Supporting adolescent girls to stay in school, reduce child marriage and reduce entry into sex work as HIV risk prevention in north Karnataka, India: protocol for a cluster randomised controlled trial

BMC Public Health

Lori Heise²  Stephen Moses³  Charlotte Watts²  James F Blanchard³  Martine Collumbien²  Gautam Sudhakar¹  Raghavendra Thalinja¹  Sapna Nair¹  Prakash Javalkar¹  Calum Davey²  Shajy Isac¹  Parinita Bhattacharjee¹  Tara S Beattie² 

[1] Karnataka Health Promotion Trust, Bangalore, India;Department of Global Health and Development, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SN, UK;University of Manitoba, Winnipeg, Canada

关键词: HIV;    Maternal and child health;    Social norms;    Gender;    India;    Adolescent;    Sexual debut;    Devadasi;    Sex work;    Child marriage;   

Others  :  1170964
DOI  :  10.1186/s12889-015-1623-7

 received in 2015-02-19, accepted in 2015-03-09,  发布年份 2015

【 摘 要 】

Background

Low caste adolescent girls living in rural northern Karnataka are at increased risk of school drop-out, child marriage, and entry into sex-work, which enhances their vulnerability to HIV, early pregnancy and adverse maternal and child health outcomes. This protocol describes the evaluation of Samata, a comprehensive, multi-level intervention designed to address these structural drivers of HIV risk and vulnerability.

Methods/Design

The Samata study is a cluster randomised controlled trial that will be conducted in eighty village clusters (40 intervention; 40 control) in Bijapur and Bagalkot districts in northern Karnataka. The intervention seeks to reach low caste girls and their families; adolescent boys; village communities; high school teachers and school governing committees; and local government officials. All low caste (scheduled caste/tribe) adolescent girls attending 7^th standard (final year of primary school) will be recruited into the study in two consecutive waves, one year apart. Girls (n = 2100), their families (n = 2100) and school teachers (n = 650) will be interviewed at baseline and at endline. The study is designed to assess the impact of the intervention on four primary outcomes: the proportion of low caste girls who (i) enter into secondary school; (ii) complete secondary school; (iii) marry before age 15; and (iv) engage in sex before age 15. Observers assessing the outcomes will be blinded to group assignment. The primary outcome will be an adjusted, cluster-level intention to treat analysis, comparing outcomes in intervention and control villages at follow-up. We will also conduct survival analyses for the following secondary outcomes: marriage, sexual debut, pregnancy and entry into sex work. Complementary monitoring and evaluation, qualitative and economic research will be used to explore and describe intervention implementation, the pathways through which change occurs, and the cost-effectiveness of the intervention.

Discussion

This is an innovative trial of a comprehensive intervention to improve the quality of life and reduce HIV vulnerability among marginalised girls in northern Karnataka. The findings will be of interest to programme implementers, policy makers and evaluation researchers working in the development, education, and sexual and reproductive health fields.

Trial registration

ClinicalTrials.Gov NCT01996241 webcite. 16^th November 2013.

【 授权许可】

   
2015 Beattie et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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