The association between HIV-related knowledge, sexual behavior, and HIV infections in Malawi

This thesis assesses the association between HIV-related knowledge, sexual behavior, and HIV infections in Malawi, a country that has been hit hard by the HIV epidemic. HIV prevention programs often rely on the assumption that knowledge about HIV motivates individuals to change their high-risk behaviors, and consequently results in a decreased number of new infections. Studies conducted in sub-Saharan Africa have assessed the relationship between HIV-related knowledge and sexual behavior with somewhat mixed results. Furthermore, there is only limited empirical evidence on the association between HIV-related knowledge and actual HIV infections. The purpose of this study was to evaluate the association between HIV-related knowledge and actual HIV status as well as the association between HIV-related knowledge and sexual behavior among Malawian women and men, and to find out whether these relationships vary according to certain social, economic or cultural factors. It was also assessed whether having local misconceptions about the disease influence the way in which biomedical knowledge about HIV is applied. Data from the nationally representative Malawi Demographic and Health Survey 2004 was used to carry out a cross-sectional analysis using logistic regression. Contrary to what was assumed, no statistically significant association was found between HIV-related biomedical knowledge and HIV-positivity among Malawian women and men, regardless of whether or not they have misconceptions about the disease. Having biomedical knowledge about HIV is, however, associated with a lower risk of being infected among economically empowered women. Among these women, the effect of having HIV-related biomedical knowledge is somewhat stronger and statistically significant only for those who do not have any misconceptions about the disease. This association between HIV-related knowledge and HIV infections can not, however, be interpreted through any differences between the knowledge grou
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