Effectiveness of drama in promoting voluntary HIV counselling and testing in rural villages in southern Malawi

Abstract

We previously reported an HIV prevalence of 24% among rural adolescent girls living in the Shire Valley southern Malawi. Voluntary HIV counselling and testing (VCT) could help prevent HIV among adolescents by encouraging informed decision-making and behavioural change. The Malawian National AIDS Control Programme has prioritized VCT as an HIV prevention strategy but it is unclear whether adolescents in rural areas are informed about VCT and how acceptable HIV testing would be to adolescents and parents. We undertook a study to assess the role of drama as a tool to promote knowledge of and positive attitudes towards VCT. The study was undertaken in 2003 in seven villages in Chikwawa District within a 12 km radius of Montfort Hospital. VCT services were available at Montfort although only 7% of clients in the previous year were adolescents. Two counsellors were interviewed about issues faced by adolescents going for VCT and these formed the basis for the drama script. The drama which was translated into Chichewa comprised songs giving information on HIV/VCT a 30-minute drama and an epilogue and was performed by two drama groups (hospital and youth). In each village on the day of the drama 25 adolescents (15–19 years) and 25 adults who had an adolescent child were asked to complete a questionnaire before and after the performance. In two villages the questionnaire was re-administered four weeks later to assess knowledge retention. The study was approved by Ethics Committees in Liverpool and Malawi. (excerpt)