The sexual health of pupils in years 4 to 6 of primary schools in rural Tanzania
Todd, J.; Changalucha, J.; Ross, D.A.; Mosha, F.; Obasi, A.I.N.; Plummer, M.; Balira, R.; Grosskurth, H.; Mabey, D.C.W.; Hayes, R.
Sexually Transmitted Infections 80(1): 35-42
2004
ISSN/ISBN: 1368-4973 PMID: 14755033 DOI: 10.1136/sti.2003.005413Document Number: 232372
Objective: To describe the sexual health of pupils (years 4-6) in 121 rural primary schools in north western Tanzania, before the implementation of an innovative sexual health intervention in 58 of the schools. Methods: A cross-sectional survey was carried out. The study population comprised of pupils registered in years 4-6 in 20 rural communities in 1998. Basic demographic information was collected from all pupils seen. Those born before 1 January 1985 (aged ~14 years and over) were invited to participate in the survey, and asked about their knowledge and attitudes towards sexual health issues, and their sexual experience. A urine specimen was requested and tested for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae and pregnancy (for females). Results: 9283 pupils were enrolled and provided demographic information and urine sample. Male pupils were significantly older than females (mean age, 15.5 vs. 14.8 years, P<0.001), but all other demographic characteristics were similar between the sexes. 14 (0.2%) pupils (4 male and 10 female) were HIV positive, 83 (0.9%) were positive for C. trachomatis, and 12 (0.1%) for N. gonorrhoeae. 32 female pupils (0.8%) were positive in the pregnancy test. Sexual experience was reported by one fifth of primary school girls, and by almost half of boys. Only 45 of 114 (39%) girls with biological markers of sexual activity reported having had sex. Conclusions: HIV, C. trachomatis, N. gonorrhoeae and pregnancy are present though at relatively low levels among primary school pupils in years 4-6. A high proportion of pupils with a biological marker of sexual activity denies having had sex. Alternative ways of collecting sensitive data about the sexual behaviour of school pupils should be explored.