Marriage, widowhood, divorce and HIV risks among women in sub-Saharan Africa.

OBJECTIVE: Studies on associations between marriage and HIV infection among women in sub-Saharan Africa are generally inconclusive. Not enough is known about HIV risks among divorced and widowed women. This study examined the relationship between marital status and HIV infection among women in seven sub-Saharan African countries.
METHODS: Retrospective data from the Demographic and Health Surveys were combined with HIV biomarker data from the AIDS Indicator Survey (AIS) for analysis. Random-effects complementary log-log models were applied to examine the relationship between marital status and HIV risks controlling for theoretically relevant covariates.
FINDINGS: Compared to never-married women, widowed women were significantly more likely to be HIV positive. Similarly, married women were more likely to be infected with HIV, compared to never-married women in Lesotho and Zimbabwe. In Tanzania and Zimbabwe, divorced women had higher risks of HIV infection, compared to never-married women.
CONCLUSION: Findings suggest that specific HIV programs be directed at vulnerable women, in particular those widowed. Similar programs are needed for both poorer and wealthier women.