Family structure dynamics and gender differences in HIV risk and prevalence in developing countries

The study of sexual behaviour lies at the heart of understanding the reproductive behavior in human populations and the transmission dynamics of sexually transmitted infections including HIV/AIDS. Perhaps the most widely conjectured demographic and health consequences of polygyny and concurrency of sexual partners is their potential effect on the transmission of HIV and other STIs. Yet, while the combination of long-term concurrent sexual partnerships and high infectiousness early in HIV infection has been suggested as a key driver of extensive spread of HIV in general populations in sub-Saharan Africa (SSA), this has never been rigorously investigated within the framework of multiple marital and non-marital sexual partners owing to the complex feature of family structure in settings where polygyny is prevalent. This paper takes advantage of large scale population-based repeated surveys of nationally representative populations from developing countries to assess, within a multilevel framework, the role of family structure dynamics on gender differences in HIV risk and prevalence and how these differences have changed across countries and over time.