Understanding Perceptions of HIV Risks among Married Couples: Why Do Wives Worry More?

Shelley Clark, University of Chicago

This paper aims to understand why wives perceive themselves to be at greater risk of having HIV/AIDS than their husbands when both biological measures and a priori expectations indicate that married couples largely share risks and have comparable rates of HIV infection. Using data from the Malawi Diffusion and Ideational Change (MDIC) survey conducted in 2001, we postulate and test three possible explanations for these stark differences in HIV risk perception by sex. While we cannot eliminate the problem of reporting errors with respect to self-reported sexual behaviors, we use an instrumental variable approach to control for measurement error associated with reports about suspicion of spouse’s sexual behaviors. The results indicate that wives are not merely “bigger worriers” than husbands nor are they engaging in “riskier” sexual behaviors, but rather that uncertainty about spouse’s behaviors, specifically their extra-marital relationships, drive the discrepancy between husbands’ and wives’ HIV risk perception.