ArticleBMC public health2024
Age-disparate and intergenerational sex partnerships and HIV: the role of gender norms among adolescent girls and young women in Malawi.
Article in BMC public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 10 citations in OpenAlex.
- Young widowhood as a predictor of HIV risk behaviors in a high HIV prevalence setting in Siaya County, Kenya.Global health action · 2026Article
- Educational Attainment and HIV Prevalence by Age Among Pregnant Women in South Africa.AIDS and behavior · 2026Article
- Greater Hypertension Risk among Foreign-born Adults: Examining the Roles of Language, Nativity, and Neighborhood Deprivation in an Ethnoracially Diverse U.S. Sample.Journal of racial and ethnic health disparities · 2026Article
- Spatial modeling of HIV prevalence in Malawi using generalized additive models.Frontiers in epidemiology · 2026Article
- Identifying sexual behavioural choices when commencing pre-exposure prophylaxis: Findings from a public health facility in eThekwini, KwaZulu-Natal, South Africa.Southern African journal of HIV medicine · 2026Article
- Impact of analytical treatment interruptions on sexual behaviors: a mixed-methods longitudinal study of women enrolled in an HIV cure-related trial in Durban, South Africa.HIV research & clinical practice · 2025Article
- Relationship Dynamics and Young Women's Contraceptive Use.Sexuality research & social policy : journal of NSRC : SR & SP · 2024Article
- HIV Stigma in Awi Zone, Northwest Ethiopia, and a Unique Community Association as a Potential Partner.International journal of environmental research and public health · 2024Article
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10 authors at 4 institutions in 2 countries.
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Abstract
backgroundAge-mixing (age-disparate [5-9 years difference] and intergenerational [≥ 10 years difference]) partnerships are hypothesized drivers of HIV in adolescent girls and young women (AGYW; 15-24 years). These partnerships are often associated with increased gender inequities which undermine women's agency and assertiveness. We assessed whether age-mixing partnerships were associated with HIV in Malawi and if endorsement of inequitable gender norms modifies this relationship.
methodsWe analyzed data from the Malawi Population-based HIV Impact Assessment, a nationally representative household survey conducted in 2015-2016. Participants underwent HIV testing and completed questionnaires related to actively endorsed gender norms and sexual risk behavior. We used multivariate logistic regression and multiplicative interaction to assess associations among AGYW who reported the age of their primary sex partner from the last year.
resultsThe analysis included 1,958 AGYW (mean age = 19.9 years, SD = 0.1), 459 (23.4%) and 131 (6.7%) of whom reported age-disparate and intergenerational partnerships, respectively. AGYW in age-mixing partnerships accounted for 13% of all AGYW and were older, more likely to reside in urban areas, to be married or cohabitating with a partner, and to have engaged in riskier sexual behavior compared with AGYW in age-concordant partnerships (p < 0.05). HIV prevalence among AGYW in age-disparate and intergenerational partnerships was 6.1% and 11.9%, respectively, compared with 3.2% in age-concordant partnerships (p < 0.001). After adjusting for residence, age, education, employment, wealth quintile, and ever been married or cohabitated as married, AGYW in age-disparate and intergenerational partnerships had 1.9 (95% CI: 1.1-3.5) and 3.4 (95% CI: 1.6-7.2) greater odds of HIV, respectively, compared with AGYW in age-concordant partnerships. Among the 614 (31% of the study group) who endorsed inequitable gender norms, AGYW in age-disparate and intergenerational partnerships had 3.5 (95% CI: 1.1-11.8) and 6.4 (95% CI: 1.5-27.8) greater odds of HIV, respectively, compared with AGYW in age-concordant partnerships.
conclusionsIn this Malawi general population survey, age-mixing partnerships were associated with increased odds of HIV among AGYW. These findings highlight inequitable gender norms as a potential focus for HIV prevention and could inform interventions targeting structural, cultural, and social constraints of this key group.
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