The Impact of Married Individuals Learning HIV Status in Malawi: Divorce, Number of Sexual Partners, and Condom Use With Spouses

Abstract

This article assesses how married individuals’ knowledge of HIV status gained through HIV testing and counseling (HTC) affects divorce, the number of sexual partners, and the use of condoms within marriage. This study improves upon previous studies on this topic because the randomized incentives affecting the propensity to be tested for HIV permit control for selective testing. Instrumental variable probit and linear models are estimated, using a randomized experiment administered as part of the Malawi Longitudinal Study of Families and Health (MLSFH). The results indicate that knowledge of HIV status (1) does not affect chances of divorce for either HIV-negative or HIV-positive respondents; (2) reduces the number of reported sexual partners among HIV-positive respondents; and (3) increases reported condom use with spouses for both HIV-negative and HIV-positive respondents. These results imply that individuals actively respond to information about their HIV status that they learn during HTC, invoking protective behavior against future risk of HIV/AIDS for them-selves and their actual and potential sexual partners. Some limitations of this study are a small sample size for those who are HIV-positive and dependence on self-reported sexual behaviors.

Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood

“…In addition, sex education implementing positive information, such as preventive (e.g., risk avoidance) and protective behaviors (e.g., STIs protection), may have a great impact on adolescent sexual health. In fact, one study showed that receiving correct information enhanced individuals' protective actions against future risky behaviors [128]. However, given the sensitive nature of these topics, before school officials and parents aim to cultivate adolescents' media literacy or provide sex-related information, confidentiality between the two parties must be established [129].…”

Linking gender, extramarital affairs, and HIV: a mixed methods study on contextual determinants of extramarital affairs in rural Tanzania

“…In Tanzania couple counseling and testing services are well implemented and accessible in various levels of the health facilities. In SSA, couple counseling and testing services are known to improve adoption of safer sex practices including condom use and reduction of multiple sexual partners among couples [ 17 , 18 ].…”

Forgotten marriages? Measuring the reliability of marriage histories

“…They usually contain information on respondents’ reported marriages, including marriage dates and how unions ended. Researchers have previously used survey-based marriage histories to calculate the probabilities of divorce and remarriage, examine the sociodemographic factors associated with these events, and identify respondents who divorced and/or remarried between survey waves ( Amoateng and Heaton 1989 ; Anglewicz and Reniers 2014 ; Boileau et al 2009 ; Brandon 1990 ; Fedor, Kohler, and Behrman 2015 ; Gage-Brandon 1992 ; Grant and Yeatman 2014 ; Hampshire and Randall 2000 ; Locoh and Thiriat 1995 ; Reniers 2003 , 2008 ; Reniers and Tfaily 2008 ; Takyi and Gyimah 2007 ; Tilson and Larsen 2000 ). Despite their value, retrospective marriage histories, like other forms of survey data, may be incomplete or contain incorrect information.…”