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Sero-Discordant Couples in Five African Countries: Implications for Prevention Strategies

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  • Damien de Walque

Abstract

Most analyses of the determinants of HIV infection are performed at the individual level. The recent Demographic and Health Surveys, which include results from HIV tests, allow the study of HIV infection at the level of the cohabiting couple. This article exploits this feature of the data for Burkina Faso, Cameroon, Ghana, Kenya, and Tanzania. The analysis yields two findings about the dynamics of the HIV/AIDS epidemic that have important implications for policy. First, at least two-thirds of the infected couples are sero-discordant, that is, only one of the two partners is infected. This implies scope for prevention efforts among infected couples. Second, among 30-40 percent of the infected couples only the woman is infected. This is at odds with levels of self-reported extramarital sex by women and with the common perception that unfaithful men are the main link between high-risk groups and the general population. These findings are confirmed by tests of robustness. These results indicate that extramarital sexual activity among women in union is a substantial source of vulnerability to HIV that should be, as much as male extramarital activity, targeted by prevention efforts. Copyright 2007 The Population Council, Inc..

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Bibliographic Info

Article provided by The Population Council, Inc. in its journal Population and Development Review.

Volume (Year): 33 (2007)
Issue (Month): 3 ()
Pages: 501-523

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Handle: RePEc:bla:popdev:v:33:y:2007:i:3:p:501-523

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Cited by:
  1. Lucia Corno & Damien de Walque, 2012. "Mines, Migration and HIV/AIDS in Southern Africa," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 21(3), pages 465-498, June.
  2. Philip Anglewicz, 2012. "Migration, Marital Change, and HIV Infection in Malawi," Demography, Springer, vol. 49(1), pages 239-265, February.
  3. Anglewicz, Philip & Clark, Shelley, 2013. "The effect of marriage and HIV risks on condom use acceptability in rural Malawi," Social Science & Medicine, Elsevier, vol. 97(C), pages 29-40.
  4. Beegle, Kathleen & de Walque, Damien, 2009. "Demographic and socioeconomic patterns of HIV/AIDS prevalence in Africa," Policy Research Working Paper Series 5076, The World Bank.
  5. Judith Lammers & Sweder van Wijnbergen & Daan Willebrands, 2011. "Gender Differences, HIV Risk Perception and Condom Use," Tinbergen Institute Discussion Papers 11-051/2, Tinbergen Institute.
  6. Kasirye, Ibrahim, 2013. "HIV/AIDS sero-prevalence and socioeconomic status: Evidence from Uganda," Research Series 148952, Economic Policy Research Centre (EPRC).
  7. Jeremy Magruder, 2011. "Marital Shopping and Epidemic AIDS," Demography, Springer, vol. 48(4), pages 1401-1428, November.
  8. Michelle Poulin & Adamson S. Muula, 2011. "An inquiry into the uneven distribution of women’s HIV infection in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 25(28), pages 869-902, December.
  9. Eva Deuchert, 2010. "The Virgin HIV Puzzle: Can Misreporting Account for the High Proportion of HIV Cases in Self-Reported Virgins?," University of St. Gallen Department of Economics working paper series 2010 2010-24, Department of Economics, University of St. Gallen.
  10. Philip Anglewicz & Hans-Peter Kohler, 2009. "Overestimating HIV infection:," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 20(6), pages 65-96, February.

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