Barriers to Sexual and Reproductive Health/HIV services for Adolescent Girls and Young Women’s Male Sexual Partners in Malawi: Insights from Community Engagement Inquiry

Authors: Y. Nyondo,¹ R. Luhanga,¹ R. Kundecha,¹ L. Muyumbu,² P. Gwaza,¹ K. Chawinga,¹

Affiliations

¹FHI 360, Zomba, Malawi
²FHI 360, East and Southern Africa Regional Office

Introduction

As the Expanding Malawi HIV/AIDS Prevention with Local Organizations Working for an effective Epidemic Response (EMPOWER) project strives for epidemic control among Adolescent Girls and Young Women (AGYW) aged 15-24 within Determined Resilient Empowered AIDS-free, Mentored and Safe (DREAMS), their male sexual partners (MSP) remain a neglected population. To implement informed and inclusive prevention efforts and design strategies for effective outreach to men, there is an urgent need to understand barriers that hinder AGYW ‘s MSP from accessing Sexual and Reproductive Health (SRH)/HIV services. This study sought to explore barriers to accessing SRH/HIV services among AGYW’s MSP with the objective of identifying effective ways to reach them with SRH/HIV services.

Methodology

Trained facilitators conducted five 3-hour focus group discussions (FGDs) among 72 AGYW aged 15-24 from DREAMS clubs in Zomba (n:42), Phalombe (n:19), and Machinga (n:11) districts. FGDs covered six key themes (Partner preferences, Societal impact, Age and background influence, Trust, AGYW’s male partners needs and social settings). We transcribed and analyzed the discussions thematically to interpret the data within context.

Results

Persistent hesitancy and shyness, negative beliefs and attitudes associating family planning services with females and decreased sexual enjoyment hindered service utilization among MSP. This underscores the prevailing misconception that SRH/HIV services are tailored for women and children, neglecting AGYW’s MSP needs. AGYW reported that MSP frequently express the need for condoms and HIV self-test kits. Social settings, including initiation ceremonies, schools, markets, sporting events, traditional concerts, and youth club gatherings, emerged as locations where AGYW’s MSP frequent, offering opportunities to effectively reach them with SRH/HIV services.

Conclusions

Understanding barriers faced by AGYW’s male partners is crucial to inform tailored interventions and accurate information dissemination to improve SRH/HIV service access. Integrating innovative community-based interventions at locations frequented by AGYW’s male partners is key to effectively reaching them.