Abstract

Gender-based violence is a public health problem in South Africa associated with increased risk of HIV infection. KwaZulu-Natal is the epicentre of the HIV epidemic in South Africa with youth of 15–24 years at high risk of infection. A school based RCT aimed to develop, implement and evaluate an intervention to reduce gender-based violence, defined as verbal (belittling), physical (hitting) and sexual (forced sex) abuse, among grade 9 students. Schools (16) were randomly selected in two Districts and trained facilitators implemented a 16 module classroom-based intervention based on prior elicitation research, in 8 experimental schools. Students completed a self-reporting questionnaire at T1 and 8 months later at T2. Of 764 students, 46.7% male, both sexes reported perpetrating violence and being abused verbally, physically and sexually. Although there was a reduction in verbal abuse (belittling boy/girlfriend) and physical abuse (hitting boy/girlfriend) after the intervention programme, a reduction in hitting was reported only by female students (β coefficient 0.16, p=0.025, 95% CI−0.047 to 0.688). The study found that students who had attended the school-based intervention programme were three times less likely than the control group to report being forced to have sex (p=0.046, OR 2.95, 95% CI 1.02 to 8.53). These findings of a reduction in gender-based violence among students exposed to the intervention indicates that such a programme is useful for universal prevention efforts, but also highlights the importance of more focused attention on male students. In addition to school-based programmes there is a need for support at community level to reinforce school-based initiatives.