Descriptive and Injunctive Norms Related to Concurrent Sexual Partnerships in Malawi: Implications for HIV Prevention, Research, and Programming

This journal article shares findings of a study to explore two types of norms, descriptive and injunctive norms, toward concurrent sexual partnerships in Malawi because concurrent sexual partnerships are hypothesised to be contributing to the HIV epidemic there. The study found participant perceptions of concurrency to be the following: 1) concurrent sexual partnerships are extremely common and 2) others in their communities heavily disapprove of concurrent sexual partnerships outside of polygamy.

On the premise that how individuals see the world shapes how they interact and engage with others, the study suggests that people’s behaviours are based on their perception of what reality is. Thus, understanding norms may strengthen prevention programmes if changing normative beliefs can lead to behaviour change. The study gathered data from 40 focus group discussions and 20 in-depth interviews conducted in five districts in Malawi, which included 318 participants aged 18–55 years.

The study found that participants perceived that the prevalence of concurrent sexual partnerships, the descriptive norm, was extremely high among both men and women, though concurrency was viewed as relatively new in their communities. "Outside of polygamy, participants overwhelmingly asserted that concurrent sexual partnerships were not acceptable for either men or women, and that community members would not encourage concurrent sexual partnerships. Women who engaged in such behaviour were reportedly highly stigmatised. Men, on the other hand, were both stigmatised and admired at the same time."

In terms of programming, the article states that there are a number of steps programmers and researchers can take to improve HIV/AIDS education programmes based on the results of the study:

• Improve the validity of self-reported behaviour and use observational research to identify reasons for inaccurate self-reported behaviour to improve data quality.
• examine current HIV programming to gain a clear idea of how messaging is being interpreted.
• Use a social norms approach in programming to correct the misperception between the perceived norm (high rates of concurrency engagement) and prevalence of the behaviour (low rates of concurrency engagement).
• Understand the perceptions among key members of individual social networks and how individual sexual behaviour is correlated to perceptions of friends’ sexual behaviour; 

In addition, the study suggests the identification of leaders in social networks to promote HIV prevention behaviours. "Peer educators may be effective in promoting risk reduction by highlighting the salience of the social norm of not engaging in concurrent partnerships, for example."