A Microsimulation Study of the Effects of Marriage, Divorce and Remarriage on Lifetime Risks of HIV/AIDS in Rural Malawi

Michael D. Bracher, Independent Researcher
Gigi Santow, Independent Researcher

HIV/AIDS prevalence is generally observed to be higher among the divorced, separated or widowed than among either the single or the currently married. In rural Malawi, divorce is coming to be seen as a measure of protection against infection with HIV from a spouse who is believed to be unfaithful. The probability of divorce has been high and may rise yet higher in response to the epidemic. We use a microsimulation model incorporating behavioural input parameters from the Malawi Diffusion and Ideational Change Project to investigate the following specific questions: 1. What are the implications for the lifetime probability of infection with HIV of high rates of marital dissolution over the life course? 2. What are the implications for the lifetime probability of infection of periods between marriages? 3. What are the implications for the lifetime probability of infection of trade-offs between fidelity in a sero-discordant marriage and divorce?