Migration, risk perception, and HIV infection in Malawi
The three essays in this dissertation examine issues related to the HIV epidemic in Malawi. The first two explore HIV risk perception among rural Malawians: the construction and accuracy of risk perception, and the effect of HIV testing on perceived risk of HIV infection. The third essay focuses on migrants from rural Malawi, and describes the relationship between marriage, HIV infection and migration. The primary question in the first paper is: in the absence of HIV testing, how do rural Malawians assess their HIV status? Using a unique dataset that includes respondents' HIV status as well as their subjective likelihood of HIV infection, results show that many rural Malawians overestimate their likelihood of current HIV infection. The discrepancy between actual and perceived status raises an important question: why are so many wrong? We identify determinants of self-assessed HIV status, compare these assessments with HIV biomarker results, and identify correlates associated with errors in self-assessments. Next, I examine the effect of HIV testing on risk perception. I identify the correlates of change in three different measures of HIV risk perception after receiving an HIV test result. I find that the relationship between risk perception, HIV testing, and other HIV risk covariates is not consistent across measures of risk perception, or by gender, which indicates that the relationship between HIV risk perception and risk behavior is more complex than it is typically portrayed. Finally, I turn to the relationship between HIV infection and migration in Malawi. Research migration and HIV infection in sub-Saharan Africa shows that migrants are at higher risk of HIV infection. Instead of focusing on ways in which migration is an individual risk factor of HIV infection, I examine the possibility that HIV infection leads to migration. Using a unique dataset from Malawi, I find that HIV positive individuals are more likely migrate than HIV negative individuals. The explanation for this phenomenon appears to be marital instability, which occurs more frequently among HIV positive individuals and leads to migration after marital dissolution.
Anglewicz, Philip, "Migration, risk perception, and HIV infection in Malawi" (2007). Dissertations available from ProQuest. AAI3292004.