It's not just who you are but where you live: An exploration of community influences on individual HIV status in rural Malawi

Social Science and Medicine

Volumn 72, Issue 5, 2011, Pages 717-725

  Feldacker, Caryl ^a,b   Ennett, Susan T ^a   Speizer, Ilene ^a,b  

^a IL   (United States)

^b UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL   (United States)

Author keywords

Accessibility; Community factors; Gender; HIV AIDS; Income inequality; Malawi; Political Economy of Health; Risk behavior; Rural populations

Indexed keywords

ACCESSIBILITY; ACQUIRED IMMUNE DEFICIENCY SYNDROME; DISEASE PREVALENCE; DISEASE TRANSMISSION; GENDER RELATIONS; HEALTH RISK; HEALTH STATUS; HUMAN IMMUNODEFICIENCY VIRUS; INCOME DISTRIBUTION; REGRESSION ANALYSIS; RISK FACTOR; RURAL POPULATION;

ADOLESCENT; ADULT; ARTICLE; CONDOM; FEMALE; HEALTH CARE ACCESS; HEALTH CARE FACILITY; HIGH RISK BEHAVIOR; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; MALAWI; MALE; POVERTY; PROSTITUTION; RISK FACTOR; RURAL AREA; SEX DIFFERENCE; SEXUAL BEHAVIOR; SEXUALLY TRANSMITTED DISEASE; SOCIOECONOMICS; TRAFFIC AND TRANSPORT;

ADOLESCENT; ADULT; FEMALE; HIV INFECTIONS; HUMANS; MALAWI; MALE; MIDDLE AGED; QUALITATIVE RESEARCH; RESIDENCE CHARACTERISTICS; RISK FACTORS; RISK-TAKING; RURAL HEALTH; SEX DISTRIBUTION; SEXUAL BEHAVIOR; SOCIOECONOMIC FACTORS; YOUNG ADULT;

MALAWI;

HUMAN IMMUNODEFICIENCY VIRUS;

EID: 79952002875     PISSN: 02779536     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.socscimed.2011.01.003     Document Type: Article

References (98)

1. Adimora A.A., Schoenbach V.J. Contextual factors and the black-white disparity in heterosexual HIV transmission. Epidemiology 2002, 13(6):707-712.
2. Altman D. Globalization, political economy, and HIV/AIDS. Theory and Society 1999, 28(4):559-584.
3. Barden-O'Fallon J.L., deGraft-Johnson J., Bisika T., Sulzbach S., Benson A., Tsui A.O. Factors associated with HIV/AIDS knowledge and risk perception in rural Malawi. AIDS and Behavior 2004, 8(2):131-140.
4. Baron R.M., Kenny D.A. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology 1986, 51:1173-1182.
5. Bello G.A., Chipeta J., Aberle-Grasse J. Assessment of trends in biological and behavioural surveillance data: is there any evidence of declining HIV prevalence or incidence in Malawi?. British Medical Journal 2006, 82(Suppl. 1):i9.
6. Benefo K.D. Determinants of Zambian men's extra-marital sex: a multi-level analysis. Archives of Sexual Behavior 2008, 37:517-529.
7. Benson T., Kanyanda S., Chinula R. Poverty mapping - Malawi - Results of the fourth iteration of the analysis 2002, International Food Policy Research Institute/the National Statistical Office, Government of Malawi, Washington, DC, USA/Zomba, Malawi.
8. Biglan A., Metzler C.W., Wirt R., Ary D., Noell J., Ochs L., et al. Social and behavioral factors associated with high-risk sexual behavior among adolescents. Journal of Behavioral Medicine 1990, 13(3):245-261.
9. Bingenheimer J.B. Men's multiple sexual partnerships in 15 sub-Saharan African countries: sociodemographic patterns and implications. Studies in Family Planning 2010, 41(1):1-17.
10. Blankenship K.M., Friedman S.R., Dworkin S., Mantell J.E. Structural interventions: concepts, challenges and opportunities for research. Journal of Urban Health 2006, 83(1):59-72.
11. Campbell C., Jovchelovitch S. Health, community and development: towards a social psychology of participation. Journal of Community & Applied Social Psychology 2000, 10(4):255-270.
12. Chimbiri A.M. The condom is an 'intruder' in marriage: evidence from rural Malawi. Social Science & Medicine 2007, 64(5):1102-1115. [Article].
13. Chirwa W.C. Migrant labour, sexual networking and multi-partnered sex in Malawi. Health Transition Review 1997, 7(Suppl. 3):5-15.
14. Columbia University Poverty mapping project 2008, The Center for International Earth Science Information Network, Retrieved February 13, 2008, From. http://sedac.ciesin.columbia.edu/povmap/.
15. Craddock S. Disease, social identity, and risk: rethinking the geography of AIDS. Transactions of the Institute of British Geographers 2000, 25(2):153-168.
16. Diez Roux A.V. Estimating neighborhood health effects: the challenges of causal inference in a complex world. Social Science & Medicine 2004, 58(10):1953-1960.
17. Doyal L., Pennell I. The political economy of health 1979, Pluto Press.
18. Doyal L. What makes women sick: Gender and the political economy of health 1995, Rutgers University Press.
19. Duncan C., Jones K., Moon G. Context, composition and heterogeneity: using multilevel models in health research. Social Science & Medicine 1998, 46(1):97-117.
20. Dworkin S.L., Blankenship K. Microfinance and HIV/AIDS prevention: assessing its promise and limitations. AIDS and Behavior 2009, 13(3):462-469.
21. ESRI ArcGIS 2008, (Version 9.2), ESRI.
22. Elbers C., Lanjouw J.O., Lanjouw P. Micro-level estimation of poverty and inequality. Econometrica 2003, 71(1):355-364.
23. Entwisle B. Putting people into place. Demography 2007, 44(4):687-703.
24. Farmer P., Nizeye B., Stulac S., Keshavjee S. Structural violence and clinical medicine. PLoS Medicine 2006, 3(10):e449.
25. Farmer P. Infections and inequalities: The modern plagues 1999, University of California Press.
26. Frazier P.A., Tix A.P., Barron K.E. Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology 2004, 51(1):115-134.
27. Gabrysch S., Edwards T., Glynn J.R. The role of context: neighbourhood characteristics strongly influence HIV risk in young women in Ndola, Zambia. Tropical Medicine and International Health 2008, 13(2):162-170.
28. Ghosh J., Kalipeni E. Women in Chinsapo, Malawi: vulnerability and risk to HIV/AIDS. Journal of Social Aspects of HIV/AIDS 2005, 2(3):320.
29. Gisselquist D., Rothenberg R., Potterat J., Drucker E. HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission. International Journal of STD & AIDS 2002, 13(10):657-666.
30. Gisselquist D. HIV transmission through health care in sub-Saharan Africa. Lancet 2004, 364(9446). [Letter], 1665-1665.
31. Glynn J.R., Carael M., Auvert B., Kahindo M., Chege J., Musonda R., et al. Why do young women have a much higher prevalence of HIV than young men? A study in Kisumu, Kenya and Ndola, Zambia. AIDS 2001, 15(Suppl. 4):S51-S60.
32. Government of Malawi: Ministry of Health and Population Malawi national health facilities development plan, 1999-2004 1999, Vol. 2. National Health Facilities.
33. Greig F.E., Koopman C. Multilevel analysis of women's empowerment and HIV prevention: quantitative survey: results from a preliminary study in Botswana. AIDS Behavior 2003, 7(2):195-208.
34. Halperin D.T., Steiner M.J., Cassell M.M., Green E.C., Hearst N., Kirby D., et al. The time has come for common ground on preventing sexual transmission of HIV. The Lancet 2004, 364(9449):1913-1915.
35. Helleringer S., Kohler H.P. Sexual network structure and the spread of HIV in Africa: evidence from Likoma Island, Malawi. AIDS 2007, 21(17):2323-2332.
36. Helleringer S., Kohler H. Cross-sectional research design and relatively low HIV incidence, rather than blood exposures, explain the peripheral location of HIV cases within the sexual networks observed on Likoma. AIDS 2008, 22(11):1378-1379.
37. Holtgrave D.R., Crosby R.A. Social capital, poverty, and income inequality as predictors of gonorrhoea, syphilis, chlamydia and AIDS case rates in the United States. Sexually Transmitted Infections 2003, 79:62-64.
38. Hunter M. The changing political economy of sex in South Africa: the significance of unemployment and inequalities to the scale of the AIDS pandemic. Social Science & Medicine 2007, 64(3):689-700.
39. Kaler A. My girlfriends could fill a yanu-yanu bus: rural Malawian men's claims about their own serostatus. Demographic Research 2003, 349-372.
40. Kaler A. The moral lens of population control: condoms and controversies in southern Malawi. Studies in Family Planning 2004, 35(2):105-115.
41. Kalichman S.C., Simbayi L.C., Kagee A., Toefy Y., Jooste S., Cain D., et al. Associations of poverty, substance use, and HIV transmission risk behaviors in three South African communities. Social Science & Medicine 2006, 62(7):1641-1649.
42. Kathewera-Banda M., Gomile-Chidyaonga F., Hendriks S., Kachika T., Mitole Z., White S. Sexual violence and women's vulnerability to HIV transmission in Malawi: a rights issue. International Social Science Journal 2005, 57(186):649-660.
43. Kawachi I., Kennedy B.P. Socioeconomic determinants of health: health and social cohesion: why care about income inequality?. British Medical Journal 1997, 314(7086):1037.
44. Kawachi I. Social capital and community effects on population and individual health. Annals of the New York Academy of Sciences 1999, 896(1):120.
45. Kim J., Ferrari G., Abramsky T., Watts C., Hargreaves J., Morison L., et al. Assessing the incremental effects of combining economic and health interventions: the IMAGE study in South Africa. Bulletin of the World Health Organization 2009, 87(11):824-832.
46. Kleinschmidt I., Pettifor A., Morris N., MacPhail C., Rees H. Geographic distribution of human immunodeficiency virus in South Africa. American Journal of Tropical Medicine and Hygiene 2007, 77(6):1163-1169.
47. Krieger N. Embodying inequality: a review of concepts, measures, and methods for studying health consequences of discrimination. International Journal of Health Services 1999, 29(2):295-352.
48. Krieger N. Monitoring socioeconomic inequalities in sexually transmitted infections, tuberculosis, and violence: geocoding and choice of area-based socioeconomic measures - the public health disparities geocoding project (US). Public Health Reports 2003, 118(3):240-260.
49. Lachaud J.P. HIV prevalence and poverty in Africa: micro-and macro-econometric evidences applied to Burkina Faso. Journal of Health Economics 2007, 26(3):483-504.
50. Leclerc-Madlala S. Age-disparate and intergenerational sex in southern Africa: the dynamics of hypervulnerability. AIDS 2008, 22:S17.
51. Lindgren T., Rankin S.H., Rankin W.W. Malawi women and HIV: socio-cultural factors and barriers to prevention. Women & Health 2005, 41(1):69-86.
52. Loewenson R. Exploring equity and inclusion in the responses to AIDS. AIDS Care-Psychological and Socio-Medical Aspects of AIDS/HIV 2007, 19:S2-S11.
53. Luke N. Age and economic asymmetries in the sexual relationships of adolescent girls in sub-Saharan Africa. Studies in Family Planning 2003, 34(2):67-86.
54. MEASURE DHS HIV prevalence testing in population-based surveys Retrieved May 23, 2008, from. http://www.measuredhs.com/topics/hivprev/start.cfm.
55. Macintyre S., Ellaway A., Cummins S. Place effects on health: how can we conceptualise, operationalise and measure them?. Social Science & Medicine 2002, 55(1):125-139.
56. Mackinnon D.P., Dwyer J.H. Estimating mediated effects in prevention studies. Evaluation Review 1993, 17(2):144.
57. Maharaj P., Cleland J. Risk perception and condom use among married or cohabiting couples in KwaZulu-Natal, South Africa. International Family Planning Perspectives 2005, 31(1):24-29.
58. Maman S., Campbell J., Sweat M.D., Gielen A.C. The intersections of HIV and violence: directions for future research and interventions. Social Science & Medicine 2000, 50(4):459-478.
59. Mbweza E., Norr K.F., McElmurry B. Couple decision making and use of cultural scripts in Malawi. Journal of Nursing Scholarship 2008, 40(1):12-19.
60. Ministry of Health Malawi National Health Accounts (NHA) 2002-2004 with subaccounts for HIV and AIDS 2007, Reproductive and Child Health, Lilongwe, Malawi.
61. Minkler M. Personal responsibility for health? A review of the arguments and the evidence at century's end. Health Education & Behavior 1999, 26(1):121.
62. Mnyika K.S., Klepp K.I., Kvale G., Ole-King'Ori N. Determinants of high-risk sexual behaviour and condom use among adults in the Arusha region, Tanzania. International Journal of STD & AIDS 1997, 8(3):176.
63. Montana L., Spencer J. Incorporating geographic information into measure surveys: A field guide to GPS data collection 2004, MACRO International and Carolina Population Center of the University of North Carolina, Chapel Hill.
64. Morris M., Kretzschmar M. Concurrent partnerships and the spread of HIV. AIDS 1997, 11(5):641-648.
65. Msisha W.M., Kapiga S.H., Earls F.J., Subramanian S.V. Place matters: multilevel investigation of HIV distribution in Tanzania. AIDS 2008, 22(6):741.
66. Mtika M.M. Political economy, labor migration, and the AIDS epidemic in rural Malawi. Social Science & Medicine 2007, 64(12):2454-2463.
67. National Statistical Office Malawi 1998 Population and Housing Census Retrieved June 23, 2010, From. http://www.nso.malawi.net/data_on_line/demography/census_98/census_results.html.
68. National Statistical Office Malawi Malawi Demographic and Health Survey 2004 2005, NSO and ORC Macro, Calverton, MD.
69. Neville R., Neville J. What can health care professionals in the United Kingdom learn from Malawi?. Human Resources for Health 2009, 7:26.
70. ORC Macro Sampling manual 1996, ORC Macro, Calverton, MD.
71. ORC Macro HIV testing laboratory manual: Demographic and health surveys 2005, ORC Macro, Calverton, MD.
72. Oakes J.M. The (mis) estimation of neighborhood effects: causal inference for a practicable social epidemiology. Social Science & Medicine 2004, 58(10):1929-1952.
73. Parker R.G., Easton D., Klein C.H. Structural barriers and facilitators in HIV prevention: a review of international research. AIDS 2000, 14(Suppl. 1):S22-S32.
74. Porter G. Living in a walking world: rural mobility and social equity issues in sub-Saharan Africa. World Development 2002, 30(2):285-300.
75. Poulin M. Sex, money, and premarital partnerships in southern Malawi. Social Science & Medicine 2007, 65(11):2383-2393.
76. Pronyk P.M., Kim J.C., Abramsk T., Phetla G., Hargreaves J.R., Morison L.A., et al. A combined microfinance and training intervention can reduce HIV risk behaviour in young female participants. AIDS 2008, 22(13):1659-1665.
77. Quinn T.C., Overbaugh J. HIV/AIDS in women: an expanding epidemic. Science 2005, 308(5728):1582-1583.
78. Rhodes T., Singer M., Bourgois P., Friedman S.R., Strathdee S.A. The social structural production of HIV risk among injecting drug users. Social Science & Medicine 2005, 61(5):1026-1044.
79. Schatz E. 'Take your mat and go'! Rural Malawian women's strategies in the HIV/AIDS era. Culture Health & Sexuality 2005, 7(5):479-492.
80. Smith D.R., Gordon A., Meadows K., Zwick K. Livelihood diversification in Uganda: patterns and determinants of change across two rural districts. Food Policy 2001, 26(4):421-435.
81. Smith K., Watkins S. Perceptions of risk and strategies for prevention: responses to HIV/AIDS in rural Malawi. Social Science & Medicine 2005, 60(3):649-660.
82. Sobel M.E. Asymptotic intervals for indirect effects in structural equations models. Sociological methodology 1982, 290-312. Jossey-Bass, San Francisco. S. Leinhart (Ed.).
83. Soobader M.J., LeClere F.B. Aggregation and the measurement of income inequality: effects on morbidity. Social Science & Medicine 1999, 48(6):733-744.
84. StataCorp Stata statistical software: Release 9 2005, StataCorp LP, College Station, TX.
85. Swidler A., Watkins S.C. Ties of dependence: AIDS and transactional sex in rural Malawi. Studies in Family Planning 2007, 38(3):147-162.
86. Tanser F., Barnighausen T., Cooke G.S., Newell M.L. Localized spatial clustering of HIV infections in a widely disseminated rural South African epidemic. International Journal of Epidemiology 2009.
87. Tanser F., Lesueur D., Solarsh G., Wilkinson D. HIV heterogeneity and proximity of homestead to roads in rural South Africa: an exploration using a geographical information system. Tropical Medicine and International Health 2000, 5(1):40-46.
88. Tavory I., Swidler A. Condom semiotics: meaning and condom use in rural Malawi. American Sociological Review 2009, 74(2):171-189.
89. Tawfik L., Watkins S.C. Sex in Geneva, sex in Lilongwe, and sex in Balaka. Social Science & Medicine 2007, 64(5):1090-1101.
90. UNAIDS Rural HIV/AIDS Retrieved April 23, 2008, from. http://data.unaids.org/Topics/Gender/ruralhivaids_en.pdf.
91. USAID Malawi HIV/AIDS health profile From. http://www.usaid.gov/our_work/global_health/aids/Countries/africa/malawi_profile.pdf.
92. Uthman O.A., Moradi T., Lawoko S. The independent contribution of individual-, neighbourhood-, and country-level socioeconomic position on attitudes towards intimate partner violence against women in sub-Saharan Africa: a multilevel model of direct and moderating effects. Social Science & Medicine 2009, 68(10):1801-1809.
93. Watkins S.C. Navigating the AIDS epidemic in rural Malawi. Population and Development Review 2004, 30(4):673-705.
94. Weinhardt L.S., Galvão L.W., Stevens P.E., Masanjala W.H., Bryant C., Ng'ombe T. Broadening research on microfinance and related strategies for HIV prevention: commentary on Dworkin and Blankenship (2009). Aids and Behavior 2009, 13(3):470-473.
95. Weir S.S., Pailman C., Mahlalela X., Coetzee N., Meidany F., Boerma J. From people to places: focusing AIDS prevention efforts where it matters most. AIDS 2003, 17(6):895-903.
96. Weir S.S., Tate J.E., Zhusupov B., Boerma J.T. Where the action is: Monitoring local trends in sexual behaviour. Sexually Transmitted Infections 2004, 80(Suppl. 2):ii63-68.
97. Wellings K., Collumbien M., Slaymaker E., Singh S., Hodges Z., Patel D., et al. Sexual behaviour in context: a global perspective. Lancet 2006, 368(9548):1706-1728.
98. Wilkinson R.G., Pickett K.E. Income inequality and population health: a review and explanation of the evidence. Social Science & Medicine 2006, 62(7):1768-1784.