An inquiry into the uneven distribution of womenâ€™s HIV infection in rural Malawi
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 districtâ€™s elevated HIV levels.
References listed on IDEAS
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- 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.
- 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.
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- 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.
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