An Exploration of the Understandings of Adolescents, Living in Botswana, Pertaining to the Risk of their Peers Contracting HIV and AIDS, and Strategies for Reducing its Spread

Abstract

<p>HIV and AIDS is a major cause of death in most sub-Sahara Africa countries and research shows that older adolescents and young adults are at great risk of HIV infection. It is therefore important to understand and alter those beliefs and practices that put young people at risk of HIV infection. An exploratory mixed-method approach was employed with secondary students in Gaborone, Botswana which examined their beliefs about the attitudes and behaviours of their peers in relation to the risk of contracting HIV and AIDS and their perceptions of those strategies that may curtail the spread of infection. Phase One (the qualitative component; n = 216) informed the construction of the survey instrument employed in Phase Two (the quantitative component; n = 593). Findings indicated that adolescents rated the level of risk that their peers would contract HIV and AIDS as very high. However, there was a tendency by most adolescents to transfer personal vulnerability to others. Participants perceived that, in spite of having significant knowledge relating to HIV and AIDS, many of their peers participated in behaviours linked to HIV infection. These behaviours included heterosexual activity, nonuse of condoms and concurrent multiple sexual partners - factors that have been identified in other studies. Analysis of data from Phase One suggested that a two-stage decision-making process determined adolescent involvement in at-risk behaviour. The first stage of this decision-making process was an initial intention, which most often was to avoid risk behaviours. The second stage involved a reframing process that often overturned the initial intentions. This resulted from an array of internal and social pressures associated with the journey from adolescence to young adulthood. Results from both Phase One and Phase Two indicated that a number of the reframing pressures for males and females differed. Females indicated that they faced pressure for involvement in intergenerational sex while males indicated that peer acceptance and social pressures often led to circumstances involving sexual activity. For both males and females, an important mediating practice in the reframing process was the use of alcohol and drugs. The two-stage decision-making model suggests that a reduction in adolescent potential for risk-taking behaviour depends on programs that simultaneously increase the strength of adolescents’ initial intentions while reducing the reframing pressures and mediating practices. This leads to a series of recommendations that includes helping adolescents develop those life-skills that enables them to withstand the pressures impacting their initial intentions.</p>