Tsogolo la Thanzi: Navigating reproduction in an AIDS epidemic

Sara Yeatman, PhD, MSc, Assistant Professor, Department of Behavioral Sciences, University of Colorado Denver, is an investigator on this project being conducted between 2008-2013 in Balaka, Malawi. Despite the severity of the AIDS epidemic and the centrality of pregnancy and fertility to life in sub-Saharan Africa, little is known about how AIDS and its consequences alter reproductive goals and strategies. Tsogolo la Thanzi is an ongoing panel study of 2500 young men and women (ages 15-24) designed to investigate how young adults transitioning to parenthood amid a generalized epidemic simultaneously navigate the dual goals of avoiding HIV/AIDS and healthy childbearing. We situate the study in rural Malawi because counseling and testing for HIV, which are likely to influence reproduction, are just becoming available in rural areas. The study uses an intensive panel design in which respondents are interviewed three times a year over a period of three years. Data include a survey designed to capture change over time, a biomarker for pregnancy, and the randomized introduction of HIV testing and counseling. Using these new data, we address questions critical for individual, couple, national and international efforts to achieve healthy childbearing in a high-fertility and high HIV-prevalence setting