HIV prevalence and sexual behaviour at older ages in rural Malawi

Freeman, Emily; Anglewicz, Philip

doi:10.1258/ijsa.2011.011340

Cited by 103 publications

(62 citation statements)

References 34 publications

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“…Although individuals of reproductive ages are the primary focus of HIV infection programs, HIV infection is also relevant at older ages (Freeman & Anglewicz, 2012; Gómez-Olivé et al, 2013; Negin & Cumming, 2010). Older HIV-positive migrants may be particularly difficult to connect to antiretroviral therapy due to their mobility, unless the purpose of the move is to seek treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In the coming decades, the annual growth rate of the 60 and older population in Africa is expected to be higher than in other regions; this population is projected to nearly double in size by 2030, and then double again by 2050 (United Nations, 2011; Velkoff & Kowal, 2007). Some of the above health outcomes are increasingly relevant for older populations in SSA: HIV prevalence, while lower than those of reproductive ages, is non-negligible at older ages and projected to increase with expanded access to HIV anti-retroviral therapy (Freeman & Anglewicz, 2012; Gómez-Olivé et al, 2013; Negin & Cumming, 2010). Hence, research has called for increasing attention to HIV infection at older ages in SSA (Gómez-Olivé et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Migration and health at older age in rural Malawi

Kendall

Anglewicz

2017

Global Public Health

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The connection between migration and health has long been established, but relatively little is known about this relationship for older persons, particularly in sub-Saharan Africa (SSA). In this paper we examine migration selection with regards to health status among older individuals in Malawi, by testing whether older migrants differ from non-migrants in health status before migration. To do so, we use data from the Malawi Longitudinal Study of Families and Health (MLSFH), a longitudinal panel dataset that includes a relatively large number of individuals at older ages. We focus on three measures: mental health, physical health, and HIV status. We find that the relationship between migration and health selection differs by gender. Older women who are HIV-positive are nearly ten times more likely to migrate compared to their HIV-negative counterparts. For men, those with better mental health are less likely to migrate in the future. These results suggest that, although research in some settings shows that migrants have better health before moving, some older migrants have worse health than their non-migrant peers, and may therefore add to the already-heavy burden on rural health centers in Africa.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Migration and health at older age in rural Malawi

Kendall

Anglewicz

2017

Global Public Health

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“…HIV/AIDS prevalence is 11% in the national population (Malawi DHS, 2011), though HIV+ rates are much lower in the older population. This low HIV prevalence is largely due to high HIV-related mortality of these cohorts in early life (Freeman and Anglewicz, 2012). Although HIV prevalence is fairly low at older ages, the HIV epidemic has great contextual importance to this population—older adults in Malawi lived through the peak of a widespread HIV epidemic (Payne and Kohler, 2017), a traumatic process even for the HIV- population.…”

Section: Methodsmentioning

confidence: 99%

Cognition, Health, and Well-Being in a Rural Sub-Saharan African Population

et al. 2017

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Cognitive health is an important dimension of well-being in older ages, but few studies have investigated the demography of cognitive health in sub-Saharan Africa’s (SSA) growing population of mature adults (= persons age 45+). We use data from the Malawi Longitudinal Study of Families and Health (MLSFH) to document the age and gender patterns of cognitive health, the contextual and life-course correlates of poor cognitive health, and the understudied linkages between cognitive and physical/mental well-being. Surprisingly, the age-pattern of decline in cognitive health is broadly similar to that observed in the U.S. We also find that women have substantially worse cognitive health than men, and experience a steeper age-gradient in cognitive ability. Strong social ties and exposure to socially complex environments are associated with higher cognitive health, as is higher socioeconomic status. Poor cognitive health is associated with adverse social and economic well-being outcomes such as less nutrition intake, lower income, and reduced work efforts even in this subsistence agriculture context. Lower levels of cognitive health are also strongly associated with increased levels of depression and anxiety, and are associated with worse physical health measured through both self-reports and physical performance. Our findings suggest that cognition plays a key—but understudied—role in shaping late-life well-being in low-income populations.

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“…The immediate implications of the findings here suggest a need to re-examine the existing studies using MLSFH data, particularly those that analyze sensitive questions, where misreporting is common (Castro 2012). Recent studies using MLSFH data to develop models predicting risky sexual behavior (Delavande and Kohler 2012;Freeman and Anglewicz 2012; De Paula, Shapira, and Todd forthcoming) do not report controlling for interviewer effects, let alone for potential interviewer-respondent dyad effects. Because many statistical packages treat missing data with case-wise deletion, when MLSFH data on sexual behavior is analyzed, the analytical sample is reduced, genderating more uncertainty around the results.…”

Section: Discussionmentioning

confidence: 88%

The politics of local research production: surveying in a context of ethnic competition

Dionne

2014

Politics, Groups, and Identities

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Using observations from rural Malawi in 2010, this paper describes and studies two significant challenges when surveying in a context of ethnic competition. First, I provide an empirical account of the local reality of ethnoregional competition as demonstrated in local research assistant selection. Negative local perceptions about how many research assistants came from the field site generated some study refusals. Second, I use subsequent survey data to demonstrate nuanced findings on ethnicity-of-interviewer effects: overall item non-response patterns are not associated with interviewer-respondent ethnic matching; refusal to respond to questions about sexual behavior was higher in co-ethnic interview settings; and respondents inconsistent about reporting their ethnic identity often reported their ethnicity to match that of the interviewer. The findings are critical for individual-level research conducted in divided societies, especially but not exclusively in situations where scholars are studying the causes and effects of social division.

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HIV prevalence and sexual behaviour at older ages in rural Malawi

Cited by 103 publications

References 34 publications

Migration and health at older age in rural Malawi

Migration and health at older age in rural Malawi

Cognition, Health, and Well-Being in a Rural Sub-Saharan African Population

The politics of local research production: surveying in a context of ethnic competition

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