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Abstract
Although some cultural practices have been identified as a determinant of HIV transmission, research investigating how specific practices affect HIV risk is lacking. In Malawi, initiation rites, in which young people attend ceremonies around the time of puberty, have received little attention. In this qualitative study, we explored whether communities in southern Malawi perceive initiation rites to be an HIV risk factor for girls. Twelve focus group discussions were held with adolescents and adults in a rural community of Thyolo district and a peri-urban community of Mangochi district. Community members observed that certain aspects of traditional initiation rites propel girls into sexual roles expected of adulthood, without facilitating their adaption to the emerging landscape of HIV, thereby increasing HIV risk. HIV prevention programming needs to address the role of initiation rites in adolescent girls' vulnerability to HIV and help young girls navigate the conflicting messages they receive from a wide range of channels about expected sexual behavior.
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Acknowledgements
This research was funded by the President's Emergency Plan for AIDS Relief (PEPFAR) and the US Agency for International Development (USAID) under the terms of Contract No. GHH-I-00-07-00032-00, USAID ∣ Project SEARCH, Task Order 01. The contents are the responsibility of the authors and do not necessarily reflect the views of PEPFAR, the US Government or Johns Hopkins University. The authors would like to thank Glory Mkandawire and Jane Brown for their contributions to this study. Finally, our thanks go out to the men, women and youth in Thyolo and Mangochi, who participated in the focus group discussions.