Perceptions of the community leaders on adolescents´ HIV: cross sectional study in Mulanje, Malawi

Abstract

Introduction the spread of HIV among adolescents requires effective interventions as new infections are high in this cohort globally. We explored perception of community leaders on the prevalence of adolescent´s HIV in Mulanje, Malawi. Methods focus group discussion (n=11) and in-depth interviews (n=15) were conducted with community leaders in all Traditional Authorities in Mulanje district, Malawi. The interviews were audio recorded and transcribed. Data were analysed using thematic content approach. Results the perceptions of community leaders on the HIV prevalence among adolescents fall into three groups: lack of access to health services in rural areas, cultural beliefs and social practices. Unavailability of condoms and youth centres were perceived to contribute to lack of access to health services. On harmful cultural beliefs, study participants observed that initiation ceremonies and prolonged wedding dances at night were contributing to HIV spread. Several issues were reported on social issues including poverty, illicit drug and substance abuse, long distances to school, modern technologies and peer pressure. Conclusion there are many factors perceived to contribute towards high HIV prevalence among adolescents. Our study suggests urgent need for the country to sustainably address key harmful cultural and social practices that potentially increase adolescents´ vulnerability to HIV.

Determinants of teenage pregnancies in Zimbabwe: evidence from the demographic and health survey.

“…SES, like level of education, was found to be significantly associated with teenage pregnancy. Poor families in Zimbabwe are unable to provide their teenage children with adequate basic needs such as proper food, clothing, and shelter, putting them at risk of engaging in sexual relationships with older men, increasing their chances of experiencing early pregnancy (Chimatiro et al, 2020). Similarly, Wamoyi et al…”

“…According to Maemeko et al (2018) alcohol is a major determinant of teenage pregnancy, due to the fact that when teenagers are under its influence, they make poor decisions (Maemeko et al, 2018). This is supported by a study by Chimatiro et al (2020) in Malawi where it was found that substance addiction, particularly alcohol drinking and marijuana smoking (chamba), were among the leading factors contributing to the high rates of pregnancy among teenagers in their communities (Chimatiro et al, 2020). Furthermore Guo et al (2019) showed in their study that alcohol consumption is linked to unprotected intercourse, teenage pregnancies and abortion, particularly among teenagers who are still gaining the knowledge and abilities to regulate their sexual behaviour in appropriate ways (Guo et al, 2019).…”

“…In Malawi, initiation rites have been noted as traditional religious practice that exposes teenagers to pregnancy as they involve practices that stimulate sexual desire among teenagers (Chimatiro et al, 2020). As a result of the cultural behaviours that heighten their desire for sex, young men and women engage in sexual intercourse because they believe they are now fully developed and can sleep with anyone, regardless of their age (Chimatiro et al, 2020).…”

“…In Malawi, initiation rites have been noted as traditional religious practice that exposes teenagers to pregnancy as they involve practices that stimulate sexual desire among teenagers (Chimatiro et al, 2020). As a result of the cultural behaviours that heighten their desire for sex, young men and women engage in sexual intercourse because they believe they are now fully developed and can sleep with anyone, regardless of their age (Chimatiro et al, 2020). Masosoto (pulling of labium minora to grow using an aphrodisiac natural herb oil made from Nsatsi) was mentioned by the majority of traditional religious leaders in Malawi, particularly women, as one of the practices that provoke early sexual intercourse among young women (Chimatiro et al, 2020).…”

“…This may result in them experimenting in sexual relationships thereby increasing their exposure to the risk of early pregnancy. The impulsive and risky behaviour of teenagers not only exposes them to unwanted pregnancy but also short-term illnesses and sexually transmitted infections such as HIV/AIDS (Chimatiro et al, 2020). Around 85% of teenagers living with HIV/AIDS are in Sub-Saharan Africa, with 58% being females (UNICEF, 2018).…”