Volume 37 - Article 10 | Pages 251–294  

Physical attractiveness and women’s HIV risk in rural Malawi

By Margaret Frye, Sophia Chae


Background: Qualitative evidence from sub-Saharan Africa, where a generalized AIDS epidemic exists, suggests that attractiveness may play a role in shaping individual-level HIV risk. Attractive women, who are often blamed for the epidemic and stigmatized, are believed to pose a higher HIV risk because they are viewed as having more and riskier partners.

Objective: We examine the association between perceived attractiveness and HIV infection and risk in rural Malawi in the midst of the country’s severe AIDS epidemic.

Methods: We use interviewers’ ratings of respondents’ attractiveness, along with HIV test results and women’s assessments of their own likelihood of infection, to estimate the association between perceived attractiveness and HIV infection and risk for a random sample of 961 women aged 15‒35.

Results: Results show that women who are rated by interviewers as ‘much less’ or ‘less’ attractive than other women their age are 9% more likely to test positive for HIV. We also find that attractiveness is associated with women’s own assessments of their HIV risk: Among women who tested negative, those perceived as ‘much less’ or ‘less’ attractive than average report themselves to be at greater risk of HIV infection.

Conclusions: These results suggest that attractiveness is negatively associated with HIV risk in Malawi, countering local beliefs that hold attractive women responsible for perpetuating the epidemic.

Contribution: This study highlights the need to consider perceived physical attractiveness, and sexual desirability more broadly, as an under-examined axis of inequality in HIV risk in high-prevalence settings.

Author's Affiliation

Other articles by the same author/authors in Demographic Research

A mixed-methods framework for analyzing text data: Integrating computational techniques with qualitative methods in demography
Volume 37 - Article 42

Forgotten marriages? Measuring the reliability of marriage histories
Volume 34 - Article 19

Most recent similar articles in Demographic Research

The dynamic role of household structure on under-5 mortality in southern and eastern sub-Saharan Africa
Volume 49 - Article 11    | Keywords: child mortality, Health and Demographic Surveillance System, household structure, sub-Saharan Africa

Comparative evidence of years lived with reproductive-age morbidity in sub-Saharan Africa (2010‒2019)
Volume 49 - Article 6    | Keywords: life expectancy, maternal morbidities, reproductive age, sub-Saharan Africa

Women's economic empowerment in sub-Saharan Africa: Evidence from cross-national population data
Volume 47 - Article 15    | Keywords: agency, Demographic and Health Surveys (DHS), economic growth, education, employment, sub-Saharan Africa, women's economic independence

A probabilistic model for analyzing summary birth history data
Volume 47 - Article 11    | Keywords: Bayesian hierarchical model, Brass method, Malawi, spatial smoothing, temporal smoothing

“One hand does not bring up a child:” Child fostering among single mothers in Nairobi slums
Volume 46 - Article 30    | Keywords: child fostering, informal settlements, Kenya, kinship, single motherhood, sub-Saharan Africa