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 decisionmaking
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
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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.