Condom Dynamics and Dilution over Time in Young Rural Malawian Couples

Sara Yeatman, University of Colorado, Denver
Karen Hampanda, University of Colorado, Denver

In the generalized epidemics of sub-Saharan Africa, HIV is frequently transmitted within longer-term relationships, where condoms are seen as “intruders” that challenge notions of trust and commitment. In the early stages of a relationship, however, condom use is more common. Unfortunately, traditional cross-sectional approaches have left us with limited understanding of condom use dynamics as sexual relationships evolve from new to committed. In this paper, we use eight waves of longitudinal data from rural Malawi to shed light on condom use dynamics in a high HIV prevalence and high fertility context. Using a prospective dataset of 664 premarital sexual relationships, we will examine the evolution of condom use over the course of a relationship, the predictors of condom decline and changing motivation for use and non-use. Preliminary findings show a strong trend towards condom dilution over the course of a relationship and a precipitous decline at marriage.