The impact of behaviour change intervention [BCI] on adolescent HIV risk reduction in selected schools in northern Malawi

Abstract

Introduction: We conducted a study to explore the impact of adolescent exposure to HIV and AIDS behaviour change Interventions (BCI) on their HIV risk reduction and sexual behaviour change in some selected secondary schools in the district of Mzimba, district of Nkhata Bay and Mzuzu city in Northern Malawi.

Methods: We used mixed methods in a descriptive survey design triangulating both quantitative and qualitative approaches, with questionnaires and focus groups as instruments for data collection. Adolescent boys and girls [n = 552], were randomly sampled to participate in the quantitative component. For qualitative focus groups we sampled participants purposively. We analyzed quantitative data through multiple regression analysis. On the other hand qualitative data was analyzed through thematic content analysis. Results: Multiple regression analysis indicated that exposure to BCI did not impact risk reduction [Beta = -.082, p= .053, p > .05]. Qualitative focus group findings showed that proximate correlates such as: early sexual debut, lack of condom use, drug related sex, multiple and concurrent partnerships drive infection. Distal structural factors in socio-cultural, gender disparities and poverty were also noted drivers of sexual risk taking in the study area. Conclusion: Studies aimed to inform HIV prevention through top-down design of models involving primary beneficiaries are vital for the registering of positive outcomes in HIV programming for young people. Apart from identifying factors driving high HIV incidence in the study area, the study informed an intervention to test the efficacy of a risk reduction behavioural model [RRBM] developed and designed with input from adolescent participants.