Marriage as a risk factor for HIV: Learning from the experiences of HIV-infected women in Malawi

Lucy Mkandawire-Valhmu, Claire Wendland, Patricia E. Stevens, Peninnah M. Kako, Anne Dressel, Jennifer Kibicho

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.

Original languageEnglish (US)
Pages (from-to)187-201
Number of pages15
JournalGlobal Public Health
Issue number2
StatePublished - 2013
Externally publishedYes

Bibliographical note

Funding Information:
We are very grateful to the women who took their time to respond to often emotionally challenging questions related to living with HIV and violence. We would also like to acknowledge funding from the University of Wisconsin-Milwaukee Research Growth Initiative (RGI) Award 3 and the University of Wisconsin Institute on Race and Ethnicity that made this study and the write up of this article possible. Our appreciation goes to Ms Mary Ajoa Esson, who assisted us with the preparation for the initial draft of this article.


  • Malawi
  • marriage
  • violence
  • women


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