Promoting Abstinence, Being Faithful, and Condom Use with Young Africans

Promoting Abstinence, Being Faithful, and Condom Use with Young Africans

“Mary Louisa Plummer’s Promoting Abstinence, Being Faithful, and Condom Use with Young Africans draws on extensive and meticulously collected qualitative data to answer some of the most important questions about the lives of millions of young people in contemporary Africa. It is, in many respects, a substantial advance for our understanding of both the interventions we implement and the realities of the lives of their expected beneficiaries. This book compels us to look at ourselves and young people in new ways to further consider the meanings of our actions and inactions for young people in Africa in the context of poverty and HIV/AIDS.” — Chimaraoke Izugbara, African Population and Health Research Centre

“This thoughtful, detailed work provides an important analytical assessment of how and why behavioural HIV prevention interventions for adolescent populations in sub-Saharan Africa ultimately succeed or fail. Drawing on ten years of fieldwork and a rich qualitative dataset, this book explores the implementation of the MEMA Kwa Vijana intervention project in rural Tanzania. Using young people’s own voices, Mary Louisa Plummer clearly explains the difficult and complex personal and social choices that underlie the consistent practice of the ABCs of ‘abstain, be faithful, and use condoms,’ thus deconstructing many of the myths regarding the ‘simplicity’ of the ABC approach. The multidisciplinary social science/public health approach will make this an important text for a wide range of audiences and a must-read for both scholars and practitioners embarking on HIV prevention research in this setting.” — Abigail Harrison, Population Studies and Training Center, Brown University

“This is a comprehensive account of a major theory- and community-based sexual health intervention randomized, controlled trial in the Mwanza region of Tanzania. Mary Louisa Plummer describes many of the real everyday challenges to the implementation of this carefully designed intervention. A range of ideological, cultural, linguistic, attitudinal, material, gendered, methodological, and other barriers—some anticipated but many not—had large impacts on inputs and outcomes. The development and progress of the complex intervention and evaluation are described in great detail, with great thoughtfulness, insight, and honesty, always showing respect for the very real people and the very real lives that were observed. This absorbing volume makes a crucially important contribution and will be a valuable addition to the reading lists of students and researchers who may be planning health-related intervention work in poorer (indeed, in any) countries.” — Roger Ingham, Centre for Sexual Health Research, University of Southampton

Promoting Abstinence, Being Faithful, and Condom Use with Young Africans evaluates an adolescent sexual health program that was implemented in sixty-two primary schools and eighteen health facilities in Tanzania, scrutinizing its teacher-led curriculum, peer education, youth-friendly health services, youth condom distribution, and community-wide activities. This book also provides in-depth case studies examining the motivations and strategies of extraordinary young people who tried to abstain, reduce their number of partners, select low-risk partners, be faithful, and/or use condoms. It concludes with detailed recommendations for school and health facility programs and a review of promising complementary interventions for out-of-school youth, women, men, couples, and parents.

About the author
Mary Louisa Plummer was the social science coordinator for the MEMA Kwa Vijana trial. Currently, she is an independent consultant based in Dar es Salaam, Tanzania.