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An inquiry into the uneven distribution of women’s HIV infection in rural Malawi

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Author Info

  • Michelle Poulin

    (University of North Texas)

  • Adamson S. Muula

    (University of Malawi)

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    Abstract

    Ecological comparisons in sub-Saharan Africa show that HIV prevalence is lower where men are generally circumcised than where they are not. Randomized controlled trials have found a 50-60% reduction in HIV acquisition for newly circumcised men. Yet in Malawi, HIV prevalence is highest in several districts in the Southern Region, where men are commonly circumcised. We draw upon a population-based sample of ever-married women to explore this unexpected finding. Our data show that in the southern district of Balaka, women with circumcised spouses have a lower probability of HIV infection compared to those with uncircumcised spouses. However, the strength of this effect is conditioned by specific marital histories: among women with circumcised spouses, those with multiple marriages and an absence of spousal co-residence have a higher probability of HIV infection than do those married once and those who have never lived apart from their spouses. The history of marital turnover and female-headed households among the ethnic groups of Balaka offer insight into the district’s elevated HIV levels.

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    File URL: http://www.demographic-research.org/volumes/vol25/28/25-28.pdf
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    Bibliographic Info

    Article provided by Max Planck Institute for Demographic Research, Rostock, Germany in its journal Demographic Research.

    Volume (Year): 25 (2011)
    Issue (Month): 28 (December)
    Pages: 869-902

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    Handle: RePEc:dem:demres:v:25:y:2011:i:28

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    Web page: http://www.demogr.mpg.de/

    Related research

    Keywords: AIDS/HIV; inequality; Malawi; male circumcision; marriage; migration; mortality; population; Sub-Saharan Africa;

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    1. Hunter, Mark, 2007. "The changing political economy of sex in South Africa: The significance of unemployment and inequalities to the scale of the AIDS pandemic," Social Science & Medicine, Elsevier, vol. 64(3), pages 689-700, February.
    2. Jonathan Crush & Brian Williams & Eleanor Gouws & Mark Lurie, 2005. "Migration and HIV/AIDS in South Africa," Development Southern Africa, Taylor & Francis Journals, vol. 22(3), pages 293-318.
    3. Damien de Walque, 2007. "Sero-Discordant Couples in Five African Countries: Implications for Prevention Strategies," Population and Development Review, The Population Council, Inc., vol. 33(3), pages 501-523.
    4. Kirsten P. Smith & Susan Cotts Watkins, 2005. "Perceptions of Risk and Strategies for Prevention: Responses to HIV/AIDS in Rural Malawi," PGDA Working Papers 0305, Program on the Global Demography of Aging.
    5. Smith, Kirsten P. & Watkins, Susan Cotts, 2005. "Perceptions of risk and strategies for prevention: responses to HIV/AIDS in rural Malawi," Social Science & Medicine, Elsevier, vol. 60(3), pages 649-660, February.
    6. FFF1Georges NNN1Reniers, 2003. "Divorce and Remarriage in Rural Malawi," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 1(6), pages 175-206, September.
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