Access, agency and ambiguity: communication about AIDS among young people in Northern Tanzania.

Developing interpersonal communication skills is a key component in HIV prevention. Understanding the contexts and content of communication about HIV and AIDS among young people is important for the development of effective programmes and interventions. The aim of this paper is to build on study findings suggesting that significant differences exist between young people in- and out-of-school in exposure to AIDS-related information and communication in Kilimanjaro. In-depth interviews were conducted with young people between the ages of 13 and 18. Data were analyzed using a thematic and comparative approach to explore similarities and differences. A trinity of factors including access, agency and ambiguity emerged as influencing communication about HIV and AIDS. The role of social networks in structuring differences in communication is examined. Findings reveal a discourse laden with fear and mistrust. Coupled with low levels of health literacy, young people regardless of school attendance demonstrate an inability to critically appraise modes of transmission and prevention. An increased emphasis should be placed on the development of critical health literacy and open dialogue. Accessible, unambiguous and culturally relevant interventions built on an understanding of barriers to open communication, which link with community-based initiatives to stimulate dialogue and debate, are needed.