Why on Earth do a third of Malawi's female police officers have HIV?

Reports on high-risk groups for HIV in Malawi often give the prevalence of the virus for various subgroups considered high-risk. Some of these are obvious (sex workers, for example, have an infection rate above two thirds) while others require more introspection to understand (police officers and school teachers travel frequently and have a lot of bargaining power to demand sex in certain situations). But the story for the high prevalence among police officers is implicitly a male one: we think that cops can use their position of authority to pursue more risky sex, and stereotypically it’s a male cop who does that.

The data from Malawi tell the opposite story – it is the women on the police force, not the men, who have the higher infection rate. Part of this can be ascribed to the higher per-act transmission rate for women (for unprotected sex with an infected partner) but that is compensated slightly by the lower overall prevalence for women’s potential partners (i.e. men). So I really am at a loss to explain why 32.1% of female police officers tested positive for HIV, versus 24.5% for men. Another entry in the seemingly boundless list of mysteries related to sexual behavior and HIV here.

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