Multi-level Responses to Multi-level Vulnerabilities: Creating an Enabling Environment for HIV Prevention for Girls in Botswana, Malawi, and Mozambique

  • Carol UnderwoodEmail author
  • Jane Brown
  • Hilary Schwandt
Part of the Social Aspects of HIV book series (SHIV, volume 4)


In sub-Saharan Africa, girls are several times more likely to be infected with HIV than are boys of the same age and young people aged 15–24 years represent more than half of all new infections. An extensive literature review augmented by formative research conducted in Botswana, Malawi and Mozambique reveals that although individual sexual behaviors heighten risk, a complex interaction of structural factors outside of girls’ control is fueling the epidemic. Guided by the understanding that individuals are influenced by a system of socio-cultural relationships – families, social networks, communities and nations – the Go Girls! (GG) Program incorporated a social ecological approach to prevent HIV. Eight multifaceted interventions were designed and implemented to simultaneously reach communities, leaders, teachers, parents/guardians and young people themselves. This chapter highlights evidence that, despite a short implementation period of 10 months or less, positive effects were extended to girls when adults in their communities worked together to create a more enabling environment for their health, well-being and HIV prevention.


Adolescent girls HIV prevention Social-ecological programs Social-ecological programs Botswana Malawi Mozambique 


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Johns Hopkins Center for Communication ProgramsBloomberg School of Public HealthBaltimoreUSA
  3. 3.Fairhaven CollegeWestern Washington UniversityBellinghamUSA

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