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Structural determinants of adolescent girls' vulnerability to HIV: Views from community members in Botswana, Malawi, and Mozambique

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  • Underwood, Carol
  • Skinner, Joanna
  • Osman, Nadia
  • Schwandt, Hilary

Abstract

In sub-Saharan Africa, adolescent girls are three to four times more likely than adolescent boys to be living with HIV/AIDS. A literature review revealed only four studies that had examined HIV vulnerability from the perspective of community members. None of the studies focused specifically on adolescent girls. To fill this gap, in 2008 12 focus group discussions were held in selected peri-urban and rural sites in Botswana, 12 in Malawi, and 11 in Mozambique to identify factors that render girls vulnerable to HIV infection from the community members' perspective. The preponderance of comments identified structural factors - insufficient economic, educational, socio-cultural, and legal support for adolescent girls - as the root causes of girls' vulnerability to HIV through exposure to unprotected sexual relationships, primarily relationships that are transactional and age-disparate. Community members explicitly called for policies and interventions to strengthen cultural, economic, educational, and legal structures to protect girls, recognized community members' responsibility to take action, and requested programs to enhance adult-child communication, thus revealing an understanding that girls' vulnerability is multi-level and multi-faceted, so must be addressed through a comprehensive approach to HIV prevention.

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  • Underwood, Carol & Skinner, Joanna & Osman, Nadia & Schwandt, Hilary, 2011. "Structural determinants of adolescent girls' vulnerability to HIV: Views from community members in Botswana, Malawi, and Mozambique," Social Science & Medicine, Elsevier, vol. 73(2), pages 343-350, July.
  • Handle: RePEc:eee:socmed:v:73:y:2011:i:2:p:343-350
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    References listed on IDEAS

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    Cited by:

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    2. Burke, Holly McClain & Field, Samuel & González-Calvo, Lázaro & Eichleay, Margaret A. & Moon, Troy D., 2019. "Quasi-experimental evaluation using confirmatory procedures: A case study of an economic and social empowerment intervention to reduce girls’ vulnerability to HIV in rural Mozambique," Evaluation and Program Planning, Elsevier, vol. 77(C).
    3. Hannah Han & Fan Yang & Sarah Murray & Gaspar Mbita & Maggie Bangser & Katherine Rucinski & Albert Komba & Caterina Casalini & Mary Drake & Esther Majani & Kelly Curran & Yeronimo Mlawa & Agnes Junga , 2021. "Characterizing a sexual health and HIV risk stratification scale for sexually active adolescent girls and young women (AGYW) in Tanzania," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-15, March.
    4. Rainier Masa & Lauren Graham & Zoheb Khan & Gina Chowa & Leila Patel, 2019. "Food insecurity, sexual risk taking, and sexual victimization in Ghanaian adolescents and young South African adults," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(2), pages 153-163, March.
    5. Gausman, Jewel & Lloyd, Danielle & Kallon, Thomas & Subramanian, S.V. & Langer, Ana & Austin, S. Bryn, 2019. "Clustered risk: An ecological understanding of sexual activity among adolescent boys and girls in two urban slums in Monrovia, Liberia," Social Science & Medicine, Elsevier, vol. 224(C), pages 106-115.
    6. Schwandt, Hilary M. & Underwood, Carol, 2016. "Engaging school personnel in making schools safe for girls in Botswana, Malawi, and Mozambique," International Journal of Educational Development, Elsevier, vol. 46(C), pages 53-58.
    7. Gojjam Tadesse & Bereket Yakob, 2015. "Risky Sexual Behaviors among Female Youth in Tiss Abay, a Semi-Urban Area of the Amhara Region, Ethiopia," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-16, March.
    8. Sadandaula Rose Muheriwa Matemba & Rosina Cianelli & Natalie M. Leblanc & Chen Zhang & Joseph De Santis & Natalia Villegas Rodriguez & James M. McMahon, 2022. "Associations between Home- and School-Based Violent Experiences and the Development of Sexual Behavior in Young Adolescent Girls in the Rural Southern Region of Malawi," IJERPH, MDPI, vol. 19(10), pages 1-13, May.
    9. Stoebenau, Kirsten & Heise, Lori & Wamoyi, Joyce & Bobrova, Natalia, 2016. "Revisiting the understanding of “transactional sex” in sub-Saharan Africa: A review and synthesis of the literature," Social Science & Medicine, Elsevier, vol. 168(C), pages 186-197.

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