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Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998-2003.

Lopman BA, Nyamukapa C, Hallett TB, Mushati P, Spark-du Preez N, Kurwa F, Wambe M, Gregson S - Sex Transm Infect (2009)

Bottom Line: Widowers took partners who were a median of 10 years younger than themselves.Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period.High-risk partnerships may be formed when widowed men and women reconnect to the sexual network.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Disease Epidemiology, Imperial College London, London, UK. b.lopman@imperial.ac.uk

ABSTRACT

Background: AIDS is the main driver of young widowhood in southern Africa.

Methods: The demographic characteristics of widows, their reported risk behaviours and the prevalence of HIV were examined by analysing a longitudinal population-based cohort of men and women aged 15-54 years in Manicaland, eastern Zimbabwe. The results from statistical analyses were used to construct a mathematical simulation model with the aim of estimating the contribution of widow behaviour to heterosexual HIV transmission.

Results: 413 (11.4%) sexually experienced women and 31 (1.2%) sexually experienced men were reported to be widowed at the time of follow-up. The prevalence of HIV was exceptionally high among both widows (61%) and widowers (male widows) (54%). Widows were more likely to have high rates of partner change and engage in a pattern of transactional sex than married women. Widowers took partners who were a median of 10 years younger than themselves. Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period.

Conclusions: This combined statistical analysis and model simulation suggest that widowhood plays an important role in the transmission of HIV in this rural Zimbabwean population. High-risk partnerships may be formed when widowed men and women reconnect to the sexual network.

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Related in: MedlinePlus

Kaplan-Meier survival plot of remarriage after widowhood (n = 99 men; 644 women).
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U9G-85-S1-0041-f03: Kaplan-Meier survival plot of remarriage after widowhood (n = 99 men; 644 women).

Mentions: The hazard ratio of male remarriage to female remarriage was 3.4 (95% CI 2.4 to 4.9, z-test p<0.001 controlling for age; fig 3).


Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998-2003.

Lopman BA, Nyamukapa C, Hallett TB, Mushati P, Spark-du Preez N, Kurwa F, Wambe M, Gregson S - Sex Transm Infect (2009)

Kaplan-Meier survival plot of remarriage after widowhood (n = 99 men; 644 women).
© Copyright Policy - openaccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2654148&req=5

U9G-85-S1-0041-f03: Kaplan-Meier survival plot of remarriage after widowhood (n = 99 men; 644 women).
Mentions: The hazard ratio of male remarriage to female remarriage was 3.4 (95% CI 2.4 to 4.9, z-test p<0.001 controlling for age; fig 3).

Bottom Line: Widowers took partners who were a median of 10 years younger than themselves.Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period.High-risk partnerships may be formed when widowed men and women reconnect to the sexual network.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Disease Epidemiology, Imperial College London, London, UK. b.lopman@imperial.ac.uk

ABSTRACT

Background: AIDS is the main driver of young widowhood in southern Africa.

Methods: The demographic characteristics of widows, their reported risk behaviours and the prevalence of HIV were examined by analysing a longitudinal population-based cohort of men and women aged 15-54 years in Manicaland, eastern Zimbabwe. The results from statistical analyses were used to construct a mathematical simulation model with the aim of estimating the contribution of widow behaviour to heterosexual HIV transmission.

Results: 413 (11.4%) sexually experienced women and 31 (1.2%) sexually experienced men were reported to be widowed at the time of follow-up. The prevalence of HIV was exceptionally high among both widows (61%) and widowers (male widows) (54%). Widows were more likely to have high rates of partner change and engage in a pattern of transactional sex than married women. Widowers took partners who were a median of 10 years younger than themselves. Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8-17% of new HIV infections over a 20-year period.

Conclusions: This combined statistical analysis and model simulation suggest that widowhood plays an important role in the transmission of HIV in this rural Zimbabwean population. High-risk partnerships may be formed when widowed men and women reconnect to the sexual network.

Show MeSH
Related in: MedlinePlus