The findings indicate that vast majority (97%) of adolescent girls and young women in Malawi have ever heard of HIV/ AIDS. Although majority of AGYW in Malawi reported to have heard about HIV/AIDS, twenty-five percent of them did not know that using condoms consistently can reduce the risk of HIV. Similarly, about twenty-three percent of AGYW in Malawi believed that mosquitoes could transmit HIV. This is a worrisome finding as it suggests that some AGYW in Malawi are still lacking basic knowledge of HIV transmission as well as prevention methods. This result is consistent with the findings of a study done in Ghana . The present study has revealed that age, education, wealth index, frequency of listening to radio and work status were significantly associated with overall HIV/AIDS knowledge.
This study has demonstrated a positive association between education and overall HIV/AIDS knowledge. AGYW who had attained primary education and those who had secondary or higher education were more likely to have high overall knowledge of HIV/AIDS compared to those who had no education. This finding is consistent with the studies conducted in Kenya and Ghana [11, 15]. There are various potential explanations for the positive correlation between education and overall HIV/AIDS knowledge. Women with higher education are likely to know how to read which makes them understand the content of written information such as newspaper articles easily. Education also helps individuals to be proactive about their own health and to gather information to protect themselves against HIV. To reduce the risk of HIV spreading among AGYW, it is very crucial to reach out and provide HIV/AIDS information to AGYW with no education in communities.
The present study also found that young women aged 20–24 years were more likely to have high overall knowledge about HIV/AIDS compared to adolescent girls aged 15–19 years. This confirms findings of studies elsewhere [22, 23]. The possible reason why adolescent girls have low overall knowledge about HIV/AIDS is limited access to health–related information. For example, some parents/guardians in Malawi still believe that sexual and reproductive health education encourages sexual experimentation among girls. As a result, they are not open to discuss sexual and reproductive health information with adolescent girls which may lead to low knowledge of HIV among them. Therefore, there is a need to change social norms and design effective youth friendly programs that can help to increase knowledge about HIV among adolescent girls. There is also a need to empower parents, teachers and communities to freely discuss sexuality with adolescent girls and facilitate the adoption of self–protecting health behaviour among them.
The study also revealed that AGYW from rich households, those who were working as well as those who were listening to radio at least once a week had high overall HIV/AIDS knowledge compared to their counterparts. These results are consistent with previous research conducted in Sub-Saharan African Countries, where most of the participants who had good knowledge about HIV/AIDS were working, listening to radio frequently and were from rich households [12, 23]. A possible explanation for these findings is that AGYW from rich households and those employed can easily afford and access information from media and other socio platforms compared to their counterparts. Taken together, these findings suggest a need to target women from poor households, those not working and those who do not listen to radio with appropriate interventions (such as HIV/AIDS awareness campaigns in local languages) that can enhance their overall knowledge about HIV/AIDS.
These results should be interpreted in the context of the following study limitations. Firstly, the data is confined to the last MDHS round (2015–2016) and current levels of overall knowledge about HIV/AIDS among AGYW may have changed. Secondly, this study was based on secondary data analysis and we were unable to include other potential variables that might influence HIV/AIDS knowledge but not available in the MDHS dataset. The study used secondary data that were self-reported, which is prone to recall and social desirability bias. Despite these limitations, this is the first study to explore the determinants of overall HIV/AIDS knowledge among adolescent girls and young women aged 15–24 years in Malawi using a nationally representative sample. Therefore, our findings can be generalised to all AGYW in the whole country.