High HIV rates among cohabiting couples in many African countries have led to greater programmatic emphasis on spousal communication in HIV prevention. This study examines how demographic and socioeconomic characteristics of cohabiting adults influence their dyadic communication about HIV. A central focus of this research is on how the position of women relative to their male partners influences spousal communication about HIV prevention. We analyze gaps in spousal age and education and female partner’s participation in household decision-making as key factors influencing spousal communication about HIV, while controlling for sexual behaviors of both partners and other individual and contextual factors. Data are from the 2003 Kenya Demographic and Health Survey (KDHS) for 1,388 cohabiting couples (male partners age 15-54 and female partners age 15-49). Information regarding spousal communication was self-reported, assessing whether both, either, or neither partner ever discussed HIV prevention with the other. The analysis shows that higher levels of female partner’s education and participation in household decision-making are positively associated with spousal communication about HIV prevention. With female partner’s education and other factors controlled, couples with more educated male partners are more likely to discuss HIV prevention than couples where both partners have the same level of education. The findings have implications for HIV prevention programs to promote women’s empowerment and to support men’s participation in sexual health.
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