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Men with Money and the “Vulnerable Women” Client Category in an AIDS Epidemic


  • Poulin, Michelle
  • Dovel, Kathryn
  • Watkins, Susan Cotts


Why have African men been largely overlooked in HIV policy and programs, while poor women are almost always targeted? Men are more likely to die of AIDS than women, and multiple studies in Africa find that wealthier men are more likely to be infected with HIV than are poor men. We draw on survey and ethnographic data from rural Malawi, a country in southeastern Africa that has experienced a major AIDS epidemic, to examine this puzzle of the “missing men.” Using longitudinal survey data collected at the height of Malawi’s epidemic, we find that not only are wealthy urban men more likely to be HIV positive, but so too are rural men who are wealthy by rural standards. We further advance our argument using ethnographic data to show that rural Malawians understand that men with money are a risk, both to themselves and others. We then systematically analyze HIV policies and documents from the World Health Organization (WHO), UNAIDS, and the President’s Emergency Program for AIDS Relief (PEPFAR)—large international organizations at the forefront of responding to AIDS—to identify the extent to which women and men and poverty and wealth appear as targets. We present evidence showing that women, who appear in these documents more than twice than do men, are framed as unquestionably vulnerable and in need of aid, whereas men are overlooked. We argue that the international discourse on AIDS in Africa cannot be conceived of as separate from the broader discourses of economic development. The campaigns by international donors and NGOs to protect poor women while sidelining men with money gives an incomplete picture of AIDS epidemics.

Suggested Citation

  • Poulin, Michelle & Dovel, Kathryn & Watkins, Susan Cotts, 2016. "Men with Money and the “Vulnerable Women” Client Category in an AIDS Epidemic," World Development, Elsevier, vol. 85(C), pages 16-30.
  • Handle: RePEc:eee:wdevel:v:85:y:2016:i:c:p:16-30
    DOI: 10.1016/j.worlddev.2016.04.008

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    References listed on IDEAS

    1. Lachaud, Jean-Pierre, 2007. "HIV prevalence and poverty in Africa: Micro- and macro-econometric evidences applied to Burkina Faso," Journal of Health Economics, Elsevier, vol. 26(3), pages 483-504, May.
    2. Hans-Peter Kohler & Rebecca L. Thornton, 2012. "Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?," World Bank Economic Review, World Bank Group, vol. 26(2), pages 165-190.
    3. Kathleen Beegle & Michelle Poulin & Gil Shapira, 2015. "HIV Testing, Behavior Change, and the Transition to Adulthood in Malawi," Economic Development and Cultural Change, University of Chicago Press, vol. 63(4), pages 665-684.
    4. Ishida, Kanako & Arnold, Michael & Stupp, Paul & Kizito, Paul & Ichwara, Jared, 2012. "Exploring the connections between HIV serostatus and individual, household, and community socioeconomic resources: Evidence from two population-based surveys in Kenya," Social Science & Medicine, Elsevier, vol. 74(2), pages 185-195.
    5. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    6. Wight, Daniel & Plummer, Mary L. & Mshana, Gerry & Wamoyi, Joyce & Shigongo, Zachayo S. & Ross, David A., 2006. "Contradictory sexual norms and expectations for young people in rural Northern Tanzania," Social Science & Medicine, Elsevier, vol. 62(4), pages 987-997, February.
    7. Jewkes, Rachel K. & Levin, Jonathan B. & Penn-Kekana, Loveday A., 2003. "Gender inequalities, intimate partner violence and HIV preventive practices: findings of a South African cross-sectional study," Social Science & Medicine, Elsevier, vol. 56(1), pages 125-134, January.
    8. Jorge Saba Arbache & Alexandre Kolev & Ewa Filipiak, 2010. "Gender Disparities in Africa's Labor Market," World Bank Publications, The World Bank, number 2520, November.
    9. Jane Fortson, 2008. "The gradient in sub-saharan Africa: Socioeconomic status and HIV/AIDS," Demography, Springer;Population Association of America (PAA), vol. 45(2), pages 303-322, May.
    10. 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.
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    1. repec:dem:demres:v:37:y:2017:i:10 is not listed on IDEAS
    2. repec:eee:socmed:v:211:y:2018:i:c:p:175-182 is not listed on IDEAS


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