Background: Young people in sub-Saharan Africa are affected by the HIV pandemic to a greater extent than young
people elsewhere and effective HIV-preventive intervention programmes are urgently needed. The present article
presents the rationale behind an EU-funded research project (PREPARE) examining effects of community-based
(school delivered) interventions conducted in four sites in sub-Saharan Africa. One intervention focuses on changing
beliefs and cognitions related to sexual practices (Mankweng, Limpopo, South Africa). Another promotes improved
parent-offspring communication on sexuality (Kampala, Uganda). Two further interventions are more comprehensive
aiming to promote healthy sexual practices. One of these (Western Cape, South Africa) also aims to reduce intimate
partner violence while the other (Dar es Salaam, Tanzania) utilises school-based peer education.
Methods/design: A modified Intervention Mapping approach is used to develop all programmes. Cluster
randomised controlled trials of programmes delivered to school students aged 12–14 will be conducted in each
study site. Schools will be randomly allocated (after matching or stratification) to intervention and delayed
intervention arms. Baseline surveys at each site are followed by interventions and then by one (Kampala and
Limpopo) or two (Western Cape and Dar es Salaam) post-intervention data collections. Questionnaires include
questions common for all sites and are partly based on a set of social cognition models previously applied to the
study of HIV-preventive behaviours. Data from all sites will be merged in order to compare prevalence and associations
across sites on core variables. Power is set to .80 or higher and significance level to .05 or lower in order to detect
intervention effects. Intraclass correlations will be estimated from previous surveys carried out at each site.
Discussion: We expect PREPARE interventions to have an impact on hypothesized determinants of risky sexual
behaviour and in Western Cape and Dar es Salaam to change sexual practices. Results from PREPARE will (i) identify
modifiable cognitions and social processes related to risky sexual behaviour and (ii) identify promising intervention
approaches among young adolescents in sub-Saharan cultures and contexts.
Trial registrations: Controlled Trials ISRCTN56270821 (Cape Town); Controlled Trials ISRCTN10386599 (Limpopo);
Clinical Trials NCT01772628 (Kampala); Australian New Zealand Clinical Trials Registry ACTRN12613000900718