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Changing Childbearing Norms During an Era of ART Expansion in Malawi, 2009 to 2015

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Abstract

Community norms shape the childbearing goals and behaviors of persons living with HIV/AIDS (PLWHA) but little is known about how norms around HIV-positive childbearing have changed with expanded access to antiretroviral treatment (ART). We analyze data collected in 2009 and 2015 by the Tsogolo la Thanzi (TLT) project—a longitudinal, population-based study of young adults in southern Malawi. Respondents were asked about the acceptability of childbearing using vignettes that varied a hypothetical couple’s HIV status and number of children. We assess mean differences in support for childbearing over time and by respondent gender and serostatus. The acceptability of childbearing for PLWHA increased dramatically over the 6-year period; however, support levels varied based on a couple’s current number of children and whether they were seropositive concordant or discordant. Differences in attitudes by gender and HIV status diminished over time, pointing to a population-level convergence in norms about acceptable childbearing.

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Acknowledgements

This research uses data from Tsogolo la Thanzi, a research project designed by Jenny Trinitapoli and Sara Yeatman and funded by Grants R01-HD058366, R01-HD077873, and R03HD095690 from the National Institute of Child Health and Human Development. TLT data are available through restricted data-user agreements managed by Data Sharing for Demographic Research (DSDR) at the University of Michigan. We are grateful to the TLT respondents for generously giving their time, to anonymous referees for their suggestions, to Mia Carleton for her careful review of data files, and to the staff of the TLT research center for their hard work and commitment to data quality.

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Authors and Affiliations

  1. Sociology Department, University of Chicago, Chicago, USA

    Sarah Garver & Jenny Trinitapoli

  2. Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, USA

    Sara Yeatman

  3. University of Colorado Population Center (CUPC), Boulder, USA

    Sara Yeatman

  4. Social Science Research Center, 1155 E 60th St, Chicago, IL, 60615, United States

    Sarah Garver

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  1. Sarah Garver
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Correspondence to Sarah Garver.

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Appendix

Appendix

Appendix 1

See Table 5.

Table 5 Estimated size of group differences in support for childbearing: over time comparisons and by gender using Chi Square tests of independence (see Table 3)
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Appendix 2

See Table 6.

Table 6 Estimated size of group differences in support for childbearing: comparison by HIV status (women only) at 2009 and 2015 using Chi square tests of independence (see Table 4)
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Garver, S., Trinitapoli, J. & Yeatman, S. Changing Childbearing Norms During an Era of ART Expansion in Malawi, 2009 to 2015. AIDS Behav 24, 1676–1686 (2020). https://doi.org/10.1007/s10461-019-02685-4

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