Multi-Country Study on Trusted Partners Among Youth: Eritrea, Tanzania, Zambia, and Zimbabwe

This 44-page study, produced by AIDSMark with USAID funding, focuses on the sexual behaviour of 15-24 year olds who are in relationships with "trusted partners". According to the report, the objectives of this study were to:

• explore youth’s definitions of “trust”
• establish criteria youth use to determine the trustworthiness of partners
• identify types of individuals youth believe they can and cannot “trust”
• examine trust’s influence on sexual decision making and sexually transmitted infections (STIs)/HIV risk perception
• identify how sexual partners violate trust and the effects on sexual decision-making

Executive summary (excerpt):


"Data were collected in October 2001 as part of a regional Behavior Change Communication (BCC) strategy in East and Southern Africa. Country programmes chose to participate in research based on project priorities and levels of interest in participating in a regional BCC strategy. Four county programmes agreed to collect and share data: Eritrea, Tanzania, Zambia, and Zimbabwe.

A total of 33 focus groups were conducted. Research teams in each country used the same discussion guide and pretested the guide prior to data collection. Discussion groups lasted between an hour and an hour and a half, were audiotaped, and transcribed into English. Each research team conducted two discussion groups in the major urban area composed of the following strata: males 15-19 years, females 15-19 years, males 20-24 years, and females 20-24 years. The Zambia programme conducted one additional focus group with males aged 15-19."

Programme implications (exerpt):

“Although much of this research focused on condom use, several other types of behavior change interventions are appropriate for addressing the barrier trust can play in youth’s perception of risk for STIs/HIV.

This study demonstrates that youth’s beliefs about their partners, and the partner selection process generally results in inappropriately low self-risk assessment for STIs/HIV. This, in turn, contributes to behaviors that are likely to lead to HIV infection. As a result, it is critical that communications programs aimed at preventing new infections among youth address the problem of trust as it relates to low risk perception for infection. We believe there are three essential components to such a strategy.

First, youth must understand that partners’ trustworthiness and character are independent of their serostatus. In short, “bad things happen to good people,” and in generalized epidemics many good, upstanding and trustworthy people are HIV positive. Although a checklist may help youth select a good partner, unprotected sex with this or any other person must be perceived as risky.

Second, youth must personalize this understanding: 'good people who become HIV positive do not just come from other communities,' but they are friends, neighbors and potential partners, or youth themselves. It is likely that interpersonal communication campaigns or other community-level activities will help achieve this personalization of risk.

Third, although achieving a new level of personalized risk perception among youth will be challenging, channeling this new knowledge into appropriate behaviors will require the creation of new social norms. Existing social norms result in several forms of risk behavior: irregular condom use; limited knowledge of serostatus due to low use of voluntary counseling and testing (VCT) services; and relatively low levels of abstinence or delayed sexual debut. In addition to communicating new and appropriate levels of personal risk assessment, programs should strive to achieve broad social support, if not pressure for, consistent condom use, knowledge of one’s own HIV status - as well as that of all partners - and delay or reduction of sexual activity where possible.”