Lucy Mkandawire-Valhmu & Patricia Stevens, UW-M Graduate School / Research Growth Initiative
PROJECT ABSTRACT
Malawi has one of the highest HIV prevalence rates in the world; 14% of the population is infected. The HIV prevalence rate is four times higher for women than for men 15 to 24 years old. As one of the poorest countries in the world, Malawi is also marked by gender inequalities. Women experience high illiteracy, early marriages, economic dependence on husbands, and forced sex within and outside marriage, all contributing to HIV vulnerability. Limited studies focus on the intersection of violence and HIV in sub-Saharan Africa, thus, few HIV programs address the problem of violence against women (VAW). The purpose of this critical ethnography is to develop in-depth understanding of violence in the lives of HIV-infected Malawian women. Specific aims are to: a) explore lifetime experiences of sexual, physical, and emotional violence among Malawian women living with HIV, b) engage them in dialogue about how they have been affected by violence, c) describe from their perspective the events leading up to and following their HIV testing, and d) analyze their accounts about what helps and hinders them in accessing HIV treatment, care, and support. Our long-term goal is to systematically detail the violence in HIV-infected Malawian women's lives and how it may have contributed to their contraction of the disease; and to their ability to receive a diagnosis, reduce further risks, and access HIV treatment and support. From two HIV clinic sites in Malawi, we will recruit 66 HIV-infected women to participate in interviews and focus groups. From their accounts, we hope to offer crucial information for the design of effective HIV prevention and treatment programs. The proposed study brings together a multidisciplinary team of new and senior investigators in the US and Malawi. Data collection will be carried out by the PI, a native Malawian fluent in Chichewa and English, who did 3 previous studies about VAW in Malawi. Her Co-PI is an expert in qualitative methods and has a history of R01 funding from the NIH in the fields of HIV/AIDS and women's health. Funding from the RGI will allow for successful completion of this preliminary study and submission of a competitive R21application to the NIH to expand the research.
