Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998-2003.


Lopman, BA; Nyamukapa, C; Hallett, TB; Mushati, P; Spark-du Preez, N; Kurwa, F; Wambe, M; Gregson, S; (2009) Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998-2003. Sexually transmitted infections, 85 Suppl 1. i41-8. ISSN 1368-4973 DOI: https://doi.org/10.1136/sti.2008.033043

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Abstract

BACKGROUND: AIDS is the main driver of young widowhood in southern Africa. METHODS: The demographic characteristics of widows, their reported risk behaviours and the prevalence of HIV were examined by analysing a longitudinal population-based cohort of men and women aged 15-54 years in Manicaland, eastern Zimbabwe. The results from statistical analyses were used to construct a mathematical simulation model with the aim of estimating the contribution of widow behaviour to heterosexual HIV transmission. RESULTS: 413 (11.4%) sexually experienced women and 31 (1.2%) sexually experienced men were reported to be widowed at the time of follow-up. The prevalence of HIV was exceptionally high among both widows (61%) and widowers (male widows) (54%). Widows were more likely to have high rates of partner change and engage in a pattern of transactional sex than married women. Widowers took partners who were a median of 10 years younger than themselves. Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period. CONCLUSIONS: This combined statistical analysis and model simulation suggest that widowhood plays an important role in the transmission of HIV in this rural Zimbabwean population. High-risk partnerships may be formed when widowed men and women reconnect to the sexual network.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Population Studies (1974-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
PubMed ID: 19307340
Web of Science ID: 264443100007
URI: http://researchonline.lshtm.ac.uk/id/eprint/2263

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