Traditional Norms and Their Influence on HIV Prevention Behaviours among Urban Youth in Lusaka, Zambia: A Qualitative Phenomenological Study

Abstract

Despite expanded access to HIV testing, condoms, pre-exposure prophylaxis, and antiretroviral therapy, HIV incidence among urban youth in Zambia remains disproportionately high. Sociocultural norms continue to shape gender relations, sexual negotiation, and HIV prevention practices, yet limited qualitative research has explored how urban youth actively interpret and negotiate these norms within rapidly changing social and digital environments. This study explored how traditional sociocultural norms influence HIV prevention behaviours among urban youth in Lusaka, Zambia.
A descriptive qualitative study using an interpretive phenomenological approach was conducted between July and August 2025 in six urban constituencies of Lusaka District. Purposive and snowball sampling techniques were used to recruit 72 participants aged 18–30 years, comprising 36 males and 36 females. Semi-structured in-depth interviews were conducted in English, Bemba, and Nyanja. Interviews were audio-recorded, transcribed verbatim, translated where necessary, and analysed thematically following Braun and Clarke’s six-phase framework. Reflexive journaling, peer debriefing, member checking, and iterative coding procedures were employed to enhance trustworthiness and analytical rigor.
Four major themes emerged. 1. Traditional constructions of masculinity normalized multiple sexual partnerships and discouraged condom negotiation, while femininity was associated with silence, obedience, and sexual submissiveness. 2. Gendered power imbalances constrained women’s ability to negotiate HIV prevention practices. 3. Economic vulnerability and transactional relationships reinforced unsafe sexual behaviours within urban nightlife settings. 4. Participants demonstrated emerging forms of youth agency through peer support and digitally mediated HIV prevention engagement. A key analytical finding was the emergence of “normative dissonance,” defined as the simultaneous internalization and resistance of traditional sociocultural expectations. Participants frequently acknowledged the risks associated with harmful norms while continuing to conform to them because of peer pressure, social acceptance, and fear of exclusion.