PT  - JOURNAL ARTICLE
AU  - B A Lopman
AU  - C Nyamukapa
AU  - T B Hallett
AU  - P Mushati
AU  - N Spark-du Preez
AU  - F Kurwa
AU  - M Wambe
AU  - S Gregson
TI  - Role of widows in the heterosexual transmission of HIV in Manicaland, Zimbabwe, 1998–2003
AID  - 10.1136/sti.2008.033043
DP  - 2009 Apr 01
TA  - Sexually Transmitted Infections
PG  - i41--i48
VI  - 85
IP  - Suppl 1
4099  - http://sti.bmj.com/content/85/Suppl_1/i41.short
4100  - http://sti.bmj.com/content/85/Suppl_1/i41.full
SO  - Sex Transm Infect2009 Apr 01; 85
AB  - Background: AIDS is the main driver of young widowhood in southern Africa.Methods: The demographic characteristics of widows, their reported risk behaviours and the prevalence of HIV were examined by analysing a longitudinal population-based cohort of men and women aged 15–54 years in Manicaland, eastern Zimbabwe. The results from statistical analyses were used to construct a mathematical simulation model with the aim of estimating the contribution of widow behaviour to heterosexual HIV transmission.Results: 413 (11.4%) sexually experienced women and 31 (1.2%) sexually experienced men were reported to be widowed at the time of follow-up. The prevalence of HIV was exceptionally high among both widows (61%) and widowers (male widows) (54%). Widows were more likely to have high rates of partner change and engage in a pattern of transactional sex than married women. Widowers took partners who were a median of 10 years younger than themselves. Mathematical model simulations of different scenarios of sexual behaviour of widows suggested that the sexual activity of widow(er)s may underlie 8–17% of new HIV infections over a 20-year period.Conclusions: This combined statistical analysis and model simulation suggest that widowhood plays an important role in the transmission of HIV in this rural Zimbabwean population. High-risk partnerships may be formed when widowed men and women reconnect to the sexual network.