Partnering with Batswana Youth and Families for HIV and AIDS Prevention

Abstract

Introduction: This qualitative study triangulated data from adolescents, parents, and key informants in Gaborone, Botswana on adolescents' risks for HIV infection, STIs and pregnancy, the types of relationships they get into, and preventive measures they use to protect themselves against HIV infection. The goal of this qualitative research is to inform adaptation of an intervention originally developed, implemented, and evaluated in the US that was effective in reducing the risk of HIV infection and early pregnancy by delaying initiation of sexual relationships of abstinent adolescents and lowering sexual risk behaviours of adolescents who were already sexually active. The objectives of this study were to conduct in-depth interviews with youth, key informants and parents; determine the behavioural risks that young people face; Assess youth and parents' attitudes toward providing a risk reduction programme for adolescents and Use the data to adapt an evidence-based programme for Botswana. Methodology: In-depth qualitative interviews with 40 youth, 20 key informants and 40 parents elicited information on the risks and relationships that youth engaged in and their suggestions how their risky behaviours could be minimized or counteracted. Findings: Youth of both sexes engage in risky sexual behaviours that could predispose them to contracting HIV and STI infections or unplanned pregnancies. Risks were associated with use of alcohol and drugs: commonly marijuana, and engaging in unsafe sexual relations. Youth, key informants and parents showed a high level of acceptability for offering a primary prevention intervention program for adolescents. In addition, all groups of participants concurred on the importance of offering a separate program for parents to equip them with skills that can enable to them to guide their adolescents to safely transit into adulthood through education and family communication skills. Other risks confronting adolescents included sexual initiations from either older men or women (sugar daddy and mummy syndrome) in exchange for material and financial gains. Conclusion: Informants endorsed the need for primary prevention programs addressing adolescents and their families to reduce risk behaviours among Batswana youth to provide them with skills and minimise the risk of HIV infection among adolescents.

Caring for HIV‐positive orphans in the context of HIV and AIDS: perspectives of Botswana grandmothers

“…Among African–American adolescent grandchildren raised by grandmothers, they are more likely than children raised by their parents to engage in unprotected sexual intercourse (Minkler & Fuller‐Thompson, ), but this has not been assessed among Africans. Prevalence of HIV‐related risk behaviours among adolescents in Botswana is high and continues to grow, and the risks include poor parental monitoring and poor parent and adolescent communication on sexual matters (Seloilwe et al ., ) and limited or non‐existent communication on sexual issues among parents and adolescents (Seloilwe et al ., ). There are limited data on grandparent–grandchild sexual communication processes, yet many studies have been carried out on sexual communication among parents and their adolescent children (Cornelius et al ., ).…”

Gender Differences in Sexual and Reproductive Health Protective and Risk Factors of Batswana Adolescents: Implications for Parent and Adolescent Interventions

“…In order to reduce adolescents’ hesitancy to talk with their parents about sexual matters, interventions could be delivered separately, in parallel, to adolescents and parents, with structured opportunities for them to come together. This approach would be highly congruent with the desires expressed by both parties (Seloilwe et al, 2013).…”

“…These findings are congruent with previous research about cultural norms in Botswana that noted Batswana tend to avoid discussions about sexuality between parent and child (Denbow & Thebe, 2006; Ntsayagae et al, 2008). Additional research has found that both parents and adolescents expressed a desire to be able to discuss sensitive topics with one another, but felt they do not have adequate knowledge or communication skills and were hesitant to do so (Fehringer et al, 2013; Nam et al, 2009; Seloilwe et al, 2013; St. Lawrence et al, 2013), which may explain why adolescents perceived low parental responsiveness to discussing sensitive issues.…”

Batswana Adolescents’ Attitudes Toward Sex With Older Adults: Psychometric Properties of the Attitudes Toward Transactional Sex Scale

“…In qualitative interviews with male ( N = 20) and female ( N = 20) Botswana adolescents 13 to 19 years (average age was 15.3), an unexpectedly high proportion reported receiving sexual initiations from adults offering desirable goods in exchange for sex (Seloilwe et al, 2013; St Lawrence et al, 2013). Participants from urban and peri-urban areas and high-, moderate-, and low-income neighborhoods were purposively recruited from schools and youth-focused programs.…”