TY - JOUR
T1 - Structural determinants of adolescent girls' vulnerability to HIV
T2 - Views from community members in Botswana, Malawi, and Mozambique
AU - Underwood, Carol
AU - Skinner, Joanna
AU - Osman, Nadia
AU - Schwandt, Hilary
N1 - Funding Information:
The Go Girls! Initiative was funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) and the United States Agency for International Development (USAID) under the terms of Contract No. GHH-I-00-07-00032-00 , USAID | Project SEARCH, Task Order 01. The funder did not influence the study design, data collection, data analysis, data interpretation, report writing or the decision to submit the paper for publication. The contents are the responsibility of the authors and do not necessarily reflect the views of PEPFAR, the United States Government or the Johns Hopkins University.
PY - 2011/7
Y1 - 2011/7
N2 - 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.
AB - 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.
KW - Botswana
KW - Community perspective
KW - Gender
KW - Girls' vulnerability
KW - HIV/AIDS
KW - Malawi
KW - Mozambique
KW - Social ecological approach
KW - Structural determinants of HIV
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U2 - 10.1016/j.socscimed.2011.05.044
DO - 10.1016/j.socscimed.2011.05.044
M3 - Article
C2 - 21724310
AN - SCOPUS:79960252768
SN - 0277-9536
VL - 73
SP - 343
EP - 350
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 2
ER -