An Evaluation of the Mongolian Red Cross Society's HIV/AIDS Response Program
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<bold>Abstract</bold> An Evaluation of the Mongolian Red Cross Society's HIV/AIDS Response Program Tia S. Farrell Chair of the Supervisory Committee: Professor David Grembowski Department of Health Sciences <bold>Specific Aims</bold> The aim of this program evaluation is to determine whether Mongolian Red Cross Society's HIV/AIDS Response Program (HARP) increased HIV/AIDS prevention knowledge among youth aged 15-24 in targeted secondary schools and universities in Ulaanbaatar, Mongolia by the conclusion of the program period (1 July, 2008 to 30 June, 2011). <bold>Setting</bold> Although Mongolia presently has a low prevalence of HIV, with less than 0.01% of the population infected, it has been estimated that without concerted prevention efforts, between now and 2015 the country's HIV prevalence will double every two years (The Global Fund to Fight AIDS, Tuberculosis and Malaria, 2004). New HIV cases over the past two years have been mostly in youth and rates of transmission of STIs, already very high, continue to increase among youth in Mongolia. To date, most HIV prevention efforts in Mongolia have targeted most-at-risk populations; however, there is a great need for HIV awareness and prevention programs targeting the general population, specifically youth (Mongolian Red Cross Society, 2010). <bold>Methods</bold> A post-intervention survey was conducted at project end, 1 July-1 August, 2011, among 712 youth in targeted secondary schools and universities in three districts of Ulaanbaatar, Mongolia to evaluate the impact of the project. The impact of the program was assessed by a post-intervention survey of prevention knowledge, by comparing groups that were exposed to the intervention to groups that were not exposed. Knowledge was assessed through analysis of survey questions about modes of transmission of HIV/AIDS, methods of prevention, and rejection of common misconceptions. Program contribution to target group knowledge levels was assessed through survey responses to the question, "Where do you receive information about HIV/AIDS?" <bold>Results</bold> In answer to evaluation Question 1, "What is the difference in HIV/AIDS knowledge between those who were exposed to the HARP intervention and those who were not among youth aged 15-24 in targeted secondary schools and universities in Ulaanbaatar, Mongolia?" results showed a strong positive program effect on identifying all four important modes of transmission of HIV, a week positive program effect on identifying ways of preventing HIV, and a weak negative program effect on rejecting common misconceptions about HIV. The exposed group tended to answer correctly significantly more often than the non-exposed group on identifying important modes of transmission and prevention methods; however, the trend was the opposite when it came to identifying common misconceptions. It appears that the program increased knowledge among the exposed group in identifying modes of transmission and to some extent, prevention methods; but had a negative program effect when it came to rejecting misconceptions. Evaluation Question 2 was "To what extent is HARP the source of HIV/AIDS information among youth aged 15-24 in targeted schools and universities in Ulaanbaatar, Mongolia?" Sixteen percent of respondents directly credited Red Cross as a source of their knowledge about HIV/AIDS, and about 90% of respondents indicated sources of information of which Red Cross may be an indirect source. <bold>Conclusions</bold> The impact of the Mongolian Red Cross Society's HIV/AIDS response program on HIV/AIDS knowledge among students in targeted secondary schools and universities in Ulaanbaatar, Mongolia ranged from strong positive program effects in some areas to weak negative program effects in other areas. The program appears to have increased knowledge in the exposed group in terms of correct identification of unsafe behaviors that increase risk of HIV acquisition, and to some extent in terms of identifying effective ways of preventing transmission. Why the exposed group incorrectly identified some safe behaviors as unsafe is unclear. Perhaps the intervention emphasized providing knowledge of unsafe behaviors, but did not explicitly explain that other behaviors were safe. Alternatively, Evaluation Question 1 or the format for soliciting or recording answers to Question 1 may have lacked clarity.
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