Annika Lindskog

Intimate partner violence and HIV in ten sub-Saharan African countries: what do the Demographic and Health Surveys tell us?

BACKGROUND Many studies have identified a significant positive relation between intimate partner violence and HIV in women, but adjusted analyses have produced inconsistent results. We systematically assessed the association, and under what condition it holds, using nationally representative data from ten sub-Saharan African countries, focusing on physical, sexual, and emotional violence, and on the role of male controlling behaviour. METHODS We assessed cross-sectional data from 12 Demographic and Health Surveys from ten countries in sub-Saharan Africa. The data are nationally representative for women aged 15-49 years. We estimated odds ratios using logistic regression with and without controls for demographic and socioeconomic factors and survey-region fixed effects. Exposure was measured using physical, sexual, emotional violence, and male controlling behaviour, and combinations of these. The samples used were ever-married women, married women, and women in their first union. Depending on specification, the sample size varied between 11 231 and 45 550 women. FINDINGS There were consistent and strong associations between HIV infection in women and physical violence, emotional violence, and male controlling behaviour (adjusted odds ratios ranged from 1·2 to 1·7; p values ranged from <0·0001 to 0·0058). The evidence for an association between sexual violence and HIV was weaker and only significant in the sample with women in their first union. The associations were dependent on the presence of controlling behaviour and a high regional HIV prevalence rate; when women were exposed to only physical, sexual, or emotional violence, and no controlling behaviour, or when HIV prevalence rates are lower than 5%, the adjusted odds ratios were, in general, close to 1 and insignificant. INTERPRETATION The findings indicate that male controlling behaviour in its own right, or as an indicator of ongoing or severe violence, puts women at risk of HIV infection. HIV prevention interventions should focus on high-prevalence areas and men with controlling behaviour, in addition to violence. FUNDING Swedish National Science Foundation and Gothenburg Centre of Globalization and Development, University of Gothenburg, Gothenburg, Sweden.

Diversification of Human Capital Investments in Rural Ethiopia

We investigate household-level diversification of human capital investments in a rural developing country setting. Returns to schooling and to the alternative, which includes acquisition of traditional agrarian knowledge, are uncertain. The theoretical model combines a portfolio-choice model with a human capital investment model. Diversification implies a negative relationship between education of the younger and the older sibling. Diversification is more important in more risk-averse households, and we use the interaction between sibling dependency in education and risk preferences to empirically test for diversification. Moreover, diversification is less important in credit-constrained households. The empirical analysis employs data on school entry of boys and girls in the rural Amhara region of Ethiopia. The results suggest diversification across brothers in households that are less credit-constrained.Nous étudions la diversification des investissements en capital humain au niveau des ménages en milieu rural dans un contexte de pays en développement. Le retour à la scolarité et à son alternative, qui comprend l’acquisition de connaissances agraires traditionnelles, est incertain. Le modèle théorique combine un modèle de choix de portefeuille avec un modèle d’investissement en capital humain. La diversification implique une corrélation négative entre l’éducation des plus jeunes et des plus agés au sein d’une fratrie. La diversification est plus importante dans les ménages les moins enclins à prendre des risques, et nous utilisons l’interaction entre la dépendance des frères et sœurs en matière d’éducation ainsi que les préférences de risque pour tester empiriquement la diversification. En outre, la diversification est moins importante dans les ménages qui ont un faible accès au crédit. L’analyse empirique utilise des données sur l’entrée à l’école des garçons et des filles dans la région rurale d’Amhara en Ethiopie. Dans cette région, l’assurance informelle est très répandue, les parents dépendent des enfants lorsqu’ils sont vieux; c’est par conséquent une région où la diversification au niveau des ménages pourrait être importante. Les résultats suggèrent qu’une diversification au niveau des frères a lieu dans les ménages ayant un meilleur accès au crédit.