Tuesday, December 10, 2013

Bargaining Power within Households: Can it Prevent HIV?

Over the last few months, we’ve been looking at how gender imparity has affected equity and efficiency in some very high-power spaces: politics, the corporate board, academia, and the STEM fields. But what about those more banal, day-to-day issues of gender imparity---those that most people don’t even see? Namely, how couples relate to one another. As commonplace as it might seem, relationship dynamics can have wide and profound consequences for society.

In the WAPPP seminar this week on “Intra-household bargaining power and HIV prevention,” WAPPP Fellow and PhD Candidate at the University of St. Gallen in Switzerland, Berit Gerritzen, looked at how married couples in rural Malawi approach issues of sexual health. Approximately 14.3 percent of the adult population of Malawi were living with HIV/AIDS in 2005, demonstrating the need for better information on its transmission.

And because many HIV infections throughout Sub-Saharan Africa take place during heterosexual intercourse between persons in stable couple relationships, the way that each of those partners approaches the other---and the issue itself---can be most telling for the diffusion of the virus.

Through data from the Malawi Diffusion and Ideational Change Project, Gerritzen looked at questions of (a) whether partners spoke about HIV risk, (b) accepted condom usage within marriage, (c) self-reported infidelity, among other issues including, of course, (d) HIV infection itself. Gerritzen cross-referenced those answers with indicators of household bargaining power, namely a spouse’s personal economic status, the number of wives in the family, local political participation, and other demographic data.

While conceding that there are a number of additional variables at play, Gerritzen concludes that factors associated with gains in female bargaining power---such as a wife’s own earnings and education, fewer co-wives, and political participation---are in fact generally related to increases in spousal discussions of sexual health, greater acceptance of condom use within marriage, and other HIV risk-reduction efforts.

When women demand the processes and outcomes that they know to be best for themselves, the household’s own welfare improves. And behaviors within the house are often what influence societal health outcomes, further strengthening the case that empowering women and increasing agency has benefits far beyond equality.

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