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HIV Risk Among Currently Married Couples in Rural Malawi: What Do Spouses Know About Each Other?

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Abstract

In countries with generalized HIV/AIDS epidemics, married couples have a shared risk of acquiring HIV/AIDS. Yet very little research has adopted a couple-level perspective to investigate perceived risk of HIV infection. In this paper, we used population-based data from 768 married monogamous couples in the 2004 Malawi Diffusion and Ideational Change Project (MDICP) to compare respondents’ perceptions about their spouses’ HIV status to their spouses’ actual HIV status. Using chi-squared and Kappa coefficient statistics, we evaluated how accurately respondents assess their spouse’s HIV status, and compared the assessment of their spouse’s HIV status with their assessment of their own serostatus. We found that individuals tend to overestimate their spouse’s as well as their own risk of having HIV. Husbands were generally more accurate in assessing their own risk of HIV infection than that of their wives, but wives were more accurate in assessing the HIV status of their spouses. In our multivariate logistic regression results, we found that marital infidelity is the most important correlate of overestimating individual and spousal HIV risk.

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Acknowledgments

The Malawi Diffusion and Ideational Change Project is supported by grants from the Rockefeller Foundation; NICHD (R01-HD4173, R01 HD372–276); NIA (AG1236-S3); and the Center for AIDS Research and the Center on the Demography of Aging, both at the University of Pennsylvania. This paper benefited from suggestions by Susan Watkins, Jere Behrman and two anonymous reviewers.

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Correspondence to Philip A. Anglewicz.

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Anglewicz, P.A., Bignami-Van Assche, S., Clark, S. et al. HIV Risk Among Currently Married Couples in Rural Malawi: What Do Spouses Know About Each Other?. AIDS Behav 14, 103–112 (2010). https://doi.org/10.1007/s10461-008-9497-7

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