancies, this research study aims at evaluating cognitive and behavioral acquisitions, as well as the process of interactive sex education participatory approach among adolescents in Kinshasa high schools. Methods: Based on a “pre and post” virtually experimental design, two crosswise surveys were conducted in Kinshasa, for six months in 2011-2012 on 484 high school students (pre-survey) and on 441 high school students (post-survey), whose age range from 14 - 19 years including both sexes. Two participatory educational talks (PET) “A” and “B”, covered weekly in two different schools, were compared to a control group school. The PET “A” consisted of interactive interpersonal communication sessions given by an external expert as a substitute for the life education course in one school. The PET “B” carried out in another school, included more educational talk sessions, led by the external expert and supplemented by a close follow-up of teenagers divided into small groups of 10 participants. The subjects’ assessment was based on their knowledge, attitudes and practices relating to STI/HIV/AIDS dual prevention as well as to unwanted pregnancies. Results: The subjects involved in the PET “B” displayed a better/higher performance based on their knowledge, attitudes and practices related to STI/HIV/AIDS dual prevention and unwanted pregnancies. Broadly speaking, knowledge has been improved 6 times with the PET “B” (OR = 6, 10, IC 95%) (3.24 - 11.9), and 3 times with the PET “A” (OR = 3, 45, IC 95%) (1.79 - 6.81), compared to control school. Similarly, findings on subjects’ attitudes show an improvement rated 12 times with the PET”B” (OR = 11, 99, IC 95%) (5.67 - 27.38) and 5 times for the PET “A” (OR = 5.51, IC 95%) (2.54 - 12.87). As far as the subjects’ practices are concerned, an improvement of 6 more times of protected sexual intercourses with the PET “B” compared with the control school group (OR = 6, 52, IC 95%) (3.60 - 12.0). The process assessment records a spontaneous involvement of schools enhanced by the positive contribution of Life Education and Biology teachers; add a massive participation of adolescents who requested permanent PET program. Conclusion: The results of this study suggest that school sexual education programs can be improved to increase the quality of apprenticeship. The use of interactive methods and the consideration of the adolescents’ specific needs that take into account the gender approach may bring about beneficial advantages on both educational outcomes and reproductive health of adolescents.

Share and Cite:

Nsakala, G. , Coppieters, Y. and Kayembe, P. (2014) Cognitive and Behavioral Effects of Participatory Sex Education on the Dual Prevention of STI/HIV/AIDS and Unwanted Pregnancies among Adolescents in Kinshasa High Schools, DR Congo. Open Journal of Preventive Medicine, 4, 204-215. doi: 10.4236/ojpm.2014.44026.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] United Nation Fund for Population Activities UNFPA (2011) Challenges Opportunities and Action in a World of 7 Billion. World Population Day: Of Global 7 Billion Actions Campaign in DRC.
[2] DRC Multi-Sectoral National Programme Fight against AIDS, PNMLS-DRC (2011) Epidemiological Surveillance Report of HIV/AIDS.
[3] DRC National Institute of Statistics and the United Nations Fund for Children UNICEF (2011) Multiple Indicator Cluster Survey in Democratic Republic of Congo (MICS-DRC) Final Report.
[4] DRC Ministry of Planning—MACRO (2007) Demographic and Health Survey in Demographic Republic of Congo (DHS-DRC).
[5] Rwenge, J.R.M (2013) Sexual Behavior among Adolescents and Youg People in Sub-Saharian Francophone Africa ANS Associated Factors. African Journal of Reproductive Health, 17, 49-66.
[6] Nsakala, V.G. and Coppieters, Y. (2012) Vulnerability and Risk Profiles Related to the Reproductive Health of Adolescents and Youth in the Last Decade in DRC, In Congo-Afrique, 466, 427-439.
[7] Nsakala, V.G., Coppieters, Y., Kayembe, K.P., Lapika, D.B. and Gomis, D. (2012) Adolescents’ and Young People’s Perceptions of Sexual and Reproductive Health in the Democratic Republic of Congo. Revue Santé Publique, 24, 403-415.
[8] Nsakala, V.G., Coppieters, Y. and Kayembe, K.P. (2013) An Innovative Approach Using Both Cellphone and Radio to Identify Young People’s Sexual Concerns in the Democratic Republic of the Congo. Submit at Archives of Public Health.
[9] DRC Ministry of Primary, Secondary and Professional Education (2006) National Program for Primary et Secondary.
[10] Central Education Service to Live. Programs of Education Course to Live (2008) Primary and Secondary Level.
[11] UNESCO, UNAIDS, UNFPA, UNICEF, WHO (2009) International Technical Guidance on Sexuality Education. An Evidence—Informed Approach for Schools, Teachers and Health Educators.
[12] Lamoureux, A. (1995) Research and Methodology in Humans Sciences. Editions Etudes Vivantes, Paris.
[13] Turcotte, D. and Tard, C. (2003) The Evaluation of Intervention and the Programm Evaluation. In: Mayer, R., et al., Eds., Research Methods in Social Intervention, Gaetan Morin Editeur, Québec, 409 p.
[14] National Institute of Health and Medical Research (2003) Prevention Programs and Evaluation Methods. In: Health of Children and Adolescents. Proposal to Preserve. Les éditions Inserm, Paris.
[15] Tones, K. (2000) Evaluating Health Promotion: A Tale of Three Errors. Patient Education and Counseling, 39, 227-236.
[16] Evaluation of Health Education Programs (2001) In Education for the Health of Youngs. INSERM, Paris, 101.
[17] Lecomte, R. and Rutman, L. (1982) Introduction to Methods of Evaluative Research. Presses de l’Université Laval, Quebec.
[18] Baudouin, A., Lefrançois, R. and Ouellet, F. (1986) The Assessment Practices: Challenges, Strategies and Principles. Service Social, 35, 188-214.
[19] Kirby, D., Obasi, A. and Laris, B.A. (2006) The Effectiveness of Sex Education and HIV Education Interventions in Schools in Developing Countries. WHO Technical Report Series, No. 938, 103-150.
[20] Suchman, E.A. (1971) Evaluative Research. Russell Sage Foundation, New York.
[21] Daboer, J.C., Ogbonna, C. and Jamda, M.A. (2008) Impact of Health Education on Sexual Risk Behaviour of Secondary School Students in Jos, Nigeria. Nigerian Medical Journal, 17, 324-329.
[22] Main, D.S., Iverson, D.C., McGloin, J., Banspach, S.W., Collins, J.L., Rugg, D.L. and Kolbe, L.J. (1994) Preventing HIV Infection among Adolescents: Evaluation of a School-Based Education Program. Preventive Medicine, 23, 409-417.
[23] Johnson, B.T., Carey, M.P., Marsh, K.L., Levin, K.D. and Scott-Sheldon, L.A. (2003) Interventions to Reduce Sexual Risk for the Human Immunodeficiency Virus in Adolescents, 1985-2000: A Research Synthesis. Archives of Pediatrics and Adolescent Medicine, 157, 381-388.
[24] Kirby, D., Laris, B.A. and Rolleri, L. (2005) Impact of Sex and HIV Education Programs on Sexual Behaviors of Youth in Developing and Developed Countries. Youth Research Working Paper No. 2, Family Health International, Research Triangle Park.
[25] Pettersson, T. (2003) Basic Values and Civic Education, a Comparative Analysis of Adolescent Orientations towards Gender Equality and Good Citizenship. World Values Survey.
[26] Ferguson, J., Dick, B. and Ross, D. (2006) Conclusions and Recommendations in Preventing HIV/AIDS in Young People: A Systematic Review of the Evidence from Developing Countries. WHO Technical Report Series No. 938. World Health Organization, Geneva.
[27] Haberland, N. and Rogow, D. (2007) Sex Education and HIV, It Is Time to Change in Methodology. Promote the Health, Safety and Productivity. Transitions to Adulthood. Document n° 22.
[28] Shepherd, J., Kavanagh, J., Picot, J., Cooper, K., et al. (2010) The Effectiveness and Cost-Effectiveness of Behavioural Interventions for the Prevention of Sexually Transmitted Infections in Young People Aged 13-19: A Systematic Review and Economic Evaluation. Health Technology Assessment, 14, 1-206, iii-iv.
[29] Stephenson, J., Strange, V., Allen, E., Copas, A., et al. (2008) The Long-Term Effects of a Peer-Led Sex Education Programme (RIPPLE): A Cluster Randomized Trial in Schools in England. PLoS Medicine, 5, e224.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.