Trends in marriage and time spent single in sub-Saharan Africa: a comparative analysis of six population-based cohort studies and nine Demographic and Health Surveys
- M Marston1,
- E Slaymaker1,
- I Cremin2,
- S Floyd1,
- N McGrath1,3,
- I Kasamba4,
- T Lutalo5,
- M Nyirenda3,
- A Ndyanabo5,
- Z Mupambireyi6,
- B Żaba1,7
- 1London School of Hygiene and Tropical Medicine, London, UK
- 2Imperial College, London, UK
- 3Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Durban, South Africa
- 4Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda
- 5Rakai Health Sciences Program, Kalisizo, Uganda
- 6Biomedical Research and Training Institute, Harare, Zimbabwe
- 7TAZAMA Project, National Institute for Medical Research, Mwanza, Tanzania
- Ms M Marston, Centre for Population Studies, London School of Hygiene and Tropical Medicine, 49 Bedford Square, London WC1B 3DP, UK;
- Accepted 20 January 2009
Objectives: To describe trends in age at first sex (AFS), age at first marriage (AFM) and time spent single between events and to compare age-specific trends in marital status in six cohort studies.
Methods: Cohort data from Uganda, Tanzania, South Africa, Zimbabwe and Malawi and Demographic and Health Survey (DHS) data from Uganda, Tanzania and Zimbabwe were analysed. Life table methods were used to calculate median AFS, AFM and time spent single. In each study, two surveys were chosen to compare marital status by age and identify changes over time.
Results: Median AFM was much higher in South Africa than in the other sites. Between the other populations there were considerable differences in median AFS and AFM (AFS 17–19 years for men and 16–19 years for women, AFM 21–24 years and 18–19 years, respectively, for the 1970–9 birth cohort). In all surveys, men reported a longer time spent single than women (median 4–7 years for men and 0–2 years for women). Median years spent single for women has increased, apart from in Manicaland. For men in Rakai it has decreased slightly over time but increased in Kisesa and Masaka. The DHS data showed similar trends to those in the cohort data. The age-specific proportion of married individuals has changed little over time.
Conclusions: Median AFS, AFM and time spent single vary considerably among these populations. These three measures are underlying determinants of sexual risk and HIV infection, and they may partially explain the variation in HIV prevalence levels between these populations.
Contributors: All authors contributed to the individual site analyses. MM wrote the paper. ES, IC, SF, NM, MN and BZ provided comments and helped to edit the paper.
Funding: This work was supported by the Wellcome Trust, which also funds the activities of the Alpha network through grants to the Africa Centre for Health and Population Studies (50535, 65377) and McGrath (WT083495MA). TL was supported by Johns Hopkins School of Public Health, BZ was supported by the Global Fund for AIDS TB and Malaria.
Competing interests: None.