AIDS/HIV RISK, Marriage and Sexual Relations in Malawi

描述（由申请人提供）：本申请的重点是撒哈拉以南非洲马拉维农村艾滋病毒/艾滋病高流行环境中的多重过程和影响，这些过程和影响导致性伙伴关系中艾滋病毒感染的不同程度风险，以及人们通过管理其伙伴关系来管理风险的各种方式。因此，在一生中在性伙伴关系和婚姻的形成/解除方面作出的动态选择被视为决定感染艾滋病毒风险的关键因素，可能是个人如何在社会中应对艾滋病毒/艾滋病流行病的核心方面。但迄今为止，对这些过程的研究还不够充分。因此，该应用程序的主要目的是补充现有的分层随机纵向社会科学和生物标志物数据收集，这些数据收集了1998年15至49岁的已婚妇女及其丈夫在马拉维农村的艾滋病毒/艾滋病、社会互动和预防策略，分析了随着时间和地区的风险环境变化，关系模式的适应情况，并调查了家庭共同决定的艾滋病相关行为，如避孕套的使用。本研究包括生物标记物，以克服风险行为及其变化的测量问题；纵向数据，以解决在对随时间变化的因果分析中出现的估计问题，因为没有观察到丈夫、妻子和风险环境的所有特征。具体目标包括：(1)扩大现有的数据收集，随机抽取15至25岁的女性样本（如果已婚，再加上她们的配偶）；(2)利用多状态人口模型表征不同婚姻状态下个体的生命历程及其随时间和不同风险环境的变化；(3)调查与伴侣关系动态有关的行为反应的关键方面，如最初的结合，离婚和再婚，以及性行为，包括家庭内部关于避孕套使用的决策，配偶关于艾滋病风险的沟通，妇女的地位和适当的反应；(4)利用对风险环境、信息提供和社会互动的行为反应，得出以这些因素为条件的过渡矩阵，可用于模拟生命历程中的调整，并评估这些行为反应对艾滋病传播和政策干预的影响。

DESCRIPTION (provided by applicant): The focus of this application is on the multiple processes and influences in a sub-Saharan African environment of high HIV/AIDS prevalence, rural Malawi, that contribute to varying degrees of risk for HIV in sexual partnerships and the variety of ways in which people manage risk by managing their partnerships. The dynamic choices that are made in terms of sexual partnerships and the formation/dissolution of unions over the life course, thus, are seen as a critical factor determining the exposure of risk for HIV and may be central aspects of how individuals cope with the HIV/AIDS pandemic in a society. But to date these processes have been under-researched. The principle aim of this application therefore is to complement an existing stratified random longitudinal social science and biomarker data collection of married women aged 15 to 49 in 1998 and their husbands on HIV/AIDS, social interactions and prevention strategies in rural Malawi, analyze adaptation in relationship patterns in response to variation in risk environment over time and regions, and investigate joint household decisions on AIDS relevant behaviors such as condom use. This research includes biomarkers in order to overcome problems in the measurement of risk behavior and its change, and longitudinal data to solve estimation problems that arise in making causal analyses of change over time when not all the characteristics of husbands, wives and the risk environments are observed. The specific aims include: (1) augment the existing data collection with a random sample of females (plus their spouses if married) age 15 to 25; (2) use multi-state population models to characterize individuals' life-courses in different marital states, changes in these life-courses over time and across different risk-environments; (3) investigate key aspects of behavioral responses as they pertain to partnership dynamics, such as initial union formation, divorce and remarriage, and sexual behaviors, including aspects of intra-household decision-making with respect to condom use, spousal communication about AIDS risk, women's status and appropriate responses; and (4) use the behavioral responses to risk environment, information provisions and social interactions to derive transition matrices conditional on these factors that can be used to simulate adjustments in life-courses and assess the implication of these behavioral responses for AIDS transmission and policy interventions.