AIDS/HIV RISK, Marriage and Sexual Relations in Malawi

描述（由申请人提供）：本申请的重点是在艾滋病毒/艾滋病高流行率的撒哈拉以南非洲环境中的多种过程和影响，马拉维农村，这些过程和影响导致性伙伴关系中不同程度的艾滋病毒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，在性伙伴关系和一生中婚姻的形成/解除方面所作的动态选择被视为决定艾滋病毒风险的一个关键因素，并可能是个人如何在社会中科普艾滋病毒/艾滋病流行病的核心方面。但到目前为止，这些过程还没有得到充分的研究。因此，本申请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，1998年15至49岁的已婚妇女及其丈夫在马拉维农村地区的艾滋病毒/艾滋病、社会互动和预防战略方面的数据，分析关系模式对风险环境随时间和地区变化的适应，并调查家庭共同决定的艾滋病相关行为，如使用安全套。这项研究包括生物标志物，以克服测量风险行为及其变化的问题，以及纵向数据，以解决在进行因果分析时出现的估计问题，当没有观察到丈夫，妻子和风险环境的所有特征时，随着时间的推移而变化。具体目标包括：（1）在现有的数据收集基础上，随机抽取女性样本，（2）使用多状态人口模型来描述不同婚姻状态下个人的生命历程，以及这些生命历程随时间和不同风险环境的变化;（3）调查行为反应的关键方面，因为它们涉及到伙伴关系的动态，如最初的联盟形成，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、妇女地位和适当对策等方面;（4）利用对风险环境的行为反应，信息提供和社会互动，以得出以这些因素为条件的过渡矩阵，这些因素可用于模拟生活中的调整-课程，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.