Academic journal article International Perspectives on Sexual and Reproductive Health

In Malawi, HIV Prevalence Elevated among Men Coerced into Having Sex

Academic journal article International Perspectives on Sexual and Reproductive Health

In Malawi, HIV Prevalence Elevated among Men Coerced into Having Sex

Article excerpt

Men who are coerced into having sex by their long-term female partner have a dramatically increased likelihood of being or believing themselves to be HIV-positive, according to a study conducted in rural Malawi. (1) While the likelihood of HIV infection was also elevated among older men (odds ratio, 1.1 for each additional year of age) and among those who had had concurrent sexual partners in the prior four months (4.9), the strongest association in the study was with having been pressured into having sex (7.2).

Considerable research has documented the high prevalence of sexual violence against women throughout Sub-Saharan Africa and its link to HIV infection, but the few studies to date on sexual coercion among men have mostly focused on men in short-term relationships with older women. To address this issue, the investigators analyzed data from a longitudinal panel study on reproduction and AIDS conducted with a random selection of women and men residing near or in Balaka town in southern Malawi. The sample for the present analysis consisted of 684 men who were interviewed every four months. In the study's third wave, in 2010, participants completed a module on interpersonal violence. Men were asked whether their partner had ever pressured them into having sex or beaten them, and whether they had had a concurrent sexual partner during the last four months. They also provided demographic information and answered questions about condom use with their main partner and alcohol consumption in the last month.

At wave 3, about eight in 10 men were married or living with their partner (79%), half had been with their current partner for more than four years (46%) and the vast majority had not had an additional partner during the last four months (96%). The men had an average age of 26, and virtually all were the same age as or older than their partner (98%). Most men used condoms inconsistently (90%), and thought that their partner was HIV-negative (95%) and faithful (90%); some 17% had had alcohol in the previous month.

Ten percent of respondents reported they had experienced unwanted sex with their wife or partner, 2% had suffered physical abuse and 3% had either tested positive for HIV or reported that they were infected. …

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