Topical issue: HIV and AIDS - Impact of voluntary counselling and testing and health education on HIV prevention among secondary school students in northern Uganda

The study aim was to evaluate the impact of Voluntary Counselling and Testing (VCT) and School Health Education (SHE) on HIV/AIDS related knowledge, behaviours and risk perception among secondary school students in Northern Uganda. A post-test only control group study was conducted among 1,312 secondary school students classified as follows: students involved in SHE and VCT (group 1); only in SHE (group 2); in neither VCT nor SHE (group 3, control group). Almost all students are aware of AIDS and condoms and how to prevent HIV infection: abstinence and condom use were the most reported preventive measures. About 60% of those in groups 2 and 3 were sexually active compared to 31% in group 1 (P<0.001). Students of group 3 had earlier sexual debut (median age=15) than those in group 2 (median age=16) (P<0.001). No significant differences in condom use with any type of partner were observed, although students in group 2 were more likely to report consistent condom use. Overall, two-third of the students say they do not feel they are at risk of infection, but almost 70% of them reported no reason. Despite considerable knowledge about AIDS, many students engage in unprotected sex and are thus at risk of infection. Students exposed to VCT and SHE seemed to have safer behaviour, suggesting that these programs should be expanded and further research should be conducted on the effects. SHE could be the appropriate method to reach youth and their families in poor-resources settings, whereas VCT could be the appropriate choice as part of a comprehensive service delivered to the users.