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Is there evidence for behaviour change in response to AIDS in rural Zimbabwe?

Author

Listed:
  • Gregson, Simon
  • Zhuwau, Tom
  • Anderson, Roy M.
  • Chandiwana, Stephen K.

Abstract

This article reports on evidence for behaviour change in response to AIDS among women in two rural areas of Manicaland Province, Zimbabwe. It examines self-reported data on two overlapping areas of behaviour: (1) actions taken to avoid HIV-1 infection; and (2) fertility practices. The latter were used to assess the validity of the former, given that self-reported behaviour data are notoriously problematic. It is concluded that while self-reported behaviour change is exaggerated, the true level of change has nonetheless been significant and includes delayed onset of sexual relations, increased use of condoms and, possibly, increased monogamy. Reported actions taken to avoid HIV-1 infection and differentials in fertility practices were correlated with data on demographic, social and psychological factors. Differentials in fertility practices were associated with heightened risk perception--particularly when based on personal acquaintance with AIDS patients--but not with greater knowledge of HIV-1/AIDS. Results from the study suggest that effective behaviour change in Manicaland is facilitated by greater knowledge, experience and personal risk perception but obstructed by low female autonomy, marital status and economic status, and by male labour migration and alcohol consumption. Gaps in knowledge included misconceptions about the distinction between HIV-1 and AIDS, the influence of STDs, perinatal transmission, and incorrect modes of transmission. Better knowledge was associated with education, religion, travel and media exposure. Personal risk perception was quite high (42%) and correlated with non-marriage, media exposure and contact with medical services. Few respondents knew close relatives with HIV/AIDS (4%) but nearly a quarter of those who felt in danger of infection said this was because friends and relatives were dying of AIDS. Many reported credible behavioural responses, some of which would only be effective given their partner's co-operation. Intensified behaviour interventions are needed which should include peer-education initiatives targeting men and individuals without access to modern media. The epidemic may accelerate fertility decline in rural Zimbabwe through behavioural as well as biological change.

Suggested Citation

  • Gregson, Simon & Zhuwau, Tom & Anderson, Roy M. & Chandiwana, Stephen K., 1998. "Is there evidence for behaviour change in response to AIDS in rural Zimbabwe?," Social Science & Medicine, Elsevier, vol. 46(3), pages 321-330, February.
    • Handle: RePEc:eee:socmed:v:46:y:1998:i:3:p:321-330
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    Citations

    RePEc Biblio mentions

    As found on the RePEc Biblio, the curated bibliography for Economics:
    1. > Economics of Welfare > Health Economics > Economics of Pandemics > Consequences > Fertility

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    Cited by:

    1. Marlène Guillon & Josselin Thuilliez, 2015. "HIV and Rational risky behaviors: a systematic review of published empirical literature (1990-2013)," Post-Print halshs-01222571, HAL.
    2. Cho, Hyunkuk & Kwon, Jihyeon, 2021. "Pandemic and hospital avoidance: Evidence from the 2015 Middle East respiratory syndrome outbreak in South Korea," Economics Letters, Elsevier, vol. 203(C).
    3. Georges Reniers, 2008. "Marital strategies for regulating exposure to HIV," Demography, Springer;Population Association of America (PAA), vol. 45(2), pages 417-438, May.
    4. Kirsten P. Smith & Susan Cotts Watkins, 2005. "Perceptions of Risk and Strategies for Prevention: Responses to HIV/AIDS in Rural Malawi," PGDA Working Papers 0305, Program on the Global Demography of Aging.
    5. Rebecca L. Thornton & Hans-Peter Kohler, 2017. "Making marriages last: Trust is good, but credible information is better," WIDER Working Paper Series wp-2017-173, World Institute for Development Economic Research (UNU-WIDER).
    6. Francis, Andrew M., 2008. "The economics of sexuality: The effect of HIV/AIDS on homosexual behavior in the United States," Journal of Health Economics, Elsevier, vol. 27(3), pages 675-689, May.
    7. Packel, Laura & Dow, William H. & de Walque, Damien & Isdahl, Zachary & Majura, Albert, 2012. "Sexual behavior change intentions and actions in the context of a randomized trial of a conditional cash transfer for HIV prevention in Tanzania," Policy Research Working Paper Series 5997, The World Bank.
    8. repec:hal:wpaper:halshs-01222571 is not listed on IDEAS
    9. Smith, Kirsten P. & Watkins, Susan Cotts, 2005. "Perceptions of risk and strategies for prevention: responses to HIV/AIDS in rural Malawi," Social Science & Medicine, Elsevier, vol. 60(3), pages 649-660, February.
    10. Kirsten P. Smith, 2003. "Why are they worried? Concern about AIDS in rural Malawi," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 1(9), pages 279-318.
    11. Simon Gregson & Heather Waddell & Stephen Chandiwana, 2001. "School education and HIV control in sub-Saharan Africa: from discord to harmony?," Journal of International Development, John Wiley & Sons, Ltd., vol. 13(4), pages 467-485.
    12. Smith, Rachel A. & Morrison, Daniel, 2006. "The impact of stigma, experience, and group referent on HIV risk assessments and HIV testing intentions in Namibia," Social Science & Medicine, Elsevier, vol. 63(10), pages 2649-2660, November.
    13. Gamboa, Luis Fernando & Rodriguez Lesmes, Paul, 2019. "The fertility-inhibiting effect of mosquitoes: Socio-economic differences in response to the Zika crisis in Colombia," Economics & Human Biology, Elsevier, vol. 35(C), pages 63-72.
    14. Rebecca L. Thornton & Hans-Peter Kohler, 2017. "Making marriages last: trust is good, but credible information is better," WIDER Working Paper Series 173, World Institute for Development Economic Research (UNU-WIDER).

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