Community Support and Adolescent Girls' Vulnerability to HIV/AIDS: Evidence From Botswana, Malawi, and Mozambique

Carol Underwood, Hilary M. Schwandt

Research output: Contribution to journalArticle

Abstract

Girls are vulnerable to HIV in part because the social systems in which they live have failed to support and protect them. The goal of this research was to develop a viable supportive community index and test its association with intermediate variables associated with HIV risk across 16 communities in Botswana, Malawi, and Mozambique. This cross-sectional survey with separate samples randomly drawn in each country (2010) yielded a total sample of 1,418 adolescent girls (aged 11-18). Multilevel, multivariate logistic regression, while controlling for vulnerability, age, religion, and residence, found that an increase in supportive community index is positively associated with the odds of indicating improved community support for girls and with the confidence to refuse unwanted sex with a boyfriend across the three countries, as well as with self-efficacy to insist on condom use in Botswana and Mozambique. Program implementers and decision makers alike can use the supportive community index to identify and measure structural factors associated with girls' vulnerability to HIV/AIDS; this will potentially contribute to judicious decision making regarding resource allocation to enhance community-level, protective factors for adolescent girls.

Original languageEnglish (US)
Pages (from-to)317-334
Number of pages18
JournalInternational Quarterly of Community Health Education
Volume35
Issue number4
DOIs
StatePublished - 2015

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Botswana
Mozambique
Malawi
Acquired Immunodeficiency Syndrome
AIDS
vulnerability
HIV
adolescent
community
evidence
Resource Allocation
Condoms
Religion
Self Efficacy
social system
self-efficacy
decision maker
Decision Making
Cross-Sectional Studies
Logistic Models

Keywords

  • Botswana
  • community support
  • HIV
  • Malawi
  • Mozambique
  • structural interventions
  • vulnerable girls

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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abstract = "Girls are vulnerable to HIV in part because the social systems in which they live have failed to support and protect them. The goal of this research was to develop a viable supportive community index and test its association with intermediate variables associated with HIV risk across 16 communities in Botswana, Malawi, and Mozambique. This cross-sectional survey with separate samples randomly drawn in each country (2010) yielded a total sample of 1,418 adolescent girls (aged 11-18). Multilevel, multivariate logistic regression, while controlling for vulnerability, age, religion, and residence, found that an increase in supportive community index is positively associated with the odds of indicating improved community support for girls and with the confidence to refuse unwanted sex with a boyfriend across the three countries, as well as with self-efficacy to insist on condom use in Botswana and Mozambique. Program implementers and decision makers alike can use the supportive community index to identify and measure structural factors associated with girls' vulnerability to HIV/AIDS; this will potentially contribute to judicious decision making regarding resource allocation to enhance community-level, protective factors for adolescent girls.",
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