Engaging caregivers in providing comprehensive sexual education to prevent pregnancy, sexually transmitted infections, and human immunodeficiency virus among street adolescents in central Java: A quasi-experimental design
Zahroh Shaluhiyah, Bagoes Widjanarko, Budiyono Budiyono, Shabrina Arifia Qatrannada, Mina Hattori, Usha Rani, John Parish-SprowlBACKGROUND:
Prior studies have reported that street adolescents engaging in high-risk behaviors are at a substantially higher risk of human immunodeficiency virus (HIV) infection. This study examines the impact of engaging caregivers on enhancing knowledge, attitudes, and preventive skills against pregnancy, sexually transmitted infections (STIs), and HIV among street adolescents.
MATERIALS AND METHODS:
A quasi-experimental non-randomized pretest–posttest design with a control group was conducted in Central Java, Indonesia. A total of 200 street adolescents were recruited using purposive sampling, with 100 assigned to the intervention group (Semarang City) and 100 to the control group (Pekalongan and Batang Regencies). The intervention consisted of a six-month comprehensive sexuality education (CSE) program delivered by 20 trained caregivers following a five-day preparatory training. Outcomes included changes in knowledge, attitudes, and sexual risk behavior measured using structured questionnaires. Data were analyzed using Chi-square tests, independent and paired t-tests, and Linear Mixed Models to adjust for baseline differences and repeated measures.
RESULTS:
This study showed the average score for both knowledge and attitudes was increased by 7.09 and 2.80 points, respectively, after six-month interventions in the intervention group. While sexual risk behavior was decreased from 0.48 to 0.35 (0.7 points). The effectiveness of a six-month comprehensive sexual education intervention by engaging caregivers was revealed by a 56% increase in knowledge and a 21% improvement in attitudes, though positive sexual behavior changes moderately increased by only 16%.
CONCLUSIONS:
It is recommended that future interventions targeting street adolescents continue to prioritize caregiver engagement as central to these efforts, because their involvement amplifies the intervention’s effectiveness and sustainability.