HIV Among Adolescent Girls and Young Women: Scaling up HIV Prevention in "Sugar Daddy or Blesser" Transactional Sex Relationships Among University Adolescent Girls and Young Women in Blantyre City

Abstract

HIV continues to be a major public health concern for Adolescent Girls and Young Women (AGYW) in Sab Saharan Africa, Malawi, and in Blantyre city. Blantyre city registers the highest HIV infection rate among adolescent girls and young women every year. The high rate of HIV among AGYW has been proven to be correlational to Age-Disparate Transactional Sex (ADTS) relationships which are locally called "Blesser or Sugar Daddies” relationships. The “Blesser/Sugar Daddy” relationships are deeply rooted in cultural, social, and gender power imbalance and have elevated HIV risk exposure of adolescent girls and young women through failure to negotiate condom use, sexual coercion, frequent sex, and sexual violence.

Despite being the population with the highest rate of HIV, adolescent girls and young women are the least population with comprehensive knowledge of HIV prevention methods. Statistics have shown that this is attributed to societal gender inequality that hinders access to Sexual and Reproductive Health services for AGYW and brings about negative attitudes and myths associated with SRH services. In addition, the most known and easily accessible HIV prevention method is the male condom which is easy for Adolescent Boys and Young Men (ABYM) to access than AGYW.

While couples HIV testing remains an HIV prevention strategy that could be accessible for both AGYW and ABYM, AGYW in relationships with “Sugar Daddy or Blesser” cannot go for HIV testing with the “Blesser” because the relationship is supposed to be secretive. Other HIV prevention services, such as Post Exposure Prophylaxis (PEP) and Pre-Exposure Prophylaxis (PrEP), remain underutilized and least known among the AGYW.

For this reason, this project, therefore, seeks to scale up HIV prevention among AGYW by increasing their knowledge and awareness of available HIV prevention interventions and promoting their access and uptake of sexual reproductive health services to promote women's agency and reduce the HIV infection rate among AGYW. The project is going to achieve these impact outcomes by increasing knowledge and information of HIV intervention methods such as PEP, PrEP, body autonomy, SRHR awareness, and removing barriers to the negotiation of safe sex. The project will also work with SRH service providers to train them on youth friendly SRH services provision to remove negative attitudes towards AGYW accessing SRH services and work with ABYM as allies. With this intervention, the project contributes to UNAIDS's goal of ending HIV/AIDS by 2030, to Sustainable development goal number 3 Health and well-being, and most importantly, to number 5, Gender equality and 10, reducing inequality of access to information as well as suitable health services as mentioned.