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Health Literacy among Malawian HIV-positive youth: a qualitative needs assessment and conceptualisation

Lookup NU author(s): Nadege Uwamahoro, Professor Gill Rowlands



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Oxford University Press, 2020.

For re-use rights please refer to the publisher's terms and conditions.


Despite growing evidence of the significance of health literacy in managing and coping with HIV, it is not yet an integrated part of HIV/AIDS-related health promotion research and practice in Africa. This article contributes to addressing the gap in research on health literacy and HIV in Sub-Saharan Africa. We aimed to assess health literacy-related needs of young people living with HIV (YPLHIV) and adapt existing health literacy frameworks to the context of HIV/AIDS in Malawi.We used focus group discussions to collect data from a sample of the membership of the national association of YPLHIV. Twenty-four HIV-positive youth (18-29 years) participated in focus group discussions. Participants came from three regions of Malawi. Additionally, we conducted three in-depth interviews with key informants. We used a thematic framework approach to analyse data in MAXQDA. We contextualised definitions of four dimensions of health literacy: functional, interactive, critical, and distributed health literacy, which we used as an a priori analytical framework. To further contextualise the framework, we revised it iteratively throughout the analysis process. We identified the need for comprehensive information about HIV and sexual reproductive health, skills to interact with healthcare providers and navigate the health system, and skills to appraise information from different sources, among others. The identified needs were translated into 9 action recommendations for the national association of YPLHIV, and with relevance within the wider HIV sector in Malawi and beyond. We found that the dimensions in our analytical framework operate on the individual, system and public policy levels.

Publication metadata

Author(s): Uwamahoro N, Ngwira B, Vinther-Jensen K, Rowlands G

Publication type: Article

Publication status: Published

Journal: Health Promotion International

Year: 2020

Volume: 35

Issue: 5

Pages: 1137-1149

Print publication date: 01/10/2020

Online publication date: 06/11/2019

Acceptance date: 30/09/2019

Date deposited: 02/10/2019

ISSN (print): 0957-4824

ISSN (electronic): 1460-2245

Publisher: Oxford University Press


DOI: 10.1093/heapro/daz107


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