This study uses eight waves of
data from the population-based Tsogolo la Thanzi study (2009-2011) in rural Malawi
to examine changes in young women's contraceptive practices, including the use of
condoms, non-barrier contraceptive methods and abstinence, following positive and
negative HIV tests.
The analysis factors in women's prior perceptions of their HIV status
that may already be shaping their behaviour and separates surprise HIV test
results from those that merely confirm what was already believed. Fixed-effects
logistic regression models show that HIV testing
frequently affects the contraceptive practices of young Malawian women, particularly
when the test yields an unexpected result. Specifically, women who are surprised
to test HIV positive
increase their condom use and are more likely to use condoms consistently.
Following
an HIV-negative test (whether a surprise or expected), women
increase their use of condoms and decrease their use of non-barrier contraceptives;
the latter may be due to an increase in abstinence following a surprise negative
result. Changes in condom use following HIV testing
are robust to the inclusion of potential explanatory mechanisms, including fertility
preferences, relationship status and the perception that a partner is HIV positive.
The results demonstrate that both positive and negative tests can influence women's
sexual and reproductive behaviours, and emphasize the importance of conceptualizing
of HIV testing
as offering new information only insofar as results deviate from prior perceptions
of HIV status.
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- 1*Department of Sociology, Purdue University,West Lafayette, Indiana,USA.
- 2†Department of Health and Behavioral Sciences,University of Colorado Denver,Denver,Colorado,USA.
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