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Sexual networking and HIV on a Malawian island.

Sexual transmission accounts for most HIV infection in sub-Saharan Africa but there is limited knowledge about the structure and characteristics of sexual networks among the general population. This study combines complete population data on the networks of sexual relationships of roughly 1,000 individuals aged 18-35 living in seven of 18 villages on Likoma, an island on Lake Malawi. The prevalence of HIV was higher among women (11%) compared to men (5%). Half of all sexually active respondents were connected through a giant network, and more than a quarter were linked through multiple independent chains of sexual relationships. Inclusion in this large network was not necessarily associated with having many partners. The connectivity occurred through a generally moderate number of relationships with partners who also had other partners. The prevalence of HIV varied significantly across the network. Contrary to claims that sexual networks in rural sub-Saharan Africa are too sparse to sustain generalised HIV epidemics, the structure of the networks observed in Likoma appears compatible with a broad diffusion of HIV among lower-risk groups. However, the island context of the study may limit the generalisability of findings. (1)

(1.) Helleringer S, Kohler, H-P. Sexual network structure and the spread of HIV in Africa: evidence from Likoma Island, Malawi. AIDS 2007;21(17):2323-32.
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Title Annotation:ROUND UP: HIV and AIDS
Publication:Reproductive Health Matters
Geographic Code:6MALA
Date:May 1, 2008
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