Jesman Chintsanya

1. Condom use results from the 2004 Malawi Demographic and Health Survey: how do men and women differ? Jesman Chintsanya

2. Malawi Population: 13 million 85% of population lives in rural areas GDP per capita: $160 Life expectancy: 41yrs Total fertility rate: 6.0 Introduction Methods and Data Results Discussion Conclusion

3. Introduction • Almost quarter a century has passed since the first HIV case was identified in Malawi 1985 • one million young and adult population affected by HIV/AIDS. • adult population prevalence rate is 14.2 percent • disproportionate prevalence rates with women representing 56.8 percent of all HIV positive adults (MDHS, 2000).

4. HIV in Malawi 14% HIV prevalence (15-49yo) About 1 million infected Introduction Methods and Data Results Discussion Conclusion MDHS 2004

5. Introduction • many reasons cited for this disparity, • cultural practices • early exposure to sex.

6. Condom use within marriage Considered by many as a violation of trust The decision to use condoms within marriage requires a manifestation of trust and love (Tavory and Swidler 2008) Referred to as an “intruder in marriage” (Chimbiri 2007) cheated out of their right to a high-grade sexual experience (Zulu, 2002) Introduction Methods and Data Results Discussion Conclusion

7. Introduction Methods and Data Results Discussion Conclusion 2004 Malawi Demographic Health Survey (MDHS) • Analysis is from 2004 MDHS Interviewed women ( n = 11,698) and men (n = 3,261) aged 15-49 and 15-54 respectively. • Dependent variable: condom use, defined as men and women reported to have used a condom at last sex 12 months before the survey

8. Introduction Methods and Data Results Discussion Conclusion 2004 Malawi Demographic Health Survey (MDHS) • Independent Variables: • Own health, Making large purchases, Making daily purchases and Visits to family or relatives • Control variables age (age at last birthday), marital status, level of school, wealth quintile, residence and employment status.

9. Introduction Methods and Data Results Discussion Conclusion • The analyses were completed using three methods of analyses; descriptive, univariate and multivariate logistic regression analyses. • Multivariate logistic regression models were used for men and women separately to determine individual characteristics related to condom use.

10. Introduction Methods and Data Results Discussion Conclusion • Model 2 includes the control variables that were significant in the first model. • Model 3 assesses the best model that best predicts the likelihood of using a condom.

11. Introduction Methods and Data Results Discussion Conclusion Table 1.Shows a profile of respondents on condom use at last sex the past 12 months by sex. Table 2. Odds Ratios of Logistic Regression on condom use at last sex intercourse regresses on selected variables by sex

12. Introduction Methods and Data Results Discussion Conclusion • making the final decision on large household purchase, small household purchase, visit to family or relatives and own health are negatively associated with using a condom at last sex • Women who were widowed or separated and unmarried were more likely to use a condom • Women who had no education were less likely to use a condom • Women with higher economic status, though not significant, were more likely to use a condom.

13. Introduction Methods and Data Results Discussion Conclusion • Women were less likely to use a condom if they did not have the decision making power. • Largest predictor for condom use, for women, is residence and marital status while for men is residence and age.

14. Implies that there are factors that determine a woman to use a condom vary for people, in marital and non-marital relationships. Thus we have to look for other factors if we are to understand condom use and autonomy dynamics as demonstrated in the second model for the woman sample. How can we best ask questions about condom use in non-marital and marital partnerships? Introduction Methods and Data Results Discussion/Conclusion

15. Limitations Absence of reliable data on actual condom use Concerns about validity of self-reports Introduction Methods and Data Results Discussion/Conclusion