Profiles of Malawian adolescents at risk for HIV infections: implications for targeted prevention, policy, and practices.

Young people are at the center of the HIV epidemic. In fact, HIV has been referred to as a "youth-driven disease" worldwide. This cross-sectional study identified a typology of risk for HIV among Malawian adolescents, examined the distribution of HIV status within each group in the typology, and tested the association between class membership and changes in sexual behaviors to avoid HIV. The sample was restricted to males and females between the ages of 15 and 18 from three regions in Malawi who reported never having been married. Latent Class Analysis was conducted to examine youth population clusters based on shared characteristics. A chi-squared test was used to test whether class membership was associated with changes in sexual behaviors to avoid HIV. The study results indicate that two classes of risk exist among Malawian youths in this sample: At High Risk class and At Risk class. Individuals in the At High Risk class were significantly more likely than the At Risk class to perceive themselves as currently infected with HIV. The At High Risk class was not significantly less likely than the At Risk class to report changes in their sexual behaviors to avoid HIV. Findings are discussed and recommendations are suggested for clinicians to consider the heterogeneity among Malawi adolescents and tailor services accordingly. We provide suggestions on potential interventions that target the specific needs for the two groups to mitigate the spread of HIV among adolescents in Malawi.