The intervention took place in two experimental urban sites, while a third similar control site received prevailing services. One of the 3 sites is located in the transit route of illegal drugs that come from India; another is a closed community with a proportionately smaller migrant population. Both intervention sites received the community intervention, which involved sensitisation and outreach to community stakeholders (parents and religious and community leaders) to encourage local support. Out-of-school youth ages 13 to 19 were offered a 20-session "life skills" curriculum that included RH education. Specifically,

In the school-based work, adolescents aged 14 to 15 years were addressed, as follows:

The experimental sites also received a clinical component, in which providers were trained to offer a variety of affordable adolescent-friendly services to their clients (in- and out-of-school adolescents aged 10-19 years). Specifically,

Organisers explain that the RH curriculum used in these interventions was developed with the active participation of teachers, programme managers, and adolescents. Topics were identified on the basis of findings of focus group discussions, which were conducted among teachers, religious leaders, community leaders, and parents, and a baseline survey carried out among adolescents and their parents. Upon topic selection, the 5 existing curricula were reviewed and a draft curriculum was developed that incorporated the following features:

Education experts, adolescents, programme managers, and health personnel reviewed the draft curriculum. From time to time, adolescents and teachers also provided their input in participatory workshops and group meetings. Curriculum experts observed the RH sessions to assess whether teachers were comfortable in delivering accurate RH information and following the sequence of the topics. Teachers then received refresher training to further strengthen their ability to teach sensitive issues.

Youth, Reproductive and Sexual Health.

Approximately 25% of Bangladesh's 132 million people are adolescents. Traditionally, teenage marriage - especially among females - is highly prevalent. Pre-marital sex is taboo in Bangladesh for social, religious, and cultural reasons. According to organisers, a majority of adolescents (both married and unmarried) lack information on sexuality, contraception, and STIs/HIV/AIDS. Nevertheless, RH education has not been a part of the education curriculum, and the existing service delivery system is not catering to the needs of unmarried adolescents. Bangladesh continues to have low HIV prevalence, but has high levels of documented risk behaviours: low levels of condom use, very high turn over of clients of commercial sex workers, low knowledge regarding HIV/AIDS, and extensive needle and syringe sharing by drug users. Adolescents, in particular, are increasingly getting involved in the sex trade, taking drugs, and migrating to other countries where they are exposed to risky situations.

The Ministry of Health and Family Welfare used the study findings in support of a proposal for school-based HIV/AIDS education to the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM). In addition, Save the Children (UK) included the teaching model and outreach material in their programme; several national organisations plan to use project materials to assist vulnerable women. In 2002, the school and clinic interventions were expanded to 34 additional schools and 88 health facilities.