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Perceptions of Risk and Strategies for Prevention: Responses to HIV/AIDS in Rural Malawi

Author

Listed:
  • Kirsten P. Smith

    (Population Studies Center, University of Philadelphia)

  • Susan Cotts Watkins

    (Population Studies Center, University of Philadelphia)

Abstract

This paper combines quantitative and qualitative data to investigate changes in perceived risk of contracting HIV/AIDS in rural Malawi. Using longitudinal survey data, we find that Malawians worried less about contracting HIV/AIDS in 2001 than in 1998. According to qualitative interviews and observational journal accounts, HIV/AIDS and strategies to prevent it are a frequent topic of conversation amongst married Malawians. Women report worrying most about their husbands as a possible source of infection, discussing with them the importance of avoiding infection, and, increasingly, using divorce to reduce their risk. Men report worrying most about their extramarital partners and adopting preventive strategies such as fewer partners and more careful partner selection. We show that the decline in perceived risk is significantly associated with declines in the behaviors that Malawians worry most about and perceptions of risk in individuals’ social networks. We interpret these findings as evidence that Malawians are changing their behavior in ways that may reduce the spread of HIV/AIDS.

Suggested Citation

  • 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.
    • Handle: RePEc:gdm:wpaper:0305
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    References listed on IDEAS

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    1. Hans-Peter Kohler & Jere R. Behrman & Susan Cotts Watkins, 1999. "The structure of social networks and fertility decisions: evidence from S. Nyanza District, Kenya," MPIDR Working Papers WP-1999-005, Max Planck Institute for Demographic Research, Rostock, Germany.
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    5. Georges Reniers, 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.
    6. Kirsten P. Smith, 2003. "Why are they worried? Concern about AIDS in rural Malawi," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 1(9), pages 279-318.
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    Cited by:

    1. Ning Hsieh, 2013. "Perceived risk of HIV infection and mental health in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 28(13), pages 373-408.
    2. Margaret Frye & Sophia Chae, 2017. "Physical attractiveness and women’s HIV risk in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 37(10), pages 251-294.
    3. Scorgie, Fiona & Khoza, Nomhle & Delany-Moretlwe, Sinead & Velloza, Jennifer & Mangxilana, Nomvuyo & Atujuna, Millicent & Chitukuta, Miria & Matambanadzo, Kudzai V. & Hosek, Sybil & Makhale, Lerato & , 2021. "Narrative sexual histories and perceptions of HIV risk among young women taking PrEP in southern Africa: Findings from a novel participatory method," Social Science & Medicine, Elsevier, vol. 270(C).
    4. Tyler W. Myroniuk & Hans-Peter Kohler & Iliana Kohler, 2021. "Marital dissolutions and changes in mental health: Evidence from rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 44(41), pages 993-1022.
    5. 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.
    6. Coast, Ernestina, 2006. "Local understandings of, and responses to, HIV: Rural-urban migrants in Tanzania," Social Science & Medicine, Elsevier, vol. 63(4), pages 1000-1010, August.
    7. Yamauchi, Futoshi & Ueyama, Mika, 2008. "Social learning, selection, and HIV infection: Evidence from Malawi," IFPRI discussion papers 817, International Food Policy Research Institute (IFPRI).
    8. Rebecca L. Thornton & Hans-Peter Kohler, 2017. "Making marriages last: Trust is good, but credible information is better," WIDER Working Paper Series wp-2017-173, World Institute for Development Economic Research (UNU-WIDER).
    9. Gerritzen, Berit C., 2014. "Intra-Household Bargaining Power and HIV Prevention: Empirical Evidence from Married Couples in Rural Malawi," Economics Working Paper Series 1408, University of St. Gallen, School of Economics and Political Science.
    10. Packel, Laura & Dow, William H. & de Walque, Damien & Isdahl, Zachary & Majura, Albert, 2012. "Sexual behavior change intentions and actions in the context of a randomized trial of a conditional cash transfer for HIV prevention in Tanzania," Policy Research Working Paper Series 5997, The World Bank.
    11. Pauline Peters & Peter A. Walker & Daimon Kambewa, 2008. "Striving for Normality in a Time of AIDS in Malawi," CID Working Papers 167, Center for International Development at Harvard University.
    12. Alexander A. Weinreb & Guy Stecklov, 2009. "Social inequality and HIV-testing," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 21(21), pages 627-646.
    13. 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.
    14. Parijat Chakrabarti & Margaret Frye, 2017. "A mixed-methods framework for analyzing text data: Integrating computational techniques with qualitative methods in demography," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 37(42), pages 1351-1382.
    15. Julia Cordero Coma, 2013. "When the group encourages extramarital sex," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 28(30), pages 849-880.
    16. Georges Reniers & Benjamin Armbruster, 2012. "HIV Status Awareness, Partnership Dissolution and HIV Transmission in Generalized Epidemics," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-7, December.
    17. Jethro Banda & Albert Dube & Sarah Brumfield & Abena Amoah & Amelia Crampin & Georges Reniers & Stephane Helleringer, 2021. "Knowledge, risk perceptions, and behaviors related to the COVID-19 pandemic in Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 44(20), pages 459-480.
    18. Kim, Jinho, 2016. "The effect of peers on HIV infection expectations among Malawian adolescents: Using an instrumental variables/school fixed effect approach," Social Science & Medicine, Elsevier, vol. 152(C), pages 61-69.
    19. Smith, Rachel A. & Morrison, Daniel, 2006. "The impact of stigma, experience, and group referent on HIV risk assessments and HIV testing intentions in Namibia," Social Science & Medicine, Elsevier, vol. 63(10), pages 2649-2660, November.
    20. Zhou, Amy, 2016. "The uncertainty of treatment: Women's use of HIV treatment as prevention in Malawi," Social Science & Medicine, Elsevier, vol. 158(C), pages 52-60.
    21. Tawfik, Linda & Watkins, Susan Cotts, 2007. "Sex in Geneva, sex in Lilongwe, and sex in Balaka," Social Science & Medicine, Elsevier, vol. 64(5), pages 1090-1101, March.
    22. Rebecca L. Thornton & Hans-Peter Kohler, 2017. "Making marriages last: trust is good, but credible information is better," WIDER Working Paper Series 173, World Institute for Development Economic Research (UNU-WIDER).

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    Keywords

    Aids; risk; prevention; Malawi;
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