Vulnerable Girls' Index: Validation from survey research in Botswana, Malawi, and Mozambique

Background: There is a growing recognition of and interest in adolescent girls' vulnerability to HIV. The factors that render girls vulnerable have rarely been systematically studied. The objective of this study was to validate a newly developed vulnerable girls' index (VGI) in Botswana, Malawi, and Mozambique. Methods:Survey research was conducted from October-December 2009 to test and validate the VGI. Random samples of adolescent girls ages 10-17 were drawn from selected geographic areas for this study: 800 in Botswana, 800 in Malawi, and 1000 in Mozambique. Results: A recent literature review found that girls are often vulnerable to HIV due to extra-individual factors, including social inequality and the unequal distribution of essential resources. Based on these findings, the VGI was constructed. This survey research was intended to evaluate internal construct validity, concurrent criterion validity, and predictive criterion validity. The structural domain, which includes items that measure levels of poverty, work, education, violence/safety, and initiation rites, of the VGI in Malawi has an alpha of 0.73 while in Mozambique the structural index has an alpha of 0.70. Analysis of the VGI structural domain with the Botswana data is forthcoming. Conclusions:The VGI is the first attempt at measuring girls' vulnerability from the perspective of girls. Initial analysis indicates the structural aspect of the VGI is potentially a valid measure of vulnerability. Future analysis will include further tests of the VGI, analysis of Botswana data, and measures of associations between the VGI and sexual risk taking behaviors.