The girls-only clubs reducing HIV vulnerabilities
Clubs in Malawi that gave 12 to 14-year-old girls the space to discuss sexual health found they increased peer support and school attendance and reduced unequal and abusive practices at home.
Girls who attended ‘Go Girl clubs’, as part of the DREAMS programme, in Malawi reported developing important life skills and knowledge of sexual and reproductive health and rights (SRHR). Attending the clubs also helped girls address unequal practices at home.
DREAMS was a multi-country HIV prevention programme for adolescent girls and young women. It took a layered approach to HIV prevention, offering interventions to improve access to health services alongside education support, social skills, and economic activities. The DREAMS programme ended in 2018, and the findings reported here are part of a larger implementation science study into the impact of the DREAMS programme.
The findings published here are from interviews with 23 young adolescent girls (ages 12-14), who took part in ‘Go Girl Clubs’ in Zomba and Machinga – two rural districts in Malawi with high HIV prevalence.
Early adolescence is an important time as this is when most people reach puberty and may become sexually active. But most adolescent SRHR programmes focus on older adolescents, overlooking the needs of this younger age group.
The interviewees’ experiences suggest that attending the club had made things more equal for them at home. For instance, girls said that after learning at the club that there is no difference between what a male and female can do, they were able to talk to their family about why they were expected to do chores and their brothers were not, and parents had responded by sharing tasks between siblings. Establishing more equal gender norms could help adolescent girls feel better able to make decisions around their sexual health, such as whether to have sex.
Abusive practices, such as forced marriage or being kept home from school to look after siblings, also gradually decreased. Again, girls reported that this happened after they explained to their parents why and how such practices are abusive.
Most interviewees (78%) were in school. Girls who were not said they had stopped going because they lacked basic things, such as uniform, books and pens. Small business loans were offered to parents and caregivers (mainly women) of club attendees. This resulted in some girls returning to school as their family could now afford basic school materials. Other girls returned to school after getting these things at the clubs themselves.
Several girls had left school because they did not see a future in studying. But motivational talks at the club, led by those who were at school, encouraged some to return. Keeping girls in school is a key strategy for reducing HIV vulnerability and so an important success of the ‘Go Girl clubs’.
The majority of girls said the club had given them important life skills like time management. It had also created a ‘sisterhood’ bond between members that helped them stand up for one another in times of trouble. This finding is also significant. Often, adolescent girls in rural places have fewer opportunities than boys to make friends. Creating a space for socially isolated girls to talk about personal issues, such as sexual health, provided a rare opportunity for emotional peer support, which is particularly important for identifying and reducing gender-based violence.
Most of the girls said the club taught them about sexual health issues for the first time, including about HIV, contraception, menstrual hygiene and STIs. A number of girls had already been taught about sexual health at school but said they had gained a deeper knowledge from the club.
Some girls applied this newfound knowledge to their lives. Five interviewees were in sexual relationships and all reported using condoms due to the club’s influence. Some girls tested for HIV through the clubs. This included those who were sexually active and those who were not.
Almost every girl said they joined the clubs to learn about issues affecting their lives, including SRHR, child abuse and education. Most said the decision to join was influenced by teachers, neighbours, friends, parents or community leaders. Some reported that other girls who had not joined the clubs discouraged them from participating, for instance by saying the club would encourage them to have sex.
The findings show that girl-only clubs not only provide girls with much-needed SRHR knowledge, but they can also influence the social, economic and cultural norms that make adolescent girls and young women more vulnerable to HIV. Creating a space for young adolescent girls to interact freely, learn, and discuss personal issues is one way to equip them with the knowledge and skills they need to protect themselves from HIV, STIs and unintended pregnancies, both in the present and later in life.
This, and other evidence from DREAMS, shows that addressing multiple needs is more effective at reducing HIV risk behaviours than single interventions.