'Kusvika taparadzaniswa nerufu' (Until death do us part)

Area of Science:

• Epidemiology
• Public Health
• Sociology

Background:

• HIV remains a significant public health concern in sub-Saharan Africa.
• Understanding the role of marital status and cohabitation in HIV acquisition is crucial for targeted prevention strategies.
• Gender-specific risk factors for HIV seroconversion require further investigation in diverse populations.

Purpose of the Study:

• To assess the protective effect of marriage against HIV acquisition in a rural Zimbabwean population.
• To examine gender differences in risk factors associated with HIV seroconversion.
• To compare HIV infection odds across different relationship statuses, including marriage, cohabitation, and widowhood/divorce.

Main Methods:

• Cross-sectional study design.
• Inclusion of 7,667 non-virgin participants aged 15-54 years.
• Statistical analysis adjusting for known confounders and significant risk factors for HIV infection.

Main Results:

• Individuals in stable first marriages and long-term consensual unions had higher odds of HIV infection compared to never-married individuals.
• However, those in stable unions had a lower risk of HIV infection than divorced or widowed individuals.
• Partner-related risk factors were more dominant in determining HIV prevalence among females, while personal sexual behavior risk factors were more dominant for males.

Conclusions:

• Stable marital and cohabiting unions in this rural Zimbabwean context do not appear to offer protection against HIV acquisition compared to never-married individuals.
• Marital status is a complex factor influencing HIV risk, with divorced/widowed individuals facing the highest risk.
• Gender differentials in risk factors highlight the need for tailored HIV prevention interventions, addressing partner dynamics for women and personal behavior for men.