AIDS and Behavior

, Volume 22, Issue 6, pp 1775–1786 | Cite as

Individual, Partner, and Couple Predictors of HIV Infection among Pregnant Women in Malawi: A Case–Control Study

  • Nora E. Rosenberg
  • Lauren A. Graybill
  • Austin Wesevich
  • Nuala McGrath
  • Carol E. Golin
  • Suzanne Maman
  • Mercy Tsidya
  • Limbikani Chimndozi
  • Irving F. Hoffman
  • Mina C. Hosseinipour
  • William C. Miller
Original Paper


We aimed to understand drivers of HIV-infection in pregnant women in Malawi. The study was conducted in antenatal and labor and delivery wards. HIV-infected women and their partners (cases) were frequency matched in a 1:2 ratio based on age and screening location to HIV-uninfected women and their partners (controls) in a prevalent case–control study. Characteristics associated with female HIV infection were assessed using logistic regression modeling. At screening, HIV-infected women were more likely to have partners outside Lilongwe than HIV-uninfected women (24% vs. 0%, p < 0.0001). Case females were more likely to have HIV-infected study partners than control females (75% vs. 4%, p < 0.0001). The odds of female HIV-infection were higher if either couple member reported ≥ 2 lifetime marriages (OR 9.0, CI 2.6–30.9) or ≥ 3 lifetime partners (OR 18.0, CI 3.1–103.6) and lower if either reported past couple HIV testing and counseling (OR 0.1, CI 0.04–0.3). Targeting women with migrating partners, promoting couple HIV testing and counseling, and limiting partners could slow HIV transmission.


HIV Counseling Testing Prevention Risk Couple 



The study and NER were supported by the National Institute of Mental Health (K99MH104154). LAG and MCH were supported by the National Institute of Child Health and Human Development (4T32HD052468-09, R01HD080485 respectively). AW was supported by the Doris Duke International Clinical Research Fellowship. We would like to thank Lighthouse Trust and Lilongwe District Health Office for their support. We would like to thank Nivedita Bhushan for designing the database and Mary Kacheyo for providing HIV testing and counseling.


This study was funded by X the National Institute of Mental Health (K99MH104154).

Compliance with Ethical Standards

Conflict of interest

Authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Nora E. Rosenberg
    • 1
    • 3
    • 6
  • Lauren A. Graybill
    • 1
    • 3
  • Austin Wesevich
    • 1
  • Nuala McGrath
    • 4
  • Carol E. Golin
    • 2
    • 3
  • Suzanne Maman
    • 3
  • Mercy Tsidya
    • 1
  • Limbikani Chimndozi
    • 1
  • Irving F. Hoffman
    • 1
    • 2
  • Mina C. Hosseinipour
    • 1
    • 2
  • William C. Miller
    • 5
  1. 1.UNC ProjectUniversity of North Carolina at Chapel HillLilongweMalawi
  2. 2.School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.School of Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Faculty of Medicine and Faculty of Social, Human, and Mathematical SciencesUniversity of SouthamptonSouthamptonEngland, UK
  5. 5.Department of EpidemiologyOhio State UniversityColumbusUSA
  6. 6.UNC Project, Tidziwe CentreLilongweMalawi

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