The Ugandan non-governmental organisation (NGO) Straight Talk Foundation (STF) has been implementing mass media communication programmes in Uganda and Kenya since 1993 in an effort to bring information about sexual and reproductive health to young people. The information below is specific to the activities that have been carried out in Uganda.

A core programme vision is to talk directly to and with adolescents, but also to help influential adults (e.g., parents) to talk to them about safe behaviour. Core components include: Straight Talk (ST) radio programmes meant for in- and out-of-school youth, which are broadcast to various districts in English and 11 other Ugandan languages; ST newspapers in English and 6 other Ugandan languages, primarily geared toward secondary school students; and an English-language Young Talk (YT) newspaper designed for primary school students. STF also implements various school-based activities, invests in community activities such as health fairs, and has worked to support youth-friendly health care services.

The evaluation described here employed several strategies, including a cross-sectional household survey of 2,400 never-married adolescents (aged 10 to 19 years) in 6 districts, a household survey of parents, an assessment of the school environment, and a cost study. Analysis employed bivariate and multivariate methods.

Evaluators found that:

• Overall, 55% of all adolescents had listened to the ST radio programme; notably, whereas 76% of those in the high-intensity districts (i.e. those receiving English-language as well as local language broadcasts) had listened, only 13% of respondents from low-intensity districts (i.e. those receiving just the English-language broadcasts) had listened.
• The YT newspaper had been read by 49% of respondents, including 53% in high-intensity and 35% in low-intensity districts; among those who had completed primary school and entered secondary school, 85% had read YT.
• Overall, 35% of the study sample had read the ST newspaper sample, including 45% of high-intensity and 25% of low-intensity district respondents. Among secondary school respondents, 90% had read it.

Seventy percent of respondents had been exposed to at least one STF product, including virtually all secondary and two-thirds of primary school students, as well as 56% of out-of-school youth. "Exposure is fundamentally linked to STF's use of local language materials - in the high-intensity districts where vernacular products were used, 84 percent of respondents had been exposed to STF materials, compared to 42 percent in districts without local languages."

Multivariate analysis showed that exposure to STF materials was significantly associated with ever having talked with parents about adolescent sexual and reproductive health (ASRH) - among both males and females; males and females at the highest level of ST exposure were 4 times as likely to have talked to their parents about these issues.

Most young people say they have someone to tell if they were pressured to have sex. Living in high media intensity districts and exposure to more STF materials is associated with higher proportions reporting someone to tell, indicating that messages about turning to a trusted adult, in most cases identified by the adolescents as a parent, are being heard and accepted. Girls seem to feel more confident that they can tell someone about abuse, and those exposed to STF products were more confident than those not exposed.

Researchers found that greater exposure to STF materials is significantly associated with higher ASRH knowledge, and each incremental exposure is associated with increased knowledge. (See page 30 of the document indicated in the Source section, below, for specific findings.) Adolescents at the highest level of exposure were 2.7 times more likely to have higher knowledge than those with no exposure, controlling for covariates. For example, males, urban residents, and those in school (all associated with higher exposure to ST) are most likely to know that other diseases besides HIV/AIDS are transmitted through sexual intercourse. The STF products seem to have been particularly effective on the topic of sexually transmitted infections (STIs), with ST exposure associated with awareness of STIs.

Both male and female adolescents exposed to all 3 STF items are 3 times more likely to have positive attitudes about condoms compared to those who had not been exposed.

STF materials promote empowerment among female adolescents: females exposed to the materials were twice as likely to report high self-confidence, twice as likely to possess more equitable attitudes about gender, and 4 times more likely to abstain from sex if they had a boyfriend, compared to their unexposed counterparts.

Exposure to STF activities was associated with getting tested for HIV. Female adolescents were three-and-a-half times more likely to have been tested than those not exposed, and male adolescents were nearly 4 times more likely to have been tested.

Female adolescents exposed to STF materials were 4 times more likely to abstain from sex if they had a boyfriend, compared to their unexposed counterparts. Males exposed to the materials were less than half as likely to engage in sexual activity and 3 times more likely to resume abstinence if they had previously had sex, compared to those not exposed.

Exposure to STF products is also associated with some increase in condom use, but the relationship is not statistically significant, largely due to the small sample size limiting statistical analysis.