Couple-Level Age and Educational Asymmetries and HIV Risk in Kenya

Ashley Fox, Icahn School of Medicine at Mount Sinai
Colleen Lynch, Icahn School of Medicine at Mount Sinai

Age and economic-asymmetries, and concomitant power imbalances between men and women in sexual relationships, are commonly cited as reasons for young women’s disproportionate vulnerability to HIV in sub-Saharan Africa. Though they are suggested to be common, little is known about the actual prevalence of age and economically-asymmetric relationships in Africa, nor their association with women’s HIV risk. Using couples data from Kenya’s 2003 and 2008 Demographic and Health Survey with HIV biomarkers, this study aimed to assess the prevalence of age and educational asymmetries among couples in Kenya, and to evaluate if these predictors are associated with increased risk of HIV infection in women adjusting for covariates. Age and educationally asymmetric relationships were relatively common (21 & 30% respectively). Age asymmetries (where the man was >=10 years older) was associated with higher HIV risk for women, but educational asymmetries were not associated with an increased risk of HIV for women.