AIDS/HIV RISK, Marriage and Sexual Relations in Malawi

说明(申请人提供)：本申请的重点是在艾滋病毒/艾滋病高度流行的撒哈拉以南非洲马拉维农村环境中的多种进程和影响，这些进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管理风险的各种方式。因此，在性伙伴关系和在生命过程中结合的形成/解散方面作出的动态选择被视为决定艾滋病毒风险暴露的关键因素，并可能是个人如何应对社会中的艾滋病毒/艾滋病流行病的核心方面。但到目前为止，这些过程一直没有得到充分的研究。因此，这项应用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记数据收集，收集1998年马拉维农村地区15至49岁的已婚妇女及其丈夫关于艾滋病毒/艾滋病、社会互动和预防战略的数据，分析关系模式对风险环境随时间和地区的变化的适应情况，并调查家庭对艾滋病相关行为的联合决定，如使用避孕套。这项研究包括生物标志物，以克服风险行为及其变化测量中的问题，以及纵向数据，以解决在没有观察到丈夫、妻子和风险环境的所有特征时，在对随时间的变化进行因果分析时出现的估计问题。具体目标包括：(1)对年龄在15岁至25岁的女性(如果已婚，还包括其配偶)进行随机抽样，以增加现有的数据收集；(2)使用多状态人口模型来描述个人在不同婚姻状态下的生命历程、这些生命历程随时间和跨越不同风险环境的变化；(3)调查与伙伴关系动态有关的行为反应的关键方面，例如最初的结合、离婚和再婚以及性行为，包括关于避孕套使用、关于艾滋病风险的配偶交流、妇女地位和适当反应的家庭内决策方面；(4)利用对风险环境、信息提供和社会互动的行为反应，推导出符合这些因素的转移矩阵，用于模拟生命过程中的调整，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.