Obstacles to creating an environment conducive to HIV prevention for young people

  • Roselyn NM Kareithi
  • Crick Lund


The external environment of an organisation influences the desired goals and interventions of that organisation in many ways. However, strategies for influencing the external context to create a more enabling environment for the interventions of non-governmental organisations (NGOs) are often inadequately addressed. This article draws on an empirical multiple-case study conducted in 2007/08 of four NGOs providing HIV-prevention services to young people in several low-resource, high-HIV-prevalence communities in Cape Town, South Africa. In an earlier study, young people reported that the external environment hampered their ability to institutionalise HIV-prevention messages. The current study explored how the NGOs endeavoured to influence the external environment, and the challenges they faced. The findings show that the NGOs practised a combination of strategies, encompassing inter-organisational relationships, influencing policy, and championing by example. Key constraints to their influencing practices included fear of losing legitimacy as a service  provider; inadequate knowledge, skills and opportunity; perceived deviation  from their usual work; inadequate funding; conflicts over values and messages; and a habit of focusing more on young people’s individual behaviours and less on context. The development management task of influencing the external environment to create an environment more conducive to HIV prevention seemed constrained mainly because: 1) donors focused on funding and monitoring the activities they were interested in and conceptualised as HIV-prevention services; 2) NGO efforts were restricted to programme implementation based on agreed  deliverables, thus influencing was mainly confined to championing by example; consequently, 3) ‘influencing efforts’ to create an environment more conducive to HIV prevention were left mainly to young people themselves, who can affect their peers only to a narrow, albeit crucial extent. The external environment thus remains adverse to HIV prevention.

Keywords: development management, HIV/AIDS, multiple-case study, non-governmental organisations, public sector, social change, South Africa, strategic planning, youth

African Journal of AIDS Research 2011, 10(4): 465–477

Author Biographies

Roselyn NM Kareithi
University of Cape Town, Adolescent Health Research Unit, 46 Sawkins Road, Rondebosch 7700, Cape Town, South Africa
Crick Lund
University of Cape Town, Department of Psychiatry and Mental Health, Centre for Public Mental Health, 46 Sawkins Road, Rondebosch 7700, Cape Town, South Africa

Journal Identifiers

eISSN: 1608-5906
print ISSN: 1727-9445