DEMOGRAPHIC

AND

HEALTH

SURVEYS

DHS WORKING PAPERS

2018 No. 141

Beston B. Maonga

Tapiwa Sphiwe Gondwe

Kennedy Machira

June 2018

This document was produced for review by the United States Agency for 

International Development.

Determinants of Risky Sexual Behavior 

Among the Youth in Malawi

DHS Working Paper No. 141

Determinants of Risky Sexual Behavior

Among the Youth in Malawi

Beston B. Maonga1

Tapiwa Sphiwe Gondwe2

Kennedy Machira1

ICF

Rockville, Maryland, USA

June 2018

1Lilongwe University of Agriculture and Natural Resources, Faculty of Development Studies, Department 

of Agricultural and Applied Economics, P.O. Box 219, Lilongwe, Malawi.

2Lilongwe University of Agriculture and Natural Resources, Faculty of Food and Human Sciences, 

Department of Human Ecology, P.O. Box 219, Lilongwe, Malawi.

Corresponding author: Beston B. Maonga, Lilongwe University of Agriculture and Natural Resources, 

Faculty of Development Studies, Department of Agricultural and Applied Economics, P.O. Box 219, 

Lilongwe, Malawi; email: maonga.b05@gmail.com.
Acknowledgments: The authors thank USAID for funding their research project through the 2018 DHS 

Fellows program implemented by ICF. They express their gratitude to the organizers and facilitators for 

wonderful sessions in Harare, Zimbabwe, and Colombo, Sri Lanka. Also appreciated are the reviewers for 

their professional critiques and the editors and formatting experts for their work well done. Last but not 

least, the authors thank management of LUANAR for allowing workshop participants to leave duty during 

busy academic periods to participate. Their valuable comments during presentations helped to shape the 

direction of the research and the production of the final paper.

Editor: Bryant Robey

Document Production: Joan Wardell

This study was carried out with support provided by the United States Agency for International 

Development (USAID) through The DHS Program (#AID-OAA-C-13-00095). The views expressed are 

those of the authors and do not necessarily reflect the views of USAID or the United States Government.

The DHS Program assists countries worldwide in the collection and use of data to monitor and evaluate 

population, health, and nutrition programs. For additional information about The DHS Program contact: 

DHS Program, ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; phone: +1 301-572-0950; 

fax: +1 301-572-0999 or +1 301-407-6501; email: reports@dhsprogram.com; internet: 

www.dhsprogram.com.

Recommended citation:

Maonga, Beston B., Tapiwa Sphiwe Gondwe, and Kennedy Machira. 2018. Determinants of Risky Sexual 

Behavior among the Youth in Malawi. DHS Working Paper No. 141. Rockville, Maryland, USA: ICF.
iii

CONTENTS

TABLES........................................................................................................................................................ v

FIGURES .................................................................................................................................................... vii

ABSTRACT.................................................................................................................................................. ix

1 INTRODUCTION.............................................................................................................................. 1

1.1 Background ......................................................................................................................... 1

1.2 Rationale of the Study......................................................................................................... 1

1.3 Objectives of the Study ....................................................................................................... 2

2 DATA AND METHODS ................................................................................................................... 3

2.1 Conceptual Framework ....................................................................................................... 3

2.1.1 Individual factors influencing risky sexual behavior among men........................... 3

2.1.2 Household factors influencing risky sexual behavior among men......................... 3

2.1.3 Community factors influencing risky sexual behavior among men........................ 4

2.2 Theoretical Framework ....................................................................................................... 4

2.3 Data..................................................................................................................................... 5

2.4 Variables ............................................................................................................................. 5

2.5 Statistical Analysis .............................................................................................................. 6

3 RESULTS ........................................................................................................................................ 7

3.1 Background Characteristics of the Respondents................................................................ 7

3.1.1 Condom use among male youths and adults by marital status ............................. 8

3.2 Bivariate Analysis Results................................................................................................... 9

3.2.1 Determinants of men’s engagement in non-marital non-cohabiting sexual 

partnerships and condom use among youth and adults ........................................ 9

3.3 Multivariable Analysis Results .......................................................................................... 11

3.3.1 Determinants of men’s engaging in sex with non-marital non-cohabiting 

sexual partners among unmarried and married male youths and adults ............ 11

3.3.2 Determinants of condom use with non-marital non-cohabiting sexual 

partners among male youths and adults in Malawi.............................................. 13

4 DISCUSSION................................................................................................................................. 15

5 CONCLUSIONS............................................................................................................................. 17

6 POLICY RECOMMENDATIONS................................................................................................... 19

REFERENCES............................................................................................................................................ 21

v

TABLES

Table 2.1 Definitions and measures of the variables ................................................................... 5

Table 3.1 Background characteristics of male youths and adults by marital status among 

those who had sexual intercourse within the last 12 months preceding the 

2015-16 MDHS............................................................................................................. 8

Table 3.2 Percent distribution of male youths and adults who used condoms during sex 

with a non-marital non-cohabiting partner within the 12 months preceding 

the 2015-16 MDHS....................................................................................................... 9

Table 3.3 Unadjusted model results estimating determinants of number of non-marital 

non-cohabiting sexual partnerships among youths and adults by marital status....... 10

Table 3.4 Unadjusted model results estimating determinants of condom use among the 

youths and adults with non-cohabiting partners in Malawi......................................... 11

Table 3.5 Negative binomial regression results estimating determinants of number of 

non-marital non-cohabiting sexual partners among youths and adults...................... 12

Table 3.6 Logistic regression results estimating factors influencing condom use among 

unmarried and married youths and adults.................................................................. 13

vii

FIGURES

Figure 2.1 Conceptual frameworks................................................................................................ 4

ix

ABSTRACT

Generally, men of reproductive age in Malawi continue to be vulnerable to new HIV and AIDS infection 

and re-infection due to risky sexual behavior, including having sexual intercourse with multiple nonmarital, non-cohabiting sexual partners and not using condoms with them. With a sample of 7,478 men age 

15-54 drawn from the 2015-16 Malawi Demographic and Health Survey (MDHS), this study examines 

determinants of risky sexual practices among men in Malawi. The study considers risky sexual behavior as

having multiple non-marital, non-cohabiting sexual partners and not using condoms during sexual 

intercourse with these partners. This risky behavior can have serious health consequences and carries

medium-to-long-term health and socioeconomic implications for the youth of Malawi. The study examines

male youth age 15-24 and adults age 25-54 who had sexual intercourse in the past 12 months preceding the 

2015-16 MDHS, by their marital status. Negative binomial and logistic regression analysis was used to

identify determinants associated with their risky sexual behavior. The study found that religion was a key 

factor associated with having an increased number of non-marital, non-cohabiting sexual partners. Also,

attainment of formal education was a consistent predictor that significantly reduced men’s high-risk sexual 

behavior. Thus, education serves as the most important tool to facilitate behavior change among men in 

Malawi. Based on the findings, this study proposes redesigning and implementing extensive pro-men sexual 

and reproductive health educational campaigns to tackle key health and demographic topics aimed at 

changing men’s attitudes and behavior toward engaging in sexual intercourse with multiple non-marital 

non-cohabiting partners and toward consistent and correct condom use. Such education campaigns must 

cut across the social fabric of Malawi’s society, including religious institutions.

KEY WORDS: non-marital non-cohabiting sexual partners, high-risk sexual practices, male youths and 

adults, condom use, Malawi

1

1 INTRODUCTION

1.1 Background

In sub-Saharan Africa, inconsistent condom use during sexual intercourse, especially among men, continues 

to pose a serious health challenge with a high likelihood of negatively affecting the region’s socioeconomic 

development. This condition is exacerbated by cultural beliefs, customs, and practices and the lack of a 

coherent regional approach to comprehensively tackle such issues. The UNAIDS Global AIDS Monitoring

Report (2017) reiterated that risky behavior among youths and adults results in increased prevalence of 

HIV/AIDS infections, leading to high death rates among the economically active age group, 15-60 years.

The 2015-16 Malawi Demographic and Health Survey (MDHS) indicated that Malawi has a high 

prevalence of men with multiple non-marital non-cohabiting sexual partners among other risky sexual 

practices (National Statistical Office (NSO) and ICF 2017). In response, the Malawi health sector has been 

promoting different sexual and reproductive health campaigns to change people’s sexual behavior. For 

instance, the Malawi Government adopted a political directive that aimed at scaling up efforts on HIV/AIDS 

control—the 90–90–90 campaign, which aims to achieve 90% of the population knowing their HIV status, 

ensure that 90% of affected people are on sustained treatment, and that 90% have their viral load suppressed 

upon receiving antiretroviral therapy. In addition, the Malawi Reproductive Health Policy advocates for 

increased access to condoms by, among other efforts, ensuring free distribution of condoms in public places.

Despite such admirable efforts, men’s practices of having multiple sexual partners and non-use of condoms 

still prevail among both youths and adults. There are few studies in Malawi that explore factors affecting 

or associated with men’s behavior to have multiple sexual partners and not to use condoms in such risky 

practices. Chavula (2016) attempted to explore the factors that influence sexual behavior among men in 

Malawi. However, the scope of the work focused on academia and hence cannot be generalized. Within the 

African continent, scholars who have explored the factors influencing risky sexual behavior have focused 

on adolescents and women as a unit of analysis; men tend to be ignored in most studies (Odimegwu et al.

2017; Shore et al. 2017). In Botswana a nationally representative study explored risky sexual behavior

among youths (Letano et al. 2013). However, the study scarcely discussed core issues influencing the 

youths’ engaging in sexual partnerships with multiple non-marital, non-cohabiting sexual partners and nonuse of condoms.

Despite the existing sexual and reproductive health policies and studies aimed at improving the health and 

well-being of people in Malawi, little is known about key factors that influence men to engage in multiple 

sexual partnerships and continued non-use of condoms. With a special focus on the male youth as well as 

adult men, this study therefore attempts to explore these factors.

1.2 Rationale of the Study

In a country whose development has been rocked by population-related challenges, studies of sexual risky 

behavior contribute in principle to encouraging policy dialogue. This study is therefore envisaged to 

contribute to Malawi’s policy debate on the national agenda to curb the spread of HIV/AIDS and other 

sexually transmitted diseases, as well as efforts to control population growth. The study intends to shed 

some insight into the promotion of adolescent health by creating a platform on which the youths could be 
2

well informed and would understand the risks associated with high-risk sexual behavior. Such 

understanding is necessary to minimize public health challenges facing the Malawi population, especially 

among youth. The study is intended to identify the determinants of risky sexual behavior among men,

especially among rural youth who are in the majority in Malawi. The topic is approached from three 

fronts—individual, household, and community factors that explain men’s engaging in sexual activity with 

a number of non-marital, non-cohabiting sexual partners and not using condoms during sexual intercourse 

with non-cohabiting partners.

1.3 Objectives of the Study

The study investigates prevalence and determinants of risky sexual behavioral practices in Malawi with a 

special focus on men (youths and adults) by their marital status. Specific objectives of the study are:

1) To assess the background characteristics of men (youths age 15-24 and adults age 25-54) 

engaging in risky sexual practices by their marital status,

2) To assess sociodemographic factors that influence men (youths and adults) to indulge in 

multiple sexual partnerships and that affect condom use with non-cohabiting partners.
3

2 DATA AND METHODS

2.1 Conceptual Framework

In the data-driven conceptual framework (Figure 2.1), the study examines risky sexual behavior at two

levels, namely number of non-marital non-cohabiting sexual partners, and non-use of condoms (identified 

as high-risk sexual behavior), both of which are assessed through factors at the individual, household, and 

community levels. The study focuses on men who had sex with non-cohabiting partners in the past 12 

months before the 2015-16 MDHS. Similarly, for condom use, the focus is on men who had sex with nonmarital, non-cohabiting partners in the past 12 months before the MDHS.

2.1.1 Individual factors influencing risky sexual behavior among men

Chosen from an array of possible individual factors are educational attainment and religion. In the context 

of this study, educational attainment was thought to have an inverse association with engaging in nonmarital, non-cohabiting sexual partnerships and a positive association with men’s consistent use of condoms 

in sexual intercourse with non-marital, non-cohabiting partners. This is premised on the positive role that 

education makes in enlightening society on issues of behavioral change. Of note, this conceptual framework 

is limited to the content and type of data available in the 2015-16 Malawi DHS; if not restricted due to data 

availability, the framework could include other background factors.

2.1.2 Household factors influencing risky sexual behavior among men

Among household factors, having a relatively large number of living children was hypothesized to have a 

negative influence on men’s decision to engage in multiple sexual partnerships with non-marital noncohabiting partners, but to have a positive effect on consistent condom use. The assumption was that men 

in such a situation would not want to have more children due to the socioeconomic cost implications. On 

the other hand, in a female-headed household the woman might engage in multiple sexual partnerships with 

non-marital non-cohabiting partners for economic survival reasons and therefore might have a high 

likelihood of not consistently using condoms outside marriage, as she likely would have low bargaining 

power over the men. This would also lead men to engage in non-marital non-cohabiting sexual partnerships. 

Youths in female-headed households might also behave differently from those in male-headed households 

because they would fear a male head more than a female head. This study considers that men from wealthier 

households might be more likely to have multiple sexual partnerships than their poorer counterparts, as it 

would be easier for them to find sexual partners other than their wives, using economic advantage (Uchudi 

et al. 2012).

Exposure to media was deemed to have a dual effect on whether men with high exposure to media would 

be more likely to engage in sexual relationships with non-marital non-cohabiting partners and/or use 

condoms consistently, as this might depend upon the type of information and messages received. It is argued 

that youths as well as adult men who are frequently exposed to pornographic and sexual-related news and 

information tend to be more likely to engage in multiple sexual partnerships (Uchudi et al. 2012). On the 

other hand, men with a high level of exposure to advisory news and information on the dangers of engaging 

in multiple sexual partnerships and to advocacy on the need for consistent condom use would be more likely 
4

avoid multiple sexual relationships and also to use condoms. Therefore, like economic wealth, the influence 

of exposure to media on men’s risky sexual behavior could be indeterminate.

Figure 2.1 Conceptual frameworks

2.1.3 Community factors influencing risky sexual behavior among men

Place of residence was thought to exhibit mixed influence on men’s high-risk sexual behavior, and the 

direction of influence was indeterminate. On one hand, men living in socioeconomically better-off urban 

areas would likely have a higher risk of engaging in non-marital non-cohabiting sexual partnerships than 

men in poorer rural areas (Uchudi et al. 2012). On the other hand, urban men would likely have more 

exposure to information about sexually transmitted infections, including HIV/AIDS, owing to heavy 

presence of well-equipped health and medical facilities and a variety of media outlets, leading to reduced 

risks compared with those in rural areas (Silas 2013).

2.2 Theoretical Framework

The study attempts to adopt health promotion theories among the people who are vulnerable to adverse 

health outcomes. Three models—the Lewin Theory of Change, the Health Belief Model, and the Theory of 

Reasoned Actions—can be used to understand men’s behavior regarding their engagement in non-marital 

non-cohabiting sexual partnerships and condom use. Based on the study objectives, the Health Belief Model 

was deemed most appropriate.

The Health Belief Model (HBM) is a theory of behavioral change that can be used to understand how people 

act when faced with various health-related challenges. The constructs of the HBM include perceived 

susceptibility, threat and severity, cues to action, modifying factors, perceived benefits and barriers, and 

self-efficacy. In the context of this study, an individual who feels susceptible to life-threatening sexually 

transmitted infections will likely change his or her sexual behavior. However, behavior change is dependent 

Individual factors

- Educational attainment

- Religion

Household factors

- Number of living children

- Sex of household head

- Household wealth

- Exposure to media

Community Factors

- Place of residence

Risky Sexual Behaviors

- Multiple Sexual Partners

- Condom Use
5

upon modifying factors, which among others include education (knowledge), religion, exposure to media, 

and other socioeconomic factors such as household wealth and place of residence. Taking action to change 

behavior entails examination of benefits and barriers as well as self-efficacy. For instance, an individual 

would likely use condoms with non-marital non-cohabiting sexual partners if the perceived benefits 

outweighed the negative effects of such an action; and this must be backed by one’s self-confidence to use 

condoms (Glanz, Rimer and Lewis 2002).

2.3 Data

The study employed data from the 2015-16 Malawi Demographic and Health Survey to assess determinants 

of risky sexual behavior among male youths and adults in Malawi. The MDHS is a nationally representative 

sample survey that collected information among people of reproductive age on family planning, sexually 

transmitted infections, and HIV/AIDS, among other topics. The 2015-16 MDHS collected data on 

reproductive health from women age 15-49 and men age 15-54. This study focused on the 7,478 men who 

had sex in the last 12 months preceding the survey to study determinants of their engagement in non-marital 

non-cohabiting sexual partnerships and condom use. Detailed description about the study is available 

elsewhere (NSO and ICF 2017).

2.4 Variables

Table 2.1 presents the variables used in the analysis of determinants of men’s behavior of having nonmarital non-cohabiting sexual partners and non-use of condoms, among men in Malawi who had sex in the 

last 12 months preceding the 2015-16 MDHS. The study defines “youths” as young men age 15-24, and 

“adults” as men age 25-54.

Table 2.1 Definitions and measures of the variables

Variables Definitions Measures

Dependent variables

Non-marital noncohabiting partners Number of sexual partners excluding spouse in last 

12 months preceding the DHS survey Count variable from 0, 1, 2, 3...

Condom Use 

Condom use during sexual intercourse with nonmarital partners 1 = “Yes, used”; 0 = “No, not used condom” 

Independent variables

Education Educational attainment of the respondent 

0 = No education, 1 = Incomplete primary, 

2 = Complete primary, 3 = Incomplete 

secondary, 4/max = Complete secondary or 

higher

Religion Religious belief of the respondent

1 = Catholics, 2 = Protestants (other 

Christians), 3 = Muslims and Others (no 

religion, cults and traditionalists) 

Number of living children Number of children ever born to a woman (age 15-49) 0 = “0”; 1 = “1 - 3”; 2 = “4+”

Media exposure Access to family planning information in the media

0 = “Neither on Radio nor TV”; 1 = “Either on 

Radio or TV”; 2 = “Both on Radio and TV”

Household wealth Wealth status (quintile) of the household 

1 = “Poorest”; 2 = “Poor”; 3 = “Medium”; 

4 = “Rich”; 5 = “Richest”

Sex of household head Gender of the household head 0 = “Male”; 1 = “Female”

Place of residence Place where the respondent resides 1 = “Rural” 2 = “Urban”
6

2.5 Statistical Analysis

The study used descriptive statistics, percentages, and frequencies to describe individual, household, and

community characteristics of the respondents. Sampling weights were taken into account to adjust for 

representativeness of the estimates and for non-response. Unadjusted and adjusted regressions were fit for 

both outcomes. For the outcome of “number of non-marital non-cohabiting partners,” a negative binomial 

regression was used to examine the associations with the independent variables. Abinary logistic regression

was used for analyzing determinants of condom use at last sex with a non-marital, non-cohabiting partner

among those who have had sex in the last 12 months with this type of partner. Separate models were fit for 

unmarried and married youth (age 15-24) and adults (age 25-54); therefore, there were four models fit for 

each outcome. This was performed because of the different distributions these four groups have with respect 

to the outcomes.

To test the degree of correlations between the variables, pairwise Pearson Correlation was conducted, and 

a coefficient of less than 0.5 denoted no major correlation between the independent variables, and thus was 

considered for analysis. Appropriateness of the ordinary Poisson regression was checked for analyzing the 

count variable ‘number of non-marital non-cohabiting sexual partners’ and significant over-dispersion was 

found. Hence, negative binomial regression was used instead. Additionally, the model was adjusted for the 

complex sample design of the 2015-16 MDHS, which collected data using a two-stage sampling method. 

Data analysis was performed using Stata (v 15.0).
7

3 RESULTS

3.1 Background Characteristics of the Respondents

Table 3.1 presents background characteristics of male youth age 15-24 and adults age 25-54 who had sexual 

intercourse in the past 12 months preceding the 2015-16 DHS survey in Malawi, by marital status. A total 

of 5,743 men in the sample had sexual intercourse in the 12 months preceding the survey. About 30% 

(1,721) were youths and 70% (4,022) were adults. Among the youths 31% were married and 69% were not. 

By contrast, among the adults only 8% were not married and 92% were married.

By educational attainment, 56% of married youths and 55% of unmarried youths had incomplete primary 

education, while 33% of married adults and 45% of unmarried adults had incomplete primary education. 

Among married youths, 11% had attained secondary education and higher versus 15% among unmarried 

youths. Among married adults, 18% had completed secondary school or higher compared with 34% of 

unmarried adults. In terms of religious affiliation, a majority of the male respondents were Protestants—

66% of married youth and 63% of unmarried youth, and 67% of married adults and 68% of unmarried 

adults.

A majority of married youth (72%) were in households that had one to three children, while only about 1% 

of married youth had four or more children. In contrast, 51% of married adults lived in households with 

four or more children, while 54% of unmarried adults lived in households with no children. In terms of 

exposure to media, regardless of marital status a majority of both the youths and adults accessed family 

planning information on either television or radio, at a minimum of 51%. However, only a small proportion 

of the sample had access to family planning information on both television and radio—from just 7% among 

married youth to 18% of unmarried adults.

By household wealth, among married youth about 31% were in the poorest household wealth quintile, while 

11% were in the richest. In contrast, among married adults 16% were in the poorest household quintile and 

27% were in the richest. Among unmarried youths 12% were in the poorest households and 27% were in

the richest. Among unmarried adults 14% were in the poorest households and 48% were in the richest.
8

Table 3.1 Background characteristics of male youths and adults by marital status among those who had 

sexual intercourse within the last 12 months preceding the 2015-16 MDHS

Variables

Youths Adults

Married Not married Married Not married

(%) (%) (%) (%)

Educational Attainment

No education 4.5 1.8 9.0 6.2

Incomplete primary 55.7 54.5 45.2 33.2

Complete primary 11.5 5.1 12.2 6.2

Incomplete secondary 17.1 23.9 15.7 20.6

Complete secondary and higher 11.2 14.7 18.0 33.9

Religious Affiliation

Catholic 20.3 21.6 18.4 16.1

Protestants 65.8 62.9 67.1 67.8

Muslim and others 14.0 15.5 14.5 16.1

Number of Living Children

0 26.9 94.4 3.4 54.0

1 – 3 72.2 5.7 45.9 33.5

4+ 1.0 0.0 50.7 12.6

Media Exposure

Neither on radio nor TV 35.7 36.8 29.5 31.2

Either on radio or TV 57.5 54.0 57.1 50.9

Both on radio and TV 6.8 9.2 13.4 17.9

Household Wealth

Poorest 30.7 12.1 16.1 13.5

Poor 26.7 16.2 20.0 10.3

Medium 17.8 22.4 20.5 10.7

Rich 14.2 22.4 20.7 17.6

Richest 10.6 26.9 22.6 48.0

Sex of Household Head

Male 91.0 69.9 96.3 77.2

Female 9.0 30.1 3.7 22.9

Place of Residence

Urban 9.9 17.6 17.2 38.1

Rural 90.1 82.4 82.8 61.9

Observations 536 1,185 3,695 327

Only a small proportion of men reported to be in female-headed households. A relatively larger proportion 

of unmarried men were in female-headed households, at 30% among youth and 23% among adults, than 

their married counterparts, at only 9% among youths and 4% among adults. By residential status, 90% and 

83% of married youths and adults, respectively, lived in rural communities. Among unmarried men, 82% 

of youths and 62% of adults resided in rural areas.

3.1.1 Condom use among male youths and adults by marital status

Table 3.2 presents percentage distribution of male youths and adults who used condoms during sexual 

intercourse with a non-marital non-cohabiting partner in the 12 months preceding the MDHS survey in 

Malawi. Among youths, 93% (1,178) of those who used a condom during sex with such partners were not 

married, while among adults, 40% (292) were not married. In all, youths constituted 63% (1,263) of the 

sample that used condoms during sex with non-marital non-cohabiting partners. The table shows that those 

with incomplete primary education had the highest percentage of condom use among youth (both married 

and unmarried at around 55%) and among married (43%) youth. For unmarried adults the highest 

percentage was found for those with secondary or higher level of education. 
9

Table 3.2 Percent distribution of male youths and adults who used condoms during sex with a non-marital 

non-cohabiting partner within the 12 months preceding the 2015-16 MDHS

Distribution (%) of male youths and adults who used condoms during sexual intercourse with non-cohabiting 

partners

Youths Adults

Variables

Married Not married Married Not married

(%) (%) (%) (%)

Educational Attainment

No education 3.7 1.2 6.6 6.1

Incomplete primary 54.7 54.6 43.0 28.3

Complete primary 9.1 5.2 13.3 5.9

Incomplete secondary 20.8 24.1 16.7 22.9

Secondary and higher 11.6 14.6 20.5 36.7

Religious Affiliation

Catholic 23.2 21.4 15.4 15.0

Protestant 54.0 63.3 65.9 68.4

Muslims and others 22.8 15.3 18.7 16.6

Number of Living Children

0 19.8 94.8 5.3 61.2

1 to 3 78.1 5.2 53.8 29.8

4 and higher 2.1 0.0 41.0 9.0

Media Exposure

Neither TV nor Radio 31.1 36.7 26.5 29.4

Either TV or Radio 64.8 53.9 61.3 51.8

Both TV and Radio 4.1 9.4 12.2 18.8

Household Wealth

Poorest 22.2 12.1 12.2 11.0

Poor 28.4 16.2 15.7 10.5

Medium 18.7 22.3 20.3 9.9

Rich 16.7 22.4 24.8 17.6

Richest 14.0 27.0 27.0 50.9

Sex of Household Head

Male 87.4 69.9 96.3 76.7

Female 12.6 30.1 3.7 23.3

Place of Residence

Urban 13.3 17.5 19.9 42.2

Rural 86.7 82.5 80.1 57.8

Observations 85 1,178 436 292

3.2 Bivariate Analysis Results

3.2.1 Determinants of men’s engagement in non-marital non-cohabiting sexual 

partnerships and condom use among youth and adults

Table 3.3 presents results of the unadjusted model estimating factors associated with the number of nonmarital non-cohabiting sexual partners the men had. Among male youths age 15-24 who had sex in the past 

12 months preceding the MDHS, the major factors significantly associated with increasing relative risk of 

having a number of non-marital non-cohabiting sexual partners were education, religious affiliation, media 

exposure, number of living children, sex of the household head, and place of residence. The results reveal 

that, although similar determinants are significant, the direction of the relationships is the reverse for 

unmarried youths relative to married youths. Among unmarried adult men age 25-54, almost all 

determinants, apart from incomplete education, were not significant. The results for married adults were 

almost similar to the results for married youth.
10

Table 3.3 Unadjusted model results estimating determinants of number of non-marital non-cohabiting 

sexual partnerships among youths and adults by marital status

Incidence rate ratios for acquisition of non-marital, non-cohabiting sexual partners sexual partners

Variables 

Youths Adults

Married Not married Married Not Married

(IRR) [95% CI] (IRR) [95% CI] (IRR) [95% CI] (IRR) [95% CI]

Educational Attainment

No education 1.0 1.0 1.0 1.0

Incomplete primary 0.2*** [0.1-2.7] 1.4* [1.1-1.8] 0.1*** [0.1-0.2] 1.0 [0.8-1.3]

Complete primary 0.2 [0.1-0.3] 1.2*** [1.1-1.3] 0.1*** [0.1-0.2] 0.9 [0.7-1.1]

Incomplete secondary 0.3 [0.2-0.5] 1.6* [1.1-2.1] 0.1*** [0.1-0.2] 1.4* [1.1-1.8]

Secondary and higher 0.2 [0.1-0.4] 1.2*** [1.1-1.3] 0.2*** [0.1-0.2] 1.1 [1.0-1.2]

Religious Affiliation

Catholic 1.0 1.0 1.0 1.0

Protestant 0.2*** [0.1-0.2] 1.2*** [1.2-1.3] 0.1*** [0.1-0.2] 1.1 [1.0-1.2]

Muslims and others 0.4*** [0.2-0.7] 2.4*** [1.4-4.2] 0.2*** [0.1-0.3] 1.1 [0.9-1.4]

Media Exposure

Neither TV nor Radio 1.0 1.0 1.0 1.0

Either TV or Radio 0.2*** [0.2-0.3] 1.3*** [1.1-1.6] 0.2*** [0.1-0.2] 1.1 [1.0-1.3]

Both TV and Radio 0.1* [0.1-0.3] 1.5* [1.1-1.9] 0.2*** [0.1-0.3] 1.1 [0.9-1.4]

Household Wealth 

Poorest 1.0 1.0 1.0 1.0

Poor 0.2*** [0.1-0.3] 1.2*** [1.1-1.2- 0.1*** [0.1-0.2] 1.1 [0.8-1.4]

Middle 0.2*** [0.1-0.4] 1.2*** [1.1-1.3] 0.1*** [0.1-0.2] 1.2 [0.8-1.7]

Rich 0.3*** [0.1-0.5] 1.3*** [1.2-1.6] 0.2*** [0.1-0.3] 1.2 [0.9.1.5]

Richest 0.2*** [0.1-0.4] 1.8*** [1.2-2.7] 0.2*** [0.1-0.2] 1.1 [1.0-1.3]

Number of Living Children

0 1.0 1.0 1.0 1.0

1 to 3 0.2*** [0.2-0.3] 1.4 [0.9-2.2] 0.2*** [0.8-1.2] 1.0 [0.1-0.2]

4 and higher 0.4 [0.1-1.5] 0.1*** [0.5-1.4] 0.9 [0.1-0.2]

Sex of Household Head

Male 1.0 1.0 1.0 1.0

Female 0.3*** [0.2-0.4] 1.8* [1.2-2.6] 0.1*** [0.1-0.2] 1.2 [0.9-1.4]

Place of Residence

Urban 1.0 1.0 1.0 1.0

Rural 0.2*** [0.1.0.3] 1.3*** [1.2.1.3] 0.1*** [0.1-0.2] 1.0 [0.9-1.2]

Note: *p<0.05, **p<0.01, ***p< 0.001; IRR: incidence risk ratio

Concerning condom use among men with non-marital non-cohabiting sexual partners (Table 3.4), the study 

found that the models for both married and unmarried male youths and adults had predictors that 

significantly increased the odds of using condoms during sexual intercourse with non-marital noncohabiting sexual partners. Based on the analytical results, all the variables except for sex of household 

head showed some level of significance in all of the groups examined. The unadjusted odds ratios for 

condom use was not significant by sex of household head for married youth and adults. 
11

Table 3.4 Unadjusted model results estimating determinants of condom use among the youths and adults 

with non-marital non-cohabiting partners in Malawi 

Odds of condom use

Variables

Youths Adults

Married Not married Married Not Married

(OR) [95% CI] (OR) [95% CI] (OR) [95% CI] (OR) [95% CI]

Educational Attainment

No education 1.0 1.0 1.0 1.0

Incomplete primary 4.8*** [2.3-10.2] 2.1*** [1.7-2.6] 2.0*** [1.4-2.8] 2.8** [1.5-5.3]

Complete primary 2.6 [0.3-21.4] 8.9** [2.6-3.9] 2.6** [1.3-5.3] 1.1 [0.4-3.3]

Incomplete secondary 2.6 [0.6-11.8] 5.5*** [3.8-8.1] 1.9* [1.1-3.3] 6.4*** [2.8-14.6]

Secondary and higher 3.3 [0.8-13.8] 5.3*** [3.2-8.9] 10.6*** [4.7-24.1] 7.1*** [3.1-16.0]

Religious Affiliation

Catholic 1.0 1.0 1.0 1.0

Protestant 2.1** [1.0-4.4] 3.3*** [2.6-4.1] 2.5*** [1.8-3.4] 5.3*** [3.2-8.8]

Muslims and others 5.3** [1.6-18.7] 2.1** [1.4-3.3] 1.8** [1.0-3.2] 1.3 [0.4-2.9]

Media Exposure

Neither TV nor radio 1.0 1.0 1.0 1.0

Either TV or radio 5.4*** [2.7-11.2] 3.3*** [2.6-4.2] 3.0*** [2.1-4.2] 3.5*** [2.1-5.9]

Both TV and radio 1.9 [0.3-11.6] 5.7*** [2.9-11.2] 2.3** [1.1-4.7] 7.1*** [2.6-19.2]

Household Wealth

Poorest 1.0 1.0 1.0 1.0

Poor 5.9** [1.7-20.1] 2.3*** [1.6-3.3] 2.4** [1.1-3.7] 1.9 [0.8-4.5]

Middle 3.1 [0.8-12.7] 2.5*** [1.8-3.5] 2.4** [1.5-4.0] 3.5** [1.1-11.7]

Rich 11.0** [2.1-57.3] 2.8*** [2.0-3.9] 3.0*** [1.7-5.2] 3.3** [1.4-7.3]

Richest 1.5 [0.3-7.8] 5.1*** [3.4-7.7] 3.3*** [1.9-5.6] 7.2*** [3.7-14.0]

Number of Living Children

0 1.0 1.0 1.0 1.0

1 to 3 4.4*** [2.3-8.4] 3.1** [1.5-6.4] 3.0*** [2.0-4.3] 3.6*** [2.1-6.3]

4 or higher 1.9*** [1.3-2.8] 1.3 [0.3-4.8]

Sex of Household Head

Male 1.0 1.0 1.0 1.0

Female 2.5 [0.5-13.2] 3.7*** [2.7-5.1] 2.6 [0.6-10.9] 4.6*** [2.2-9.6]

Place of Residence

Urban 1.0 1.0 1.0 1.0

Rural 4.5*** [2.5-8.0] 2.8*** [2.3-3.3] 2.1*** [1.6-2.8] 2.8*** [1.8-4.3]

Note: *p<0.05, **p<0.01, ***p< 0.001; OR: odd ratio

3.3 Multivariable Analysis Results

3.3.1 Determinants of men’s engaging in sex with non-marital non-cohabiting sexual 

partners among unmarried and married male youths and adults

The study explored the factors associated with male youths and adults in Malawi with the number of nonmarital non-cohabiting sexual partnerships they had. Table 3.5 presents negative binomial results of two 

models fitted for the outcome among unmarried and married youths and adults. Religion and number of 

children in the household were the key factors associated with the number of non-marital non-cohabiting 

sexual partnerships for unmarried youths and for married adults. Unmarried Muslim youths and those of

“other religious beliefs” had a greater number of non-marital partners compared with Roman Catholics 

(IRR=2.3; p<0.001). The number of non-marital partners increased by 130% for Muslims and others 

compared with Catholics. Regarding the number of living children, the study found that unmarried male 

youths in households with 1-3 children had a significantly higher number of non-marital non-cohabiting 

sexual partners compared with households with no children (IRR=2.2; p<0.01), implying that the number 

of non-marital partners among this category was 1.2 times higher than among those in households without 
12

children. For married adult men, the study found that being Protestant or Muslim and others was 

significantly associated with having a higher number of non-marital non-cohabiting sexual partners 

compared with Catholics (IRR = 1.4; p<0.05 and IRR = 2.5; p<0.001 respectively). Married adult men in 

households with four or more children had relatively low odds for number of non-marital non-cohabiting 

sexual partners compared with their counterparts without children (IRR = 0.3; p< 0.01).

The study found that among unmarried adult men, education and household wealth were the determinants 

significantly associated with their number of non-marital non-cohabiting sexual partners. The number of 

non-marital non-cohabiting partners significantly increased by 90% among adult men with incomplete 

secondary education compared with men with no education (IRR=1.9; p<0.05). By household wealth 

quintile, unmarried adult men in the rich and richest households, respectively, had significantly higher 

incidence risk ratios for number of non-marital non-cohabiting sexual partners compared with those in the 

poorest households (IRR = 1.6; p<0.05). Adult men in the rich (IRR = 1.7; p<0.05) and the richest (IRR = 

1.8; p<0.05) household quintiles had significant incidence risk ratios for higher number of non-marital noncohabiting sexual partners compared with the poorest group.

Table 3.5 Negative binomial regression results estimating determinants of number of non-marital noncohabiting sexual partners among youths and adults

Incidence risk ratios for number of non-marital, non-cohabiting sexual partners

Youths Adults

Married Not married Married Not married

Variables IRR [95% CI] IRR [95% CI] IRR [95% CI] IRR [95% CI]

Educational Attainment

No education 1.0 1.0 1.0 1.0

Incomplete primary 1.5 [0.6-3.7] 1.0 [0.6-1.8] 0.9 [0.5-1.8] 1.5 [0.9-2.4]

Complete primary 1.1 [0.4-3.5] 1.2 [0.7-2.2] 1.0 [0.5-2.0] 1.0 [0.5-1.9]

Incomplete secondary 1.7 [0.6-5.0] 1.0 [0.6-1.9] 0.8 [0.4-1.7] 1.9* [1.1-3.2]

Secondary and higher 1.2 [0.4-3.9] 1.1 [0.6-2.0] 0.8 [0.4-1.6] 1.3 [0.8-2.0]

Religious Affiliation

Catholic 1.0 1.0 1.0 1.0

Protestant 0.8 [0.4-1.3] 1.0 [0.8-1.1] 1.4* [1.0-2.0] 0.8 [0.6-1.2]

Muslims and others 2.1 [1.0-4.4] 2.3*** [1.5-3.4] 2.5*** [1.5-4.0] 1.4 [09-2.2]

Media Exposure

Neither TV nor radio 1.0 1.0 1.0 1.0

Either TV or radio 1.4 [0.9-2.3] 1.1 [0.9-1.4] 1.3 [0.9-1.7] 1.2 [0.9-1.6]

Both TV and radio 0.7 [0.2-1.8] 1.1 [0.7-1.5] 1.2 [0.7-2.1] 1.0 [07-1.4]

Household Wealth

Poorest 

Poor 1.1 [0.6-2.1] 1.1 [0.8-1.4] 1.1 [0.6-1.7] 1.4 [0.9-2.3]

Middle 1.3 [0.6-2.9] 1.2 [0.9-1.5] 1.2 [0.8-1.9] 1.2 [0.7-2.0]

Rich 1.9 [0.8-4.3] 1.2 [0.8-1.6] 1.7* [1.0-2.7] 1.6* [1.0-2.5]

Richest 1.6 [0.6-4.0] 1.3 [0.8-1.9] 1.8* [1.1-3.1] 1.6* [1.1-2.5]

Number of Living Children

0 1.0 1.0 1.0 1.0

1 to 3 1.6 [0.9-2.7] 2.2** [1.3-3.5] 0.6 [0.3-1.2] 0.9 [0.7-1.2]

4 and higher 2.6 [0.4-16.8] - 0.3** [0.1-0.7] 0.9 [05-1.5]

Sex of the Household 

Head

Male 1.0 1.0 1.0 1.0

Female 1.4 [0.7-2.7] 1.2 [1.0-1.6] 0.9 [0.5-1.5] 1.1 [0.8-1.4]

Place of Residence

Urban 1.0 1.0 1.0 1.0

Rural 1.0 [0.5-2.2] 0.9 [0.6-1.2] 1.1 [0.7-1.8] 0.8 [0.6-1.1]

Observations 541 2,685 3,743 509

Note: *p<0.05; ** p<0.01; ***p<0.001; IRR= incident risk ratio
13

There were no significant factors among married male youth associated with their likelihood of having 

multiple non-marital non-cohabiting sexual partners.

3.3.2 Determinants of condom use with non-marital non-cohabiting sexual partners 

among male youths and adults in Malawi

Table 3.6 presents results of logistic regression analysis on the determinants of condom use during sexual 

intercourse with non-marital non-cohabiting partners among unmarried and married male youths and adults 

in the 12 months preceding the 2015-16 Malawi DHS.

Table 3.6 Logistic regression results estimating factors influencing condom use among unmarried and 

married youths and adults 

Odds of condom use

Youths Adults

Married Not Married Married Not married

Variables OR [95% CI] OR [95% CI] OR [95% CI] OR [95% CI]

Educational Attainment

No education (R) 1.0 1.0 1.0 1.0

Incomplete primary 5.9 [0.1-354.7] 1.7 [0.5-5.5] 2.2 [0.8-6.0] 3.5 [0.6-19.2]

Complete primary 27.0 [0.5-1334.2] 6.5* [1.3-34.2] 2.7 [0.8-8.9] 1.2 [0.2-9.2]

Incomplete secondary 4.7 [0.1-485.7] 3.7* [1.1-12.1] 1.8 [0.6-5.1] 4.7 [0.5-47.4]

Secondary and higher 2.7 [0.0-334.3] 3.2 [0.9-11.0] 11.7*** [3.1-44.2] 4.2 [0.4-39.0]

Religion Affiliation

Catholic (R) 1.0 1.0 1.0 1.0

Protestant 0.1* [0.0-0.6] 1.0 [0.7-1.5] 0.9 [0.4-1.9] 1.4 [0.6-3.6]

Muslims and others 0.2 [0.0-2.7] 0.7 [0.4-1.3] 0.8 [0.3-1.9 0.5 [0.1-2.2]

Exposure to Media

Neither TV nor radio (R) 1.0 1.0 1.0 1.0

Either TV or radio 2.5 [0.7-8.9] 1.1 [0.8-1.6] 2.1* [1.1-3.9] 1.0 [0.4-2.2]

Both TV and radio 0.5 [0.0-9.9] 1.4 [0.6-2.9] 0.7 [0.3-1.8] 0.9 [0.3-2.8]

Household Wealth

Poorest (R) 1.0 1.0 1.0 1.0

Poor 1.3 [0.2-7.4] 0.7 [0.4-1.3] 1.7 [0.6-4.7] 1.2 [0.3-4.6]

Medium 1.0 [0.2-6.3] 0.8 [0.5-1.4] 2.1 [0.9-5.0] 2.7 [0.6-11.2]

Rich 16.8 [0.2-1474.1] 0.8 [0.4-1.4] 2.0 [0.8-4.8] 2.2 [0.5-9.3]

Richest 1.6 [0.1-25.9] 1.1 [0.5-2.2] 1.3 [0.5-3.5] 2.3 [0.5-10.9]

Number of Living Children

0 (R) 1.0 1.0 1.0 1.0

1 to 3 2.8 [0.6-12.5] 1.0 [0.4-2.3] 3.5* [1.0-12.4] 0.8 [0.3-1.7]

4 and higher - - - 2.1 [0.6-7.6] 0.4 [0.1-2.1]

Sex of Household Head

Male (R) 1.0 1.0 1.0 1.0

Female 0.3 [0.0-2.3] 1.4 [0.9-2.1] 1.8 [0.4-7.8] 1.6 [0.6-4.5]

Place of Residence

Urban (R) 1.0 1.0 1.0 1.0

Rural 4.8 [0.5-47.8] 0.9 [0.4-1.6] 0.5 [0.2-1.1] 0.8 [0.3-1.8]

Observations 85 1,178 436 292

Note: *p<0.05, ** p<0.01, *** p<0.001; OR=odds ratio

The results show that unmarried youths who had completed primary school education and higher were more 

likely than those with no education to use condoms with a non-marital non-cohabiting sexual partner. The 

odds of condom use during sexual intercourse with non-marital non-cohabiting partners were significantly 

higher among unmarried youths who had completed primary school education (OR = 6.5, p<0.05) and those 

with incomplete secondary education (OR = 3.7; p<0.05) compared with those with no education. However, 

by religious affiliation, Protestant married youths had lower odds of condom use with a non-marital non-
14

cohabiting partner relative to their Catholic counterparts (OR = 0.1, p<0.05), implying that Protestant 

youths were about 90% less likely to use condoms during sex with a non-marital non-cohabiting partner.

Among adults, factors significantly associated with condom use were found only among married men. Such 

determinants included education, exposure to media, and number of living children. Married men who had 

completed secondary education and higher had greater odds of condom use with a non-marital noncohabiting partner compared with those who had no education (OR=11.7; p<0.001). The study also revealed 

that married adult men who were exposed to family planning information on either television or radio had 

increased odds of condom use with a non-cohabiting partner (OR=2.1; p<0.05). The results also show that 

married male adults with one to three living children had 3.5 times greater odds of condom use with a nonmarital non-cohabiting partner compared with married male adults with no children (OR=3.5; p<0.05).
15

4 DISCUSSION

The study identified various factors that influence the behavior of married and unmarried youths age 15-24 

and adults age 25-54 in Malawi concerning non-marital non-cohabiting sexual partners. The study also 

found factors associated with condom use during sexual intercourse with non-cohabiting sexual partners.

By religious affiliation, the study revealed that male Muslim youths and those of other undefined religions 

were generally associated with having a greater number of non-marital and non-cohabiting sexual partners 

compared with Protestant and Catholic youths respectively. Related studies have found that, on the contrary, 

Muslim youths were less likely to behave in a risky manner on sexual matters compared with Christian 

youths (Coleman and Testa 2008). Such contradictions could be attributed to diverse cultural beliefs at 

household and community levels that tend to exacerbate sexual and reproductive behavioral choices among 

youths (Tenkorang et al. 2011; Coleman and Testa 2008). Among adult men, the study found that both 

Protestants and Muslims and others who were married were more likely to have multiple non-marital noncohabiting sexual partners compared with Catholics. This implies that issues of male infidelity in marriage 

cut across religions. Therefore, this finding renders it difficult to pinpoint one religion as a single major 

culprit associated with risky sexual behavior over other religions in Malawi. Nevertheless, the fact that 

among male youths both unmarried and married Muslims and the “other” religious groupings were found 

to exhibit increased relative risk to engage in non-marital non-cohabiting sexual partnerships implies that 

something must be done to counter the behavior among the Muslim youths relative to those affiliated with 

Christian religious beliefs. Indeed, the unique behavior of people with different religious beliefs towards 

sexual matters could be attributed to their differential belief systems and frameworks at household and 

community levels among the varying religious affiliations (Mahoney et al. 2008; Mahoney et al. 2010) and 

sexual experiences (Exavery et al. 2011; Takyi 2003).

On the number of living children, the study noted that adult married men who had four or more children

were significantly less likely to have had a number of non-marital non-cohabiting sexual partnerships 

compared with their counterparts in households with no children. This could be explained by the fact that 

with more children comes increased social and economic responsibility and household obligations related 

to child care, which eventually leads men to change their sexual behavior toward family care with one 

sexual partner. On the contrary, among unmarried youth age 15-24 the study found that those with 1-3 living 

children had a higher incidence risk in the number of non-marital non-cohabiting partners they had than

their counterparts in households with no children. This finding is supported by Adu-Mireku (2003), who 

observed that the family is a fundamental primary agent of socialization that has a direct influence on the 

sexual behavior of youth, especially those who are not married and are still resident within the household. 

Lack of commitment and reduced sense of responsibility that tends to be common among unmarried male 

youths in community settings could be associated with this finding. Compared with married men in Malawi, 

most unmarried men who have children generally tend to leave the responsibility of child care in the hands 

of the children’s mother.

Regarding determinants of condom use in Malawi, the study revealed that condom use was significantly 

higher among unmarried male youths who completed primary education but did not complete secondary 

education than among male youth with no education. This implies that education can play a crucial role in 

informing society against contracting sexually transmitted infections. It is evident that among people who
16

can read and write, the chances of using condoms with non-cohabiting sexual partners could be improved. 

The study further showed that condom use among youth in Malawi was significantly lower for married 

Protestants than their Catholic counterparts. This implies that many married young Protestant men have a 

serious high-risk lifestyle with regard to sexual behavior. Such differential behavioral patterns among 

people could be attributed to cultural practices and religious beliefs, which affect their choices in seeking 

and using preventive health products such as condoms.

Concerning adult men, this study observed that those who were married and had attained secondary and 

higher education had increased odds of using condoms with non-cohabiting sexual partners compared with 

married adults with no education. This is attributed to the fact that higher education improves one’s 

knowledge and level of understanding. Facilitated within school settings, higher education also enhances 

people’s exposure to various modes of information about sex and sexual behaviors, which in the long term 

have a significant impact on improving use of condoms among men (Garofalo et al. 1998). In a related 

study, Akwor and Olaseha (2010) pointed out that, if they were well informed, men with more formal 

education tended to be more likely to possess positive health-seeking behaviors, including increased use of 

condoms. In line with education, the study also found that male adults who were exposed to and accessed 

sexual and reproductive health information on television or radio were more likely to understand the 

communicated messages and to use condoms during sex with non-cohabiting partners compared with those 

with neither radio nor television exposure. This indicates that effective multi-media reproductive health 

campaigns could have a significant impact on preventing irrational sexual behavior (Bessinger et al. 2004). 

Media exposure becomes more effective if targeted programs are consistently scheduled to inform society 

about the consequences of risky sexual practices toward one’s health (Shapiro et al. 2003).

In the discussion on men’s engagement with non-marital non-cohabiting sexual partners, the study indicated 

that married male adults with four or more children had significantly decreased incidence risk to have nonmarital non-cohabiting sexual partners. Related to this, on condom use, the study found that married adult 

men with 1-3 children had significant positive odds to use condoms with non-marital non-cohabiting sexual 

partners. As already stated, some married men would be mindful of the expanded roles and responsibilities 

that arise with more children in the household. Such men would therefore be eager to use condoms with 

non-cohabiting sexual partners to avoid contracting sexually transmitted infections and the risk of getting 

implicated in extra-marital pregnancies, and to shun the financial burdens associated with maintenance of 

extra-marital non-cohabiting sexual partnerships.
17

5 CONCLUSIONS

Using data from the 2015-16 Malawi Demographic and Health Survey, this study identified the 

determinants of risky sexual behavior among men in Malawi. The study found that regardless of the 

interventions aimed at promoting good sexual and reproductive health behavior, a significant number of 

men, both youths and adults, engage in non-marital non-cohabiting sexual partnerships across the country. 

The study has shown that among men in Malawi, education, religion, media exposure, and number of living 

children were significantly associated with men’s engagement with non-marital non-cohabiting sexual 

partners.

Formal educational attainment has been found to be a significant determinant of reducing risky sexual 

behavior involving men’s engagement with non-marital non-cohabiting sexual partnerships in Malawi. 

Education was also found to positively influence men’s behavior with regard to use of condoms during sex 

with non-marital non-cohabiting sexual partners. Religious affiliation has been found to be significantly 

associated with men’s likelihood of having non-marital non-cohabiting sexual partnerships in general, and 

also associated with reduced condom use among married youths. Furthermore, it can be concluded that 

access to family planning information on either television or radio could influence adult men to minimize 

risky sexual behavior. Therefore, this study asserts that extensive pro-men sexual and reproductive health 

educational campaigns to tackle key sexual reproductive topics would facilitate behavioral change among 

men in Malawi. It is envisaged that successful implementation of such campaigns would reduce 

vulnerability to sexually transmitted infections, and this would, in the medium-to-long term, contribute to 

improved socioeconomic development of communities and the nation as a whole.

19

6 POLICY RECOMMENDATIONS

Considering the fact that the male youth have been engaged in non-marital non-cohabiting sexual 

partnerships, there is need for Malawi to promote campaigns that will help to prevent men from initiating

sex at a young age. Such campaigns would have the potential of helping young men to improve their sexual 

and reproductive health-seeking behavior and could reap significant health dividends for the socioeconomic 

development of the country.

The study also advocates for the promotion of sexual and reproductive health education among men through 

a diversity of avenues, including religious institutions, where large numbers of people gather regularly at 

one place. This could be implemented using a community-based approach in which the danger of engaging 

in non-marital non-cohabiting sexual partnerships would be thoroughly addressed across age groups,

including both youths and adults.

Acknowledging that this study targeted men only, it is imperative for the country to institute communitybased sexual reproductive health programs and campaigns, which would promote modern knowledge of 

sexual and reproductive behavior among men. The country would likely gain from such initiatives by 

improving the level of health among its citizens and increasing the productive capacity of men to contribute 

positively toward Malawi’s socioeconomic development.

21

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