Effects of an Afrocentric Sexual Health Education Curriculum for Medical, Nursing, and Midwifery Students in Tanzania: A Single-Blinded Randomized Controlled Phase 3 Trial.
Rosser B, Mkoka D, et al. • Archives of sexual behavior • 2025
This study provides 'gold standard' evidence that training in sexual health is culturally acceptable, needed, and effective for nursing, midwifery, and medical students in Tanzania.
Key Findings
Results
The Afrocentric sexual health curriculum produced statistically significant, moderate to large increases in sexual health knowledge among intervention participants compared to controls.
Knowledge improvement: β = 3.49, SE = 0.24, p < 0.001
412 students were enrolled and randomized; final sample size was 408 due to minimal attrition (<1%)
Participants were stratified by discipline (nursing, midwifery, and medical students) before randomization
Intervention group: n = 206; waitlist control group: n = 206
Results
Intervention participants showed statistically significant increases in confidence in addressing patients' sexual health concerns compared to controls.
Confidence improvement: β = 29.34, SE = 3.26, p < 0.001
Measured at baseline, post-intervention, and three-month follow-up
The curriculum was delivered as a four-day comprehensive program
The trial was single-blinded and phase 3
Results
Intervention participants demonstrated statistically significant improvements in their ability to discuss sexual health with patients.
Ability to discuss sexual health: β = 22.00, SE = 1.99, p < 0.001
Assessed at baseline, post-intervention, and three-month follow-up
Outcome measured as a self-reported attitudinal/skill assessment
Results
Intervention participants showed statistically significant improvements in clinical skills, including interpersonal communication and medical history taking.
Interpersonal communication improvement: β = 8.04, SE = 0.60, p < 0.001
Medical history taking improvement: β = 2.50, SE = 0.28, p < 0.001
Clinical skills were evaluated through videotaped standardized patient interviews assessed by expert raters blind to arm of study and whether the interview was baseline or follow-up
Results
The majority of participants evaluated the curriculum as culturally appropriate for Africa.
76.6% of participants rated the curriculum as culturally appropriate
The curriculum covered cultural considerations as one of its topic areas
No adverse effects were observed in either the intervention or control group
Background
The curriculum covered a broad range of sexual health topics designed for health professional students in a sub-Saharan African context.
Topics included sexual health across the lifespan, male and female sexual dysfunctions, key populations (LGBT, sex workers), sexual violence, clinical skills building, ethics, policy writing, and cultural considerations
The curriculum was described as 'Afrocentric' and four days in duration
The study was conducted in Tanzania in 2021
Sub-Saharan Africa has the world's highest rates of sexual health challenges, yet sexual health curricula for health students are described as rare
Methods
Trial attrition was minimal, supporting the integrity of the randomized controlled trial findings.
Attrition was less than 1%
Final sample size was 408 out of 412 enrolled
The trial was described as a single-blinded, randomized, controlled, phase 3 trial
What This Means
This research suggests that a structured, culturally adapted sexual health training program for health professional students in Tanzania can meaningfully improve their knowledge, confidence, communication skills, and clinical abilities related to sexual health care. The study enrolled 412 nursing, midwifery, and medical students who were randomly assigned either to receive a four-day sexual health curriculum or to a waitlist (no immediate training). Students who received the training showed substantial improvements across all measured outcomes—including how well they could take a sexual health history during a simulated patient interview—compared to those who did not receive training. These benefits were assessed both immediately after training and again three months later.
The curriculum addressed a wide range of topics including sexual dysfunction, sexual violence, care for LGBT individuals and sex workers, ethics, and how to approach sexual health conversations in culturally sensitive ways. Notably, more than three-quarters of participants said the curriculum felt culturally appropriate for an African context, and no harmful effects were reported. The study used rigorous methods—including video-recorded patient interviews rated by blinded expert assessors—to objectively measure skill improvements.
This research suggests that integrating sexual health education into health professional training programs in sub-Saharan Africa and other low- and middle-income countries is both feasible and effective. Given that this region faces some of the world's most significant sexual health burdens, training future nurses, midwives, and doctors to competently address these issues could have broad public health benefits. The authors describe this as the first randomized controlled trial of such a curriculum for health students, representing a significant step in building the evidence base for sexual health education in these settings.
Rosser B, Mkoka D, Trent M, Kohli N, Mgopa L, Rohloff C, et al.. (2025). Effects of an Afrocentric Sexual Health Education Curriculum for Medical, Nursing, and Midwifery Students in Tanzania: A Single-Blinded Randomized Controlled Phase 3 Trial.. Archives of sexual behavior. https://doi.org/10.1007/s10508-025-03207-1