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The association of HIV status with rural-urban differences in wealth in Malawi: 2004-2015/16. AIDS Care 2021 Nov;33(11):1451-1457

Date

08/25/2020

Pubmed ID

32835495

DOI

10.1080/09540121.2020.1808157

Scopus ID

2-s2.0-85089782520 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

This retrospective cross-sectional study examined the association of HIV status with wealth in Malawi using the 2004, 2010, and 2015/16 Malawi Demographic and Health Survey (MDHS) data. A harmonized wealth index was generated using factor analysis of the pooled data. Bivariate and multivariate linear regression models were estimated to examine the association of HIV status with wealth stratified by urban and rural communities in Malawi. The sample consisted of 33,484 individuals(3,419 were HIV positive and 30,065 HIV-negative). While only 52% of the participants were female, women constituted 61% of those who were HIV positive. Findings showed a positive association between HIV status and wealth in rural but not in urban locations. In rural locations, HIV status was significantly associated with increased wealth (β=0.11; 0.07, 0.15), whereas having more children in the household (β=-0.02; -0.03, -0.02) and being employed (β=-0.07; -0.09, -0.04) were associated with decreased wealth. Given our findings of increased HIV prevalence among those with a higher wealth index in rural Malawi, broadening HIV-prevention efforts to include programs that target the wealthy in Malawi might help mitigate new HIV infections. To effectively address HIV in Malawi, HIV programming policies must target women and men at all socioeconomic status levels.

Author List

Ngui EM, Kako PM, Dressel A, Mkandawire-Valhmu L, Walker RJ, Gondwe KW, Prigmore HL, Egede LE

Authors

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Child
Cross-Sectional Studies
Female
HIV Infections
Humans
Malawi
Male
Retrospective Studies
Rural Population
Socioeconomic Factors