This book draws on an extraordinarily large and representative qualitative study to examine the variety of young people's sexual relationships and practices in a region typical of rural Africa. It describes how contradictory social ideals and expectations led to concealment of premarital and extramarital relationships. It then examines how this secrecy, combined with poor understanding of HIV/AIDS and the common practice of material exchange for sex, contributed to short relationships, fast partner change, concurrent partnerships, and related sexual health risks.

Promotion of the low risk "ABC" behaviors--Abstinence, Being faithful, and Condom use--has had only limited success in Africa. This book draws on a large qualitative study affiliated with an adolescent intervention trial to examine how ABC promotion can be improved. It evaluates the MEMA kwa Vijana sexual health program, which was implemented in 62 primary schools and 18 health facilities in rural Tanzania, scrutinizing its teacher-led curriculum, peer education, youth-friendly health services, youth condom distribution, and community mobilization components. The book examines how...