Extra-Marital Sexual Partnerships and Male Friendships in Rural Malawi

This 30-page paper, published by the Max Planck Democratic Research Institute, investigates the roles of two types of male friendships - best friends and friends with whom men talk about AIDS - in determining whether men have extra-marital sexual partnerships (EMSPs). The author argues that EMSPs are a major route of HIV/AIDS transmission in sub-Saharan Africa, and that men's extra-marital sexual behaviour in rural Malawi is closely correlated with the behaviour of their best friends. According to the paper, this study, along with previous findings, raises the possibility of developing effective interventions designed to change men's non-marital sexual behaviours by harnessing men's social networks, particularly their male friendships. Specifically, individuals within the social network could be targeted to better utilise men's social networks to disseminate messages about the risks of concurrent sexual partnerships.

The sample for the study consisted of 1,037 currently married men in 1998 and 935 currently married men in 2001 from three districts in northern, central, and southern Malawi. For the analysis, the sample was limited to 722 men who were interviewed in both waves of the survey.

The study found that men who believe that their best friends had EMSPs are significantly more likely to themselves report having had EMSPs in the last year. The author notes that this correlation reflects men's beliefs about their friends' behaviours rather than their actual behaviours, but that a man's perceptions about what his friends are doing may be more important to that person's own behaviours than whether his friends actually have extra-marital affairs. Another reason for this correlation could be that seeking EMSPs aids in the formation of close male friendships; for example, drinking together and then seeking out sex workers together may be a bonding experience. A third possibility is that male best friends may influence each other's behaviours.

The study also found that men who have friends who behave differently from themselves are more likely to change their behaviours with respect to EMSPs than are men who report the same behaviour as their friends. For example, a man whose friends engage in EMSPs is more likely to start having extra-marital affairs; conversely, a man whose friends do not engage in EMSPs is more likely to stop. Friends with whom men chat about AIDS also appear to be influential in changing men's behaviours.

As men who have EMSPs tend to associate with each other, using men's ties with each other could help identify and reach men at relatively high risk. However, introducing safer sex messages may be harder in closer and more intimate social networks, and best friends may ultimately reach fewer individuals. The author posits that adopting a strategy that also uses men's more distant friends and acquaintances with whom they are willing to discuss issues like AIDS may be more efficient, cost-effective, and feasible from a programmatic perspective. Finally, the paper asserts that given the strong ties between definitions of masculinity and multiple partnerships, opinion leaders either inside or outside men's existing social networks are likely to be important to address initially.

The study concludes that only through the development and testing of various types of network-based interventions among men will the most effective method be identified. Conducting studies into such interventions should therefore be made a funding and research priority in areas of sub-Saharan Africa afflicted by HIV/AIDS.