Background. International organizations have increasingly taken an interest in the HIV/AIDS epidemic in sub-Saharan Africa, often promoting the ABC message: Abstinence, Be Faithful and Condoms. Many scholars are now arguing that this message is too narrow to successfully address the social, cultural and economic complexities of the epidemic. Adolescents in these countries are perhaps the most important population to consider when examining the effectiveness of prevention campaigns, as they are the most at-risk group to HIV/AIDS infection in much of sub-Saharan Africa. Malawi, a county that has a relatively high HIV/AIDS prevalence, serves as a useful model to explore in-school HIV/AIDS prevention efforts for adolescents. This study focuses on Life Skills courses in particular, which are central to HIV/AIDS education in Malawian schools.

Methods. Utilizing a qualitative methodological approach, this descriptive case study exposes the influence of international efforts on HIV/AIDS education in secondary schools of rural Malawi, and examines how compatible that education is with the socio-cultural context of rural Malawian adolescents. There are three dimensions to this study: analysis of ethnographic diaries written by locals, which illuminates the socio-cultural context of the ABC message in rural Malawi; a textual analysis of Life Skills curriculum materials that provide insight into the intended HIV/AIDS curriculum for this socio-cultural context; and qualitative interviews with Life Skills teachers and students, which present insight into how the curriculum is actually playing out in the classroom.

Findings. The ethnographic diaries reveal the complexity of the HIV/AIDS epidemic in rural Malawi, and that combating the epidemic is not as easy as ABC. Moreover, the way the ABC message is presented in Life Skills, the lack of trainings teachers receive and the lack of materials they have, has meant this message is still often presented to secondary school students in selective and simplistic ways; usually only emphasizing the benefits of abstinence. Although, the most updated Life Skills curriculums do expand on the ABC message to include other discussions that examine the role that communication, cultural practices, gender equity and even human rights play in the HIV/AIDS epidemic in Malawi. However, these discussions are often very cursory.

Conclusion. The way Life Skills courses currently stand in rural Malawi, they are unlikely to encourage students to take seriously messages about the importance of being faithful and using condoms. Curriculum developers need to continue with their efforts to make Life Skills relevant to Malawian adolescents by expanding on their discussions of certain delicate and stigmatized issues, providing more training for teachers and more materials for classrooms. By doing so, they will likely increase the role that Life Skills can play in illuminating Malawian adolescents' understanding of HIV/AIDS and in encouraging them to engage in a variety of protective behaviors.