Abstract:
Background: Despite sub-Saharan Africa [SSA] constituting just 12% of the world’s population, the region has the
highest burden of HIV with 70% of HIV infection in general and 80% of new infections among young people
occuring in the region. Diverse intervention programmes have been implemented among young people but with
minimal translation to behavior change. A systematic review of Behavior Change Interventions [BCI] targeting
adolescents in SSA was therefore conducted with the objective of delineating this intervention vis-a-vis efficacy gap.
Methods: From April to July 2015 searches were made from different journals online. Databases searched included
MEDLINE, EBSCOhost, PsychINFO, Cochrane, and Google Scholar; Cambridge and Oxford journal websites, UNAIDS
and WHO for studies published between 2000 and 2015. After excluding other studies by review of titles and then
abstracts, the studies were reduced to 17. Three of these were randomized trials and five quasi-experimental. Overall
interventions included those prescribing life skills, peer education [n = 6] and community collaborative programmes.
The main study protocol was approved by the University of Malawi College of Medicine Ethics Committee on 30th
June 2016 [ref #: P.01/16/1847. The review was registered with PROSPERO [NIH] in 2015.
Results: The review yielded some 200 titles and abstracts, 20 full text articles were critically analysed and 17 articles
reviewed reflecting a dearth in published studies in the area of psychosocial BCI interventions targeting adolescents
in SSA. Results show that a number of reviewed interventions [n = 8] registered positive outcomes in both knowledge
and sexual practices.
Conclusions: The review demonstrates a paucity of psychosocial BCI studies targeting adolescents in SSA. There are
however mixed findings about the effectiveness of psychosocial BCI targeting adolescents in SSA. Other studies portray
intervention effectiveness and others limited efficacy. Peer education as an intervention stands out as being more
effective than other psychosocial regimens, like life skills, in facilitating HIV risk reduction. There is therefore need for
further research on interventions employing peer education to substantiate their potential efficacy in HIV risk reduction
among adolescents
