INTRODUCTION This study aims to describe the sexual behaviors of youth living with human immunodeficiency virus (HIV) in Malawi. As a high-risk population, understanding the contextual factors that shape their sexual behaviors is of particular interest when designing strategies to reduce HIV transmission. METHODS Semi-structured qualitative interviews were used to collect information about sexual behaviors from 22 youth (12 females and 10 males) living with HIV aged from 15 to 24 years. All participants were recruited from a specialized HIV clinic in Malawi. Thematic analysis was applied to identify current themes. RESULTS The majority of participants were sexually active. Engaging in sexual behaviors was largely related to social processes identified in three main themes: (1) Risk-taking in pursuit of confidence and maturity; (2) A lack of voice in decision making concerning practising safe sex; (3) Perceived barriers to safe sex practice such as poverty, dropping out of school, and personal perspectives about transmitting HIV to others. CONCLUSION Our results suggest that prevention strategies targeting youth social and economic vulnerabilities to social influences are needed to enhance their personal and social skills. We suggest nurturing cultural and religious ceremonies and involving elders to equip youth with skills and knowledge for the prevention of HIV transmission.

中文翻译：

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“我们只是这样做......我们已经死了”：探索艾滋病毒携带者的性行为。

引言 本研究旨在描述马拉维感染人类免疫缺陷病毒 (HIV) 的青年的性行为。作为高危人群，在设计减少 HIV 传播的策略时，了解影响其性行为的背景因素尤为重要。方法 半结构化定性访谈用于收集 22 名 15 至 24 岁 HIV 感染青年（12 名女性和 10 名男性）的性行为信息。所有参与者都是从马拉维的一家专门的艾滋病毒诊所招募的。应用主题分析来确定当前主题。结果 大多数参与者性活跃。从事性行为在很大程度上与三个主题中确定的社会过程有关：（1）为追求自信和成熟而冒险；(2) 在有关实行安全性行为的决策中缺乏发言权；(3) 对安全性行为的认知障碍，例如贫困、辍学以及个人对将 HIV 传播给他人的看法。结论 我们的研究结果表明，需要针对青年社会和经济易受社会影响的脆弱性采取预防策略，以提高他们的个人和社交技能。我们建议培养文化和宗教仪式，并让长者参与，让年轻人掌握预防艾滋病毒传播的技能和知识。结论 我们的研究结果表明，需要针对青年社会和经济易受社会影响的脆弱性采取预防策略，以提高他们的个人和社交技能。我们建议培养文化和宗教仪式，并让长者参与，让年轻人掌握预防艾滋病毒传播的技能和知识。结论 我们的研究结果表明，需要针对青年社会和经济易受社会影响的脆弱性采取预防策略，以提高他们的个人和社交技能。我们建议培养文化和宗教仪式，并让长者参与，让年轻人掌握预防艾滋病毒传播的技能和知识。