Assessing how Southern African AIDS Trust partner organizations are integrating multiple and concurrent sexual partnership, intergenerational sex and medical male circumcision in Malawi

Type Thesis or Dissertation - Master of Public Health Degree
Title Assessing how Southern African AIDS Trust partner organizations are integrating multiple and concurrent sexual partnership, intergenerational sex and medical male circumcision in Malawi
Author(s)
Publication (Day/Month/Year) 2011
URL http://www.medcol.mw/commhealth/mph/dissertations/GIFT CHIMWEMWE HARA_Approved.pdf
Abstract
Southern African AIDS Trust (SAT) has been conducting knowledge sharing workshops on “key drivers” of the HIV epidemic (multiple and concurrent sexual partnerships (MCP), intergenerational sex (IGS) and low prevalence of medical male circumcision (MMC)) since 2008. The participating SAT partner organisations and communities had agreed to integrate initiatives that target key drivers into their youth HIV prevention programming. Since then, no assessment had been done to understand how integration of initiatives that address key drivers of the HIV epidemic is progressing. As such, with financial support from the Health Economics and AIDS Research Division (HEARD) of the University of Kwazulu, Natal, South Africa, Southern African AIDS Trust commissioned this study in Malawi, Zambia, Zimbabwe, Tanzania and Mozambique.. This paper concentrates on the Malawi chapter. This study adopted an observational study design to assess how SAT partner organisations are integrating key drivers of the HIV epidemic in their youth HIV prevention programming. This study was mainly qualitative in nature, though some simple quantitative data was also gathered and analysed. Five organisations working in various contextual environments were sampled out. Some of these contextual environments were urban, rural and peri-urban. Thematic content analysis was used for analyzing qualitative data while descriptive measures were computed for checklist data. The study proposal was approved by the College of Medicine Post-graduate Review Committee. All study participants signed a consent form before interviews. Findings showed that integration of key drivers of the HIV epidemic depended on whether the culture and religion of the communities in which the organisation is operating identifies with the key driver or not. Medical male circumcision has been integrated by those organisations that operate in communities whose dominant culture and religion identifies with male circumcision. Furthermore, findings also showed that knowledge sharing after training is an area that needs attention among organisations that participated in this study. Lastly, the sampled organisations were found to be involving the youth more in implementation of programmes than in the design of those programmes. In conclusion, integration of key drivers on HIV prevention interventions depends on whether the culture and religion of the communities in which the organisation is operating identifies with the particular key driver or not. Being urban, rural, peri-urban and organisational type has very little bearing on integration of key drivers. Youth are not meaningfully involved in programme design.

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