HIV status and marriage dynamics in a rural community in Kisesa, Tanzania

Milly Marston, London School of Hygiene and Tropical Medicine (LSHTM)
Takudzwa Sayi, Princeton University
Georges Reniers, Princeton University
Richard Gregory
Mark Urassa, National Institute for Medical Research, Tanzania
Basia Zaba, London School of Hygiene and Tropical Medicine (LSHTM)

HIV status-based partnership mixing patterns have received little attention in the HIV prevention literature, but could be important for understanding trends in HIV incidence, and possibly offer opportunities for policy intervention. In this study we evaluate the effects of HIV status (and HIV status configuration of the couple) on marriage dissolution and remarriage across multiple rounds of sero-surveys in the Kisesa Demographic Surveillance Site in northwestern Tanzania. Preliminary results suggest that HIV positive status significantly increases the risk of union dissolution (both widowhood and divorce) and lowers remarriage rates. These effects are particularly strong for women, and a modeling study suggests that such a pattern contains the propagation of the virus but also contribute to the female disadvantage in the sex ratio of infections.