Testing as trust, condoms as suspicion: relational moralities and HIV prevention among young people in Tanzania

Abstract

HIV prevention among young people in sub-Saharan Africa is often understood as an individual response to epidemiological risk, yet in many East African contexts prevention is negotiated within relationships shaped by trust, morality, and social recognition. Drawing on data from a mixed-methods study conducted with 460 young people and 24 key informants in Tanzania's Southern Highlands, this study examines how relational commitment reshapes the meanings of HIV testing and condom use. Quantitative findings show that 68.2% of respondents reported HIV testing in the past 12 months, and testing increased with higher levels of relational commitment, whereas consistent condom use, reported by 47.5%, did not follow the same pattern. Qualitative narratives reveal a clear moral distinction: testing in committed relationships is framed as a collaborative act of care and reassurance that affirms trust, while condom negotiation is often interpreted as signalling suspicion or possible infidelity. These findings show that HIV prevention operates within relational moralities that differentiate forms of protection and highlight the need to approach prevention as a cultural and communicative process. Study findings thereby extend sexuality scholarship on intimacy, risk, and prevention in Tanzania.