Investigation of community-based communication networks of adolescent girls in rural Malawi for HIV/STD prevention messages

The study, which was based on observation, in-depth interviews, focus groups, and a household census and survey, collected information on the HIV/AIDS knowledge, attitudes, and behaviors of 215 girls aged 10-18 in Thyolo District. A majority of the girls (58%) reported having had sexual intercourse before they began menstruating and 69% had intercourse before attending the ritual initiation ceremony, an occasion (usually held a little before menstruation begins) at which older women traditionally impart much information about menstruation and sex. It is recommended that HIV/AIDS information be integrated within community-based communication networks (peers, anankungwi [the ritual initiation ceremony], church activities) and within school curriculum. Most importantly, the commitment of community elders is needed to strengthen currently unenforced social norms about abstaining from sexual behavior before menstruation and initiation, and to delay initiation until after the onset of menstruation (the mean ages of initiation and intercourse were, 13.83 and 13.63, respectively), but the mean age of menstruation is significantly older, 14.50. If the practice of holding initiation after the onset of menstruating were strictly enforced, and if girls did not have sex until after initiation, 69% of adolescent girls would delay intercourse for at least one year, which would provide them with more time to learn about the risk of HIV/STDs and AIDS, and how to negotiate condom use with their partners. These changes would also provide reinforcement for parents to continue girls" education at least until they completed Standard 8. Includes references.