Allure of a modern social identity and adolescent girls' vulnerability to HIV: Qualitative evidence from Botswana, Malawi, and Mozambique

In sub-Saharan Africa, adolescent girls compared with adolescent boys are 3-5 times more likely to be living with HIV/AIDS. Girls' vulnerability to HIV is rarely examined from the perspective of community members or girls themselves. Methods: A qualitative study conducted in November-December 2008 relied on 12 focus group discussions in Botswana, 12 in Malawi, and 11 in Mozambique, divided between urban and rural sites and grouped thusly: adolescent girls (ages 10-14; 15-19), adolescent boys (14-19), adult women (20-49), adult men (20-49), and community leaders. Results: Study participants perceived “adolescent girls' vulnerability to HIV” as linked primarily to unprotected sexual relationships, which they described as often transactional and age-disparate. Study participants highlighted the following antecedents to unprotected sex: the desire for consumer goods associated with a modern social identity and, secondarily, poverty (Botswana); poverty and, secondarily, the allure of material goods (Malawi); poverty and adolescent identity formation equally (Mozambique). At times, participants' narratives – including those of adolescent girls – blamed girls for their vulnerability, citing promiscuity, consumerism, and willfulness as causal factors. Yet, community members of all ages also identified social and structural factors (social exclusion of girls living in poverty, non-enforcement of laws that protect minors) as precursors to vulnerability. Conclusions: The findings point unequivocally to the central role of economic disparities in girls' vulnerability, reflect the importance of addressing adolescents' social identity formation concerns, and strongly indicate the need for structural-level interventions to enhance legal protections for minors and provide viable economic opportunities for girls and their families.