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

Refining seasonal mortality estimates through age adjustment: Evidence from Serbia, 2015–2023
Volume 54 - Article 15    | Keywords: age adjustment, excess mortality, life expectancy, mortality, mortality estimates, seasonal fluctuations, Serbia

A flexible model for reconstructing education-specific fertility rates: The case of sub-Saharan Africa
Volume 54 - Article 12    | Keywords: Bayesian demography, Demographic and Health Surveys (DHS), education, fertility, fertility rates, sub-Saharan Africa

Learning and reproductive health: Do early cognitive skills contribute to better sexual and reproductive health outcomes among adolescents in Ethiopia?
Volume 54 - Article 7    | Keywords: adolescence, education, education, Ethiopia, fertility, sub-Saharan Africa

The demography of loneliness: Rethinking social connections in population research
Volume 54 - Article 5    | Keywords: demography, loneliness, population, social connections

Tracking the decline of first marriage in South Korea: Timing, quantum decline, and pandemic disruptions
Volume 54 - Article 3    | Keywords: COVID-19, marriage, mean age at first marriage, nuptiality, proportion of ever married, South Korea, total first marriage rate