by Marisen Mwale, Lecturer in Psychology, Mzuzu University and Adamson S. Muula, Professor of Epidemiology and Public Health, University of Malawi

HIV and AIDS remain major global public health challenges, especially for sub-Saharan Africa. The region accounts for around 70% of the world’s burden of infections. Young people, especially young women, are affected more than other groups.

In Malawi, for example, the prevalence of HIV among people aged 15-24 years rose to 5.9% between 2010 and 2015. Prevalence fell in the broader age group of 15-49 years. In 2016, Malawi had 36,000 new HIV infections, over half of them among young people.

UNAIDS and the National AIDS Commission reports show that only about 42% of young Malawians aged 15-24 years have accurate knowledge of HIV and AIDS. This is despite various efforts to inform people and change behaviour that could put people at risk of infection. Efforts have included mandatory sexuality education in schools and extracurricular interventions such as “Why wait” and AIDS Toto. These were intended to impart risk avoidance skills and knowledge to encourage abstinence, delayed sexual debut, condom use and faithfulness to one partner.

The question is why the intervention efforts are not having the intended effect. Is their relevance the problem, or is it implementation bottlenecks?

Against the background of this rising HIV incidence and disappointing behaviour change interventions, we designed a study to identify where the gap could be. We also wanted to explore alternative interventions within a sociocultural framework. We got the help of adolescents themselves to design an intervention and then tested it to see whether it could work at a larger scale. This could be a useful part of efforts to address a combination of influences on behaviour, such as poverty and gender.

What we did

Our project, conducted in northern Malawi, had three phases. In the first phase, we wanted to find out what effect knowledge about HIV had on the behaviour of adolescents. Specifically, we were looking at behaviour to limit the number of sexual partners, delay sexual initiation, practise abstinence and consistently use condoms. Read more via Conversation