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Sex Transm Infect. 2009 Apr;85 Suppl 1:i41-8. doi: 10.1136/sti.2008.033043.

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

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  • 1Department 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.

PMID:
19307340
[PubMed - indexed for MEDLINE]
PMCID:
PMC2654148
Free PMC Article
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