Structural Determinants of Adolescent Girls’ Vulnerability to HIV: Views from Community Members in Botswana, Malawi, and Mozambique

Published in Social Science & Medicine, this study, led by researchers at the Johns Hopkins Bloomberg School of Public Health, shows that community members in sub-Saharan Africa correlate an increase in HIV vulnerability among adolescent girls with weak structural support systems. Funding for the research was provided by the President’s Emergency Plan for AIDS Relief (PEPFAR) and the United States Agency for International Development (USAID).

The basis for the study, according to the abstract, was that, in sub-Saharan Africa, adolescent girls are three to four times more likely than adolescent boys to be living with HIV/AIDS. The 2008 Go Girls! Initiative, a gender initiative on Girls’ Vulnerability to HIV, used focus group discussions with adolescent girls and boys, adult men and women, and community opinion leaders, in Botswana, Malawi, and Mozambique, to develop social, gender, and behaviour change communication approaches to reduce adolescent girls’ susceptibility to HIV infection. The study found that structural factors, especially insufficient economic, educational, socio-cultural, and legal support for adolescent girls, were identified as the root causes of girls’ vulnerability to HIV through exposure to unprotected sexual relationships, primarily relationships that are transactional and age-disparate. This finding is in line with current HIV prevention practice, which advocates for combination prevention that comprises biomedical, behavioural, and structural interventions.

Community members explicitly called for policies and interventions to strengthen cultural, economic, educational and legal structures to protect girls, findings that were used to develop the interventions implemented by the Go Girls! Initiative.

The entire study is available from the website below for a subscription or single use fee.