What Works for Women and Girls

term and long-term attitudes changed in the intervention group, with scores significantlydifferent before the talk with after the talk, with changes sustained over threemonths (Paxton, 2002). (Gray III) (adolescents, communication, self-perception, Australia)Women participants in a microcredit program with a participatory HIV/AIDS andgender empowerment education aspect for the poorest half of households in ruralLimpopo Province, South Africa reported that meeting a healthy-looking HIV-positiveyoung woman during an education session was crucial to understanding their vulnerabilityand the vulnerability of their families to HIV. One of the women surveyed reportedthat, “most people thought that HIV-positive people were skinny and sickly looking. Wewere scared because we found out that the virus can affect anyone indiscriminately… Iwill never forget her face; it reminds me about the seriousness of the virus and the needfor protection” (Phetla et al., 2008: 512). (Gray V) (self-perception, communication, SouthAfrica)8. Comprehensive programs for youth can improve HIV knowledge and encourage protectivebehavior.JSI evaluated the African Youth Alliance (AYA) Programs in Uganda (implemented2001–2005), Tanzania (2002–2005), and Ghana (2001–2005) using post-interventionanalysis between and intervention sites to determine the impact AYA’s comprehensiveintegrated program on SRH behavior. The AYA Program had six components, namely,(1) policy and advocacy coordination; (2) institutional capacity building; (3) coordinationand dissemination; (4) BCC (behavior change communication), including lifeplanning skills and enter-education activities such as sports, dance, and rap; (5) YouthFriendly Services; and (6) Integration of adolescent sexual and reproductive health(ASRH) with livelihood skills training. The study compared knowledge, attitudes, andbehavioral outcomes between intervention and control sites of 3,416 youth (17–22 yearold) in Ghana, 1,900 in Tanzania, and 3,176 in Uganda and found a significant positiveimpact of AYA on condom use, contraceptive use, partner reduction and severalself-efficacy and knowledge antecedents to behavior. Areas with little evidence of AYAimpact included delay of sexual debut and abstinence among females and males andpartner reduction among males. The impact of AYA was greater on young women thanon young men, although in many cases, the knowledge of unexposed men was muchhigher than that of unexposed women. In Ghana, AYA significantly improved the confidenceof young women in obtaining condoms and in insisting that a partner use acondom. The number young women who reported having ever used a condom, used acondom at last sex, used a condom at first sex, and who claimed to have had fewer thantwo sex partners in the last year also significantly increased. In Tanzania, young womenexpressed a significant increase in positive attitudes toward condom users, confidencein putting on a condom correctly, and confidence that they can insist that a partner use acondom. Tanzanian females exposed to AYA also were significantly more likely to reportfewer than two sexual partners in the last year, condom use at first sex, condom use atWHAT WORKS FOR WOMEN AND GIRLS133