Population Council Research that makes a difference

16th International Conference on AIDS
and Sexually Transmitted Infections in Africa (ICASA)
4–8 December 2011

Abstract

"'Meserete Hiwot': A program supporting married adolescents with HIV prevention and reproductive health in rural Ethiopia"
Aragaw Lamesgin, Gebeyehu Mekkonen, and Annabel Erulkar

Issue
It is acknowledged that out-of-school adolescents in Ethiopia often lack access to health information, counseling and legal protection. Nearly 48 percent of the girls in Amhara region are married by age 15. Age at first sexual onset was found to be 13.6 years. In the region, rural adolescents are 3 times sexually active than urban, and have 2-5 lifetime sexual partners. Girls in early marriage are at risk of HIV infection compared to unmarried sexual active girls, while married girls have unprotected sex more often with sexually experienced partners who are more likely HIV positive. This may also lead them for unwanted pregnancies, unsafe abortions and death. Research indicates that married adolescents have limited social system and networks (67% of ever married girls lives with no parents as compared 10% of never married ), less access to reproductive health information (only 35 % of rural girls' homes posses' radio), and limited decision making power. Very few programs are available to address the needs of married adolescents in Ethiopia. At present, Population Council along with the Ministry of Women, Children and Youth has been implementing a program 'Meserete Hiwot' (Base of Life) to support married adolescents with HIV prevention and reproductive health information in rural Amhara.

Description
Meserete-Hiwot is a program designed to support married adolescents with HIV prevention and reproductive health services in rural Ethiopia. Out- of- school married adolescents age 10- 24 years are mobilized in to groups that meet adult female mentors in community spaces. Trained mentors living in the community recruit married adolescents and young women by going house-to-house. Once joining a group, members receive a 4-month course that includes voluntary counseling and testing (VCT) for HIV, prevention of mother to child transmission (PMTCT), and other reproductive health information. In addition, modules on spousal communication and harmful traditional practices are included. Since 2008, over 300 female mentors have been recruited, trained and deployed. For the last 3 years, these mentors have been mobilized 130,000 married adolescents and young women in rural Amhara.

Lesson learned
Formative research indicates that significant numbers of program participants increased their knowledge of HIV/AIDS, undergone couple counseling and testing for HIV, PMTCT services, delaying unwanted pregnancies, developed assertiveness and shared responsibility among couples.

Recommendation
Married adolescents are at greater risk of HIV infection and reproductive health problems. Continued attention by large scale program in rural settings to address the reproductive health needs of married adolescents is necessary. Program managers must also continue to target harmful traditional male norms as part of programs.

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