The main purpose of this research is to investigate how youth may be 'rationed out' of HAART use by better understanding rationing and access mechanisms and their interaction. This is done by making use of both qualitative and quantitative methods. The data collection consists of 35 transcripts of face-to-face interviews. This research examines the achieved use of Highly Active Antiretroviral Therapy (HAART) by young people in Malawi. HIV prevalence in Malawi is amongst the highest national rates but is not constant across the life cycle, peaking at age 30-34. Prevalence among youth represents more recent HIV infections. Malawi initiated a national HAART programme in 2004. 170,000 HIV-infected people are considered clinically eligible for HAART. The agreed country target is to place 80,000 patients on HAART by the end of 2005. No clear consensus has been achieved for rationing criteria and a variety of implicit and explicit mechanisms exist. It is known that young people experience problems in accessing sexual and reproductive health services. Underlying causes include Malawi's conservative attitudes towards adolescent sexuality, prevailing cultural beliefs about sexual behaviour and young people's social status.

Mixed methods are used. Quantitative analysis of existing data will be used to determine existing levels of youth HAART use. Qualitative methods were used to identify and better understand HAART rationing and access mechanisms and how such mechanisms impact youth uptake. Interviews were undertaken with 11 health care providers; 12 youths accessing HAART at the time of interview and 12 youths not accessing HAART at the time of interview. The consistency of the sample is the result of purposive selection for case studies.