Shifts in Contraception Use across Relationship Trajectories: A Longitudinal, Couple-Level Study on the Effects of Fertility Preferences and Perceived HIV Risk on Contraceptive Use and Method Choice in Rural Malawi

Hannah E. Furnas, Pennsylvania State University

The Southeastern African country of Malawi is experiencing a persistent AIDS epidemic amid a fertility climate characterized by nearly universal childbearing. In such a context, making the choice to use contraception is often muddled with one’s perceived risk of HIV infection and relationship-specific fertility preferences. Cross-sectional studies have shown that the reasons for choosing to use contraception and the frequency of contraception use vary across gender, levels of perceived HIV risk, fertility desires, and relationship type. The proposed study uses couple-level data from the Tsogolo la Thanzi (TLT) research project conducted in Southern Malawi. All eight waves of TLT will be leveraged to analyze dyadic relationship trajectories across time. Longitudinal, fixed-effects models will test for the effects of HIV risk perceptions and fertility preferences on contraceptive use versus non-use and choice of method across relationship stages. Preliminary results indicate that reasons for contraceptive use vary by type of relationship.