Effectiveness of promoting the A and B portions of AIDS prevention
policies in Zimbabwe and Uganda.

I am Hanna Klaus, M.D., executive director of the Natural Family
Planning Center of Washington, D.C. and the Teen STAR program, an
educational program of sexuality for teens which has shown good results
in maintaining primary abstinence and a return to secondary abstinence
by half of previously sexually active adolescents in the USA.

Our program in Uganda is coordinated by the religious education advisor
at the Catholic Bishops Conference in Kampala. Teachers' stipends are
supplied by the schools in which they offer the Teen STAR program in
Kampala, Kasese, Soroti , Gulu, Masaka, Busheny and several other towns.
Uganda's success in reducing HIV prevalence is well documented. Our own
evaluation is still in process, but as student retention in the program
is very high, we can surmise that the message of abstinence until
marriage, coupled with ongoing charting of fertility patterns by the
girls is being received and heeded. To date no pregnancies have been
reported.

The Teen STAR program in Bulawayo, Zimbabwe is situated within Christian
Health Care Services and has received funding from Catholic Relief
Services. They reported 26 teaching sites with 48 active teachers and
total of 696 students: Age 13: 141 males, 236 females. Age 14 -16 104
males, 200 females. Age 18-21: 47 males, 68 females.post partum 309 are
registered to begin: 167 females, 142 males. Feedback has been
overwhelmingly positive.

To introduce the program, a two hour awareness meeting is held with the
communities, to recruit initial teachers. Their training begins 2-4
weeks later with a 2 ½ day workshop which discusses anatomy and
physiology im Ndebele and Shona, the predominant local languages. Other
topics include parenting, child development and counseling. The last
half day is for planning. The course manuals are then collected.

Subsequently the teachers are trained in a five day training workshop,
where the teacher trainees receive some of the course materials in order
to work with them, they are only allowed to keep the whole manual when
the preliminary preparations have been completed satisfactorily. By
then, their commitment is "sacred."

In the course of learning Teen STAR the teachers learn the Billings
Ovulation Method, which is the basis for the fertility awareness
training. This in turn enhances monogamy

The teachers are recruited from this group and attend the first stage of
teacher training, .

Enrollment and retention has been much easier in the rural areas than in
Bulawayo, and is clearly reinforced by the staged instruction. The
founder of the program, Mrs. Sybil Gray, directed the Bulawayo
Archdiocesan Natural Family Planning Program before shifting the work to
an ecumenical base in order to reach out to other health care providers
in the community. Mtbele North has seen considerable increase since.

The program in Ethiopia lagged for lack of funding, but has just
acquired a grant and looks forward to offering Teen STAR in six high
schools beginning February.

The success of these programs, and many other abstinence programs
demonstrates that different values operate when persons choose
premarital abstinence as opposed to condoms. The two are not equivalent
and must not be put on a line relationship for the sake of statistics.
One can compare outcome measures -- sexual intercourse, STI
transmission, unplanned pregnancies, but it makes no sense to randomize
participants into abstinence or condom tracks as had been attempted, and
expect youths to choose anything but the course of least resistence.
Given the fact that nearly everyone in sub-Saharan Africa knows someone
who is HIV positive, or has died from AIDS, the fear of the deadly
disease in not a scare tactic. It is a factor which operates across the
spectrum and has an undoubted deterring effect on youths who now receive
almost as much advertising for sex as do the ones in the US.

Different programs work for different populations. It is important to
ascertain the clients' values and support them, rather than using a one
size fits all approach. Since there are many FBO's who are trained to
deliver programs using the A and B approach, it is important to include
them in the Global AIDS program, which is designed not only to treat HIV
patients, but to attempt to contain the disease by preventing further
spread. There is no surer or cheaper way than A and B.

Hanna Klaus, M.D.

Natural Family Planning Center of Washington, D.C.

and Teen STAR Program

8514 Bradmoor Drive

Bethesda, MD 20817-3810

301-897-9323

<hklaus@dgsys.com>

http://www.teenstar.org