Volume 25 - Article 28 | Pages 869–902  

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

By Michelle Poulin, Adamson S. Muula

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.

Author's Affiliation

• Michelle Poulin - University of North Texas, United States of America EMAIL
• Adamson S. Muula - University of Malawi, Malawi EMAIL

Other articles by the same author/authors in Demographic Research

Reporting on first sexual experience: The importance of interviewer-respondent interaction
Volume 22 - Article 11

Most recent similar articles in Demographic Research

Excess mortality associated with HIV: Survey estimates from the PHIA project
Volume 51 - Article 38    | Keywords: excess mortality, HIV/AIDS, mortality

Is single parenthood increasingly an experience of less-educated mothers? A European comparison over five decades
Volume 51 - Article 34    | Keywords: age, children, cross-national comparison, education, Europe, family life course, inequality, single motherhood

A Bayesian model for age at death with cohort effects
Volume 51 - Article 33    | Keywords: age at death, Bayesian approach, cohort effects, Italy, mortality

Children under 5 in polygynous households in sub-Saharan Africa, 2000 to 2020
Volume 51 - Article 32    | Keywords: children, Demographic and Health Surveys (DHS), family demography, polygyny, sub-Saharan Africa

On the relationship between life expectancy, modal age at death, and the threshold age of the life table entropy
Volume 51 - Article 24    | Keywords: Gompertz law, life expectancy, lifespan variation, longevity, mode, mortality