Date of Conferral

2-13-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Tolulope Osoba

Abstract

The HIV/AIDS epidemic poses a significant public health challenge in Malawi, where women aged 15-49 years experience a higher HIV prevalence (10.8%) compared to men (7.0%). Despite free testing services, 17% of Malawian women have never been tested for HIV, hindering early diagnosis and treatment that could reduce transmission rates. Using Anderson's framework for health service utilization, this study examined how demographic factors (age, marital status, ethnicity, residence) and socioeconomic factors (education, wealth, employment) influence HIV testing among Malawian women aged 15-49 years. Two research questions guided this investigation: 1) the association between demographic factors and HIV testing after controlling for age at first sexual encounter, and 2) the relationship between socioeconomic status and HIV testing after controlling for lifetime sexual partners. Using a correlational cross-sectional design, chi-square and logistic regression analyses were conducted on data from 24,562 women from the 2015-16 Malawi Demographic and Health Survey. Results revealed that married older women in urban areas were more likely to obtain HIV testing compared to younger, never-married women in rural areas. Additionally, women with higher education levels and employment demonstrated higher testing rates compared to those with lower education and unemployment. These findings inform recommendations for targeted interventions and policy changes to enhance HIV testing accessibility. The social change implications include potential reduction in HIV transmission rates through improved testing strategies focused on vulnerable populations, particularly young, rural, and unmarried women in Malawi.

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