Age at marriage and HIV vulnerability among young married women living with HIV in northern Karnataka, India

•More than three fourth of the respondents got married before their 17th birthday.•The mean age of the respondents in the sample is 26 years and their husbands is 33 years.•Two third of the respondents were less than 25 years of age and pregnant when they were tested HIV positive.•Young women may be less capable of asserting themselves or denying sex to protect themselves from HIV vulnerability. The purpose of the study is to explore whether marriage age possibly a risk factor for HIV infection among young women living with HIV in a high HIV risk area of southern India. We used data from a cross-sectional survey of randomly selected currently married HIV-positive women aged 15 to 29. The analysis of the data revealed that more than 75% of them got married before they reach their 17th birthday. More than 71% are from rural areas, and about half of them are illiterate. Surprisingly, 28% of women began to live with their current husbands before the age of 15, and as many as 73% of respondents began to live with their current husbands below the legal age at marriage of 18 years. The average age of the interviewees was 25.6 years, while that of husbands was 32.5 years, indicating that the average age gap between husbands and spouses was 7 years. Regarding the timing of their HIV diagnosis, 37% of the respondents were diagnosed their HIV status during pregnancy and a higher percentage of younger ones were tested HIV positive when respondents were pregnant (61%) as compared to older respondents. In the past 2 years, 58% of the respondents have diagnosed with HIV. This could be mainly due to the increased awareness among women in the recent years as well as the government scaled up the HIV testing during the past few years, both in terms of increasing the testing facilities across the state and providing capacity of those staff involved in testing. Hence, there is a program need for the about-to-be-married and the newly-married couples to be educated about HIV transmission, the practice of safe sex as well as the use of HIV prevention services.