Effects of adolescent exposure to behaviour change interventions on their HIV risk reduction in Northern Malawi: a situation analysis.

Understanding adolescents' translation of HIV and AIDS-related behaviour change interventions (BCI) knowledge and skills into expected behavioural outcomes helps us appreciate behaviour change dynamics among young people and informs evidence-based programming. We explored the effects of adolescents' exposure to BCI on their HIV risk reduction in selected schools in Nkhatabay and Mzimba districts and Mzuzu city in Northern Malawi. The study used questionnaires as instruments. Data were collected between January and April 2017. Adolescent boys and girls [n = 552], ages 11-19 were randomly sampled to participate. Data analysis was through multiple regression and content analysis. Respondents included 324 female [58.7%] and 228 male [41.3%]. Multiple regression analysis indicated that exposure to BCI did not affect risk reduction in the study area. The best stepwise model isolated sexual experience ([Beta = .727, p = .0001, p < .05]) as having the strongest correlation with the dependent variable - risk reduction. BCI exposure was stepwise excluded ([Beta = -.082, p = .053, p > .05]). There was therefore no evidence against the null hypothesis of no relationship between adolescent exposure to BCI and their HIV risk reduction. Overall there was limited BCI knowledge and skills translation to behavioural risk reduction. The study points to the need to evaluate and redesign adolescent BCI in line with current behavioural dynamics among young people in Malawi. The findings have been used to inform the design and programming of a model to be tested for feasibility through a quasi-experiment in the second phase of our project.