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Early marriage is common for girls in much of sub-Saharan Africa. A common belief is that marriage protects them from HIV, but studies show that married girls are at much higher risk from HIV and from maternal morbidity and mortality. FRONTIERS conducted operations research in Ethiopia and Kenya to assess the acceptability and feasibility of community-based interventions to raise awareness of the HIV risks of early marriage and promote the use of HIV counseling and testing (C&T) services by couples. The studies were an initial phase in a planned four-year intervention; this brief reports on the feasibility of the approach. The Ethiopia study (2006–08) was conducted in the Amhara region. The Kenya intervention (2005–08) was conducted in two districts of Nyanza Province. Both interventions used similar strategies including: engaging community and religious leaders in outreach campaigns; promoting premarital C&T and, if necessary, antiretroviral services for couples; and supporting young wives through married girls’ clubs and mentoring. Findings show that addressing the reproductive health needs of adolescent wives is an important strategy for preventing HIV, and that religious leaders can be effective community educators on young women’s health risks, early childbirth, and domestic violence.






Frontiers in Reproductive Health