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The effect of marriage and HIV risks on condom use acceptability in rural Malawi

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  • Anglewicz, Philip
  • Clark, Shelley

Abstract

A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent's HIV status, HIV perceptions, and risk behaviors, and (3) spouse's HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use.

Suggested Citation

  • 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.
  • Handle: RePEc:eee:socmed:v:97:y:2013:i:c:p:29-40
    DOI: 10.1016/j.socscimed.2013.06.024
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    References listed on IDEAS

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    Cited by:

    1. Marlène Guillon & Josselin Thuilliez, 2015. "HIV and Rational risky behaviors: a systematic review of published empirical literature (1990-2013)," Post-Print halshs-01222571, HAL.
    2. Yuriy Pylypchuk & James B. Kirby, 2017. "The role of marriage in explaining racial and ethnic disparities in access to health care for men in the US," Review of Economics of the Household, Springer, vol. 15(3), pages 807-832, September.
    3. Conroy, Amy A. & Wong, Lauren H., 2015. "How reliable are self-reports of HIV status disclosure? Evidence from couples in Malawi," Social Science & Medicine, Elsevier, vol. 144(C), pages 28-37.
    4. Joseph E Enegela & Ochanya Iyaji Paul & Olanrewaju Olaiya & Edward Ugba & Patrick Okoh & Olufunmilayo Ogundeko & Ayodele Fagbemi & Oladipo Akinmade & Iko Ibanga & Amana Effiong, 2019. "Rates of Condom use among HIV Positive Patients on ART in Nasarawa Eggon North Central Nigeria," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 18(5), pages 13842-13847, June.
    5. Sarkar, Jayanta, 2022. "Do disease prevalence and severity drive COVID-19 vaccine demand?," Economic Analysis and Policy, Elsevier, vol. 75(C), pages 310-319.
    6. repec:hal:wpaper:halshs-01222571 is not listed on IDEAS
    7. Cordero Coma, Julia, 2014. "HIV prevention and marriage: Peer group effects on condom use acceptability in rural Kenya," Social Science & Medicine, Elsevier, vol. 116(C), pages 169-177.

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    Keywords

    Condom use; HIV/AIDS; Africa; Malawi;
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