Research Explores Implications for HIV Programming in Malawi

Malawians discuss how to reduce HIV risk exposure, including limiting concurrent sexual partnerships.
Malawians discuss how to reduce HIV risk exposure, including limiting concurrent sexual partnerships.

People feel pity… but he is labeled Casanova.”
-Adult male research participant

New research conducted by the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHU∙CCP) in Malawi examines concurrent sexual partnerships. Researchers from JHU∙CCP looked at social norms relating to concurrent sexual partnerships in order to present suggestions for future HIV prevention research and programming. The article is published in Health Education Research.

“The purpose of our study was to explore two types of norms, descriptive and injunctive, as they have been found to influence and predict sexual health behavior,” explained Rupali Limaye, PhD, Director of JHU∙CCP’s HIV/AIDS Global Program. “Our findings suggest a discrepancy between the descriptive norm, or the perceived prevalence of concurrent sexual partnerships, and the injunctive norm, or what individuals perceive others approve or disapprove of.”

Although concurrent sexual partnerships were viewed as a relatively new form of sexual relationships in Malawian communities, they were also thought to be extremely common. When asked to provide an example of men and women who did not have concurrent sexual partners, one female respondent said, “With the way men talk about their issues, there are very few that do not engage in concurrent partnerships… maybe a pastor.”

Women who engaged in concurrency were highly stigmatized but their male counterparts were both stigmatized and admired. Participants believed those people who engage in concurrent sexual partnerships bring hardship to their families and the larger community.

Aside from the perception that community members would consider concurrency unacceptable, it was described as leading to other negative effects such as disease and death. One adult female described, “Relationships that involve sex with different partners are not acceptable because they easily transmit diseases from one person to another thereby causing illnesses which later result in death.”

The data included 20-in depth interviews and 40 focus group discussions in five of Malawi’s districts: Blantyre, Kasungu, Machinga, Mchinji and Mzimba. Overall the analysis consisted of data from 318 participants between the ages of 18-35.

Funded by Research to Prevention (R2P), this study has important implications for HIV programming and research, much of which is currently focused on challenging the practice of concurrent sexual partnerships, particularly in southern Africa. The field must continue to enhance education efforts around the issue to inspire future change.

Authors of the article include Limaye, Stella Babalola, Caitlin Kennedy and Deanna Kerrigan.

Read Descriptive and injunctive norms related to concurrent sexual partnerships in Malawi: implications for HIV prevention research and programming.

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