Crossing the Marriage Threshold in a High HIV Setting

Michelle Poulin, Boston University

Using evidence from the 2004 Malawi Diffusion and Ideational Change survey, this paper investigates the relationship between the complex process of marriage and the AIDS epidemic in rural Malawi. We explore how sexual behaviors, partnership types, and HIV concerns evolve as young adults approach marriage, and how this process differs for women and men. The data show sexual activity rises steadily as youth approach their desired age to wed, followed by a sharp increase at marriage. HIV risk perceptions increase for women after marrying, but remain flat for men. We also show that worry about contracting HIV figures prominently in decisions about when and who to marry. Young adults consider an HIV-negative spouse important, and correspondingly seek spousal partners whom they identify as “low risk”. Having a nuanced understanding of how the process of marriage shapes and is shaped by HIV risks is critical for developing better HIV protection policies.