Feasibility of a family-based programme
All four groups of stakeholders indicated that a family-based intervention was a feasible and culturally acceptable way to prevent HIV transmission among adolescents. For example, both adolescent males and females indicated that they were interested in participating in a family-based intervention that would provide them with comprehensive skills and information to reduce their risk of acquiring HIV. When asked to elaborate, adolescent males indicated that they listened to their parents and respected their beliefs and opinions more than they would an “outsider”.
Related to this, adolescent males also recognized that a comprehensive family-based approach could be easily integrated into their daily life. As one adolescent male stated, “It is beneficial if information and skill are given by families because someone who comes from outside will only be there for one day but if you err then family is there every day to tell.”
Similarly, adolescent girls believed it would be beneficial to have their parents talk to them about HIV/AIDS and that their parents could be a good source of knowledge and skills. Family-based approaches were praised by girls for their inclusiveness. As one girl said, “We don’t feel that anybody should be excluded like girls, boys, mothers, fathers. All should come together for the programme.”
In addition, adolescent girls believed that their parents could be effective teachers, especially if given correct information and skills about HIV/AIDS.
Mothers and fathers were open to participating in a family-based programme and believed that a comprehensive family-based programme was feasible. All of the parents were concerned about their child’s health and wellbeing, and many were aware that HIV/AIDS posed a serious health risk. Like their adolescent children, parents recognized that a family-based approach might be more successful than other types of programmes. As one father stated:
Parents will say and children will listen, but when an outsider comes and talks then there are many things that children will feel shy to speak to you as an outsider, they will not talk the way we are talking to you ... they will feel shy. That’s why it is important for parents to explain to them.
Without exception, parents wanted to talk with their children about HIV/AIDS. As one mother stated, “It is the duty of parents to speak to their daughters and sons about these issues. We should only make them understand and if we don’t tell them how will they know?”
At the same time, only a small number of parents said that they had actually talked with their children about topics like HIV/AIDS and sexual behaviour. Overall, both mothers and fathers felt that they lacked the necessary information and skills to communicate effectively with their children. In particular, parents felt they lacked adequate information related to correct and consistent condom use, and would need additional help if they were to instruct their teens on this topic. For their part, mothers wanted factual information and believed that their children would listen to them if given proper information. One mother said, “You should teach us. What all we don’t know, you must tell us. You should give information to parents as well as children. Then even we will be able to speak.”
Similarly, fathers believed that they should speak with their children about sexual behaviour and HIV/AIDS, but needed additional support to have effective conversations. Fathers believed that a family-based HIV prevention programme would be especially useful as it could “give us advice which we can give our children”.