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

Michelle Poulin and Adamson S. Muula
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Michelle Poulin: University of North Texas
Adamson S. Muula: University of Malawi

Demographic Research, 2011, vol. 25, issue 28, 869-902

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.

Keywords: mortality; HIV/AIDS; marriage; migration; population; sub-Saharan Africa; inequality; Malawi; male circumcision (search for similar items in EconPapers)
JEL-codes: J1 Z0 (search for similar items in EconPapers)
Date: 2011
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (5)

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Persistent link: https://EconPapers.repec.org/RePEc:dem:demres:v:25:y:2011:i:28

DOI: 10.4054/DemRes.2011.25.28

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