Using a gender-transformative program to improve adolescent contraception use in South Africa and Lesotho

在博客中World Contraception Day,Xanthe Hunt及其同事讨论“如果我是Thabo”干预,以防止意外怀孕并促进性健康塔博ISRCTN注册表

众所周知,青少年行为很难改变。确实,大型荟萃分析表明,一系列行为改变计划平均是效率较低对于13至17岁的青少年而不是过渡到青春期的年幼儿童。而且,在所有难以改变的行为中,性行为是棘手的。

Part of this is simply because adolescents may have low levels of knowledge about how to engage in safe sex, including how to negotiate condom use, where to purchase contraceptives, and how to access accurate information about sexual health.

Dineo(Thato Makolotsa)和Thabo(Lereko Mafethe)
Dineo(Thato Makolotsa)和Thabo(Lereko Mafethe)
第5阶段电影的视频中的屏幕截图

However, years of research have shown that improving knowledge alone is not enough to shift how teenagers (or adults for that matter) behave: even with all of the information in the world, people may still behave in ways which are against their best interests.

Adolescents may be driven to engage in unsafe sex because they hold erroneous beliefs about sex and relationships, because they do not consider or comprehend the possible outcomes of their behaviors, they may not think that they are capable of taking action to protect their sexual health, and – finally – because they are extremely susceptible, because of their developmental period, to social influences.

A team of researchers from the生命课程研究所健康研究在南非的Stellenbosch大学和莱索托与英国贝尔法斯特皇后大学的同事合作,正在提供一项计划,旨在应对这些社会影响力。

If I Were Thabo是一种关系和性教育干预措施,旨在通过解决青少年性行为的复杂驱动因素来改善青少年避孕药的使用并防止青少年怀孕,重点是使少女容易受到不安全性的性别规范,并有早期父母的危险。

Young man’s back, looking into distance
Young man’s back, looking into distance
Photo by Andre Hunter on Unsplash

The intervention was first developed and trialed in the英国(asIf I Were Jack),在改编在南非和莱索托(Lesotho)之前,并探讨了青少年性行为的所有决定因素,包括对能力,知识和技能的结果和信念的信念。它有各种不同的活动,这些活动旨在通过吸引青春期男孩和女孩来解决性别规范以实现行为的改变。

If I Were Thabois delivered in high schools by trained intervention facilitators. The program’s content includes slides, classroom activities, and homework exercises which involve adolescents’ parents. However,If I Were Thabocenters on an interactive video drama which is shown to participants on the first day of the intervention.

The video tells the story of Thabo, a teenager who has just found out that his girlfriend, Anathi, is unexpectedly pregnant. The video shows the young couple negotiate finding out about the pregnancy and exploring their different options.

在每个场景之后,视频暂停和问题都会出现在屏幕上,这促使青少年观众将自己放在thabo的鞋子上,并考虑这对夫妻可能采取的每种可能行动的后果。问题包括“如果您是Thabo,您的父母会如何反应?”或“如果您是Thabo,您对这种怀孕的最强烈感觉?”

Two legs with shoes
Two legs with shoes
Photo by Aedrian on Unsplash

The subsequent class sessions continue to examine the role of boys and young men in preventing adolescent pregnancy. Activities such as ‘Controversial statements’, ‘What does it mean to be a man? What does it mean to be a woman?’, and ‘People and things’, explore gender norms and stereotypes, and how they perpetuate the power imbalances which perpetuate sexual risk for young people, particularly girls.

在“人与物”,一个活动改编自one developed for thePromundo H Toolkit, the class is divided into two groups with an imaginary line. One group of students are the people, and the other are the things. The class is then told: “THINGS: You cannot think, feel, or make decisions. You have to do what the “people” tell you. If you want to move or do something, you have to ask the person for permission. PERSONS: You can think, feel, and make decisions. Furthermore, you can tell the things what to do.”

经过5分钟的行动和居住在这种不平等的动态之后,促进者主持了关于居住在每个角色的感觉的讨论,为什么社会上的某些人可以像人类和其他人一样被视为事物,以及哪些因素,以及哪些因素。the participants’ communities might normalize the differential treatment of people, including on the basis of gender.

Two young men laughing
Two young men laughing
Photo by Shawnee D on Unsplash

Each activity in the intervention package – which is delivered over five class sessions – corresponds to a known determinant of adolescent sexual behavior. Through engaging in these activities, adolescents are equipped with knowledge, given an opportunity to challenge beliefs and improve their understanding of social influences, and – ultimately – alter their intentions and behavior in relation to sexual health, including by avoiding unprotected sex.

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