The 2001-03 Famine and the Dynamics of HIV in Malawi: A Natural Experiment

PloS One
Michael Loevinsohn

Abstract

Food security has deteriorated for many people in developing regions facing high and volatile food prices. Without effective and equitable responses, the situation is likely to worsen due to diminishing access to land and water, competition from non-food uses of agricultural products, and the effects of climate change and variability. Understanding how this will affect the burden and distribution of major diseases such as HIV is critical. This study makes use of the near-experimental conditions created by the Malawi famine to shed new light on this issue. Multilevel, random intercept models were used to relate the change in HIV prevalence at antenatal surveillance sites over the course of the famine to the proportion of rural households requiring food aid in the surrounding district at the famine's peak. Similar models were used to relate this indicator of rural hunger to changes in the composition of the antenatal population. The extent and direction of migration were estimated from a household survey conducted 1-2 years after the famine. At rural sites, the change in HIV prevalence was positively and non-linearly related to the extent of rural hunger (P = 0.016), consistent with contemporary accounts of increased transactiona...Continue Reading

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Citations

Apr 3, 2016·BMC International Health and Human Rights·Stine Hellum BraathenArne Henning Eide
Aug 23, 2020·International Journal of Environmental Research and Public Health·Rebecca ParrishAriana Zeka
Dec 18, 2020·International Journal of Environmental Research and Public Health·Patricia Nayna SchwerdtleIna Danquah

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Methods Mentioned

BETA
enzyme-linked immunosorbent assay

Software Mentioned

WinBUGS
GLLAMM
STATA
MLwiN

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