Perceptions of the community leaders on adolescents’ HIV status: cross sectional study in Mulanje, Malawi

INTRODUCTION: the spread of HIV among adolescents requires effective interventions as new infections are high in this cohort globally. We explored perception of community leaders on the prevalence of adolescent´s HIV in Mulanje, Malawi. METHODS: focus group discussion (n=11) and in-depth interviews (n=15) were conducted with community leaders in all Traditional Authorities in Mulanje district, Malawi. The interviews were audio recorded and transcribed. Data were analysed using thematic content approach. RESULTS: the perceptions of community leaders on the HIV prevalence among adolescents fall into three groups: lack of access to health services in rural areas, cultural beliefs and social practices. Unavailability of condoms and youth centres were perceived to contribute to lack of access to health services. On harmful cultural beliefs, study participants observed that initiation ceremonies and prolonged wedding dances at night were contributing to HIV spread. Several issues were reported on social issues including poverty, illicit drug and substance abuse, long distances to school, modern technologies and peer pressure. CONCLUSION: there are many factors perceived to contribute towards high HIV prevalence among adolescents. Our study suggests urgent need for the country to sustainably address key harmful cultural and social practices that potentially increase adolescents´ vulnerability to HIV.