Social support and very young adolescent girl's knowledge on sexual relationships: A comparative qualitative study of Girl Only Clubs' participants and non-participants in rural Malawi

Wanangwa Chimwaza-Manda; Mphatso Kamndaya; Nanlesta Pilgrim; Sanyukta Mathur; Effie Kondwani Chipeta; Yandisa Sikweyiya

doi:10.1371/journal.pgph.0001339

Social support and very young adolescent girl's knowledge on sexual relationships: A comparative qualitative study of Girl Only Clubs' participants and non-participants in rural Malawi

PLOS Glob Public Health. 2023 Jan 12;3(1):e0001339. doi: 10.1371/journal.pgph.0001339. eCollection 2023.

Authors

Wanangwa Chimwaza-Manda^{1

2}, Mphatso Kamndaya³, Nanlesta Pilgrim⁴, Sanyukta Mathur⁴, Effie Kondwani Chipeta², Yandisa Sikweyiya^{1

5}

Affiliations

¹ School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
² Kamuzu University of Health Sciences, Blantyre, Malawi.
³ School of Applied Sciences, University of Malawi-The Polytechnic, Blantyre, Malawi.
⁴ Population Council, Washington, DC, United States of America.
⁵ Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa.

Abstract

Early sexual relationships are associated with an increased risk of acquiring sexually transmitted diseases including HIV/AIDs, teenage pregnancies, and unsafe abortions among other negative health outcomes. Understanding sexual relationships among very young adolescents (VYAs) is important to equip them to protect themselves from negative sexual health (SH) outcomes. DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) is an HIV prevention initiative that provided an evidence-based core package of interventions to VYAs to prevent HIV acquisition in 15 countries in sub-Saharan Africa. The Girl Only Club (GOC) was the primary context for the interventions. Our objective in this study was to explore if there was any difference in social support (SS) received concerning sexual relationships between the VYA girls who attended GOCs and those who did not. In-depth interviews were conducted with 43 VYA girls, aged 10-14 years, in two rural southern districts, Zomba and Machinga, in Malawi. Twenty-three VYA girls were participants in GOCs and 20 VYA girls did not participate. A thematic, descriptive approach that involved a constant comparative analysis guided the data analysis, and Nvivo 12 software was used. In both study sites available SS concerning sexual relationships is informational support including information from parents, older relatives, and friends. However, club participants differed from non-club participants in sexual and reproductive health (SRH) knowledge and use. Club participants reported consulting others on decision-making and information on sexual relationships; receiving detailed SH information from clubs; condom use due to education received from the clubs; quitting sexual relationships; and correcting misinformation with club information. GOC participants received more SS which made them more knowledgeable and better at handling sexual relationship issues than those not in clubs. Interventions that integrate SS including social asset building and safe spaces are critical for VYA SRH programming.

Copyright: © 2023 Chimwaza-Manda et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

Funding for the study was provided in part by the generous support of the American people through the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the United States Agency for International Development (USAID) under Project SOAR (Cooperative Agreement AID–OAA–A–14–00060). The contents of this manuscript are the sole responsibility of the authors and do not necessarily reflect the views of PEPFAR, USAID, or the United States Government. In addition, this research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No. G-19-57145), Sida (Grant No:54100113), Uppsala Monitoring Center, Norwegian Agency for Development Cooperation (Norad), and by the Wellcome Trust [reference no. 107768/Z/15/Z] and the UK Foreign, Commonwealth & Development Office, with support from the Developing Excellence in Leadership, Training and Science in Africa (DELTAS Africa) Programme. The statements made and views expressed are solely the responsibility of the author.