MLSFH Data

MLSFH Data Availability

MLSFH data encompass more than a dozen major data collection waves of the MLSFH Cohort during 1998-2023, supplemented smaller data collection on specific topics  (see below for details).

Public-use version of the MLSFH data without identifying individual or village information are made publicly available with some delay after data collection. MLSFH data up to 2017 (MLSFH 9) can currently be requested by emailing a short project description and a signed copy of the MLSFH data use agreement to info@MLSFHresearch.org. A public-use version of the data is also being prepared for inclusion in the ICPSR at the University of Michigan.

Researchers interested in using MLSFH data that have not (yet) been made available as part of the MLSFH public use data files can submit a two-page proposal (including an analysis plan and IRB plan) to info@MLSFHreseaerch.org. If deemed scientifically sound and not overlapping with ongoing MLSFH research projects, researchers will then be asked to sign a Data Use Agreement to be able to access and utilize the MLSFH data that are not part of the public-use data sets. All analyses of the restricted MLSFH data are conducted in collaboration with members of the MLSFH study team.

MLSFH Cohort Profiles

MLSFH Cohort Profiles with extensive Supplemental Materials, published in the International Journal of Epidemiology (2015), BMJ Open (2017, 2020) and SocArXive (2023), summarize the key findings of the MLSFH. The MLSFH Cohort Profiles also provides information about the sampling for the MLSFH, the refreshment and extensions of the MLSFH sample over time, the procedures for HIV testing and counseling, and other study procedures that were implemented as part of the MLSFH. The MLSFH cohort profiles also reports comparisons of the MLSFH study populations with nationally representative datasets, analyses of attrition in the MLSFH sample, and it includes discussions of some specific features of the MLSFH data that have been widely used across many MLSFH-based papers.

MLSFH Data Collections

2023: MLSFH Covid-19 PHone Survey (CV2)

Follow-up of 2020 Covid-19 phone survey

Phone Survey data: Covid-19-related behaviors, risk perceptions and knowledge, Covid-19 vaccine uptake, health care utilization, mental health, economic situation, personality traits, village governance

2022: MLSFH Round 12 (M12)

Surviving an epidemic data collection: focused on MLSFH respondents aged 45+ (follow-up of M10)

Survey data: Covid-19-related behaviors, risk perceptions and knowledge; Covid-19 vaccine uptake; health care utilization; mental health and well-being; economic situation; cognition; physical health and performance; subjective risk assessments and probabilistic expectations; work efforts and productivity; economic situation and economic impacts of Covid-19; social program participation; marriage history update; activities of daily living and instrumental activities of daily living.

Measured health indicators: Grip strength (both hands), blood pressure; height, weight and BMI; hip and waist circumference 

2022: MLSFH Village Head Survey

Focus on village governance and village resource allocation

Survey data: Traditional leader characteristics, village governance, village splits, village activities, allocation of resources within village, fertilizer subsidies

2021: Sibling Enrollment

Focus on adding 1,000 siblings of MLSFH Respondents aged 45+

Survey data: maternal sibling listing and MLSFH enrollment of one sibling for 1,000 MLSFH respondents aged 45+


2021: MLSFH ACE Round 2 (ACE2)

Round 2 of MLSFH Adverse Childhood Experiences (ACEs) and Adolescent HIV Risk Project

MLSFH ACE cohort members were adolescents aged 13-20 years.

Survey data: Similar to ACE 1 (2017-18).

Measured health indicators: Height, weight and BMI.

Biomarkers: Testing and counseling for HIV; HSV2 for a subset.

Cohort Profile: Summary of MLSFH ACE1+2 (2017-21), including Supplemental Materials with details about sampling, attrition, study procedures, etc.

2020: MLSFH Covid-19 Phone Survey (cV1)

Focus on Covid-19 risk perceptions, prevention behaviors and community responses

Phone survey data: Covid-19-related behaviors, risk perceptions and knowledge, health care utilization, mental health, economic situation, trust in government and health care system.


2019: MLSFH Round 11 (M11)

Surviving an epidemic data collection: focused on MLSFH respondents not surveyed as part of M7-M10

Survey data: Anxiety, depression and well-being; cognition (detailed at ages 45+); physical health and performance; alcohol and tobacco use; subjective risk assessments and probabilistic expectations; household/family rosters and intergenerational transfers; work efforts and productivity; economic situation; social program participation; marriage history update; fertility and sexual behaviors. Additional survey data collected from village heads, health care providers and health care facilities.

Measured health indicators: Grip strength (both hands), height, weight and BMI.

Biomarkers: Testing and counseling for HIV.

Questionnaires: M11 Main Survey; M11 HTC Survey; M11 Village Head Survey. All surveys were implemented via RedCap on tablets.

Redcap dictionary: M10 Main Survey (csv/pdf); M11 HTC Survey (csv/pdf); M11 Village Head Survey (csv/pdf).

2018: MLSFH Round 10 (M10)

Follow-up survey of MLSFH mature adults aged 45+

Survey data: Anxiety, depression and well-being; cognitive function (short module); physical health and performance; alcohol and tobacco use; subjective risk assessments and probabilistic expectations; household/family rosters and intergenerational transfers; work efforts and productivity; social interactions about health and non-communicable diseases.

Measured health indicators: Grip strength (both hands), height, weight and BMI.

Questionnaire: M10 Survey (implemented via RedCap on tablets); M10 Survey Cards.

RedCap Dictionary: M10 Survey (csv/pdf).

Cohort Profile: Summary of MLSFH M7-M10 Mature Adults Cohort (2012-18), including Supplemental Materials with details about sampling, attrition, study procedures, etc.

2017: Benknow Health Infomration intervention (B9)

Providing accurate information about mortality risks to mature adults to study behavioral consequences of risk misperceptions

Survey data: Detailed data on mortality risk perceptions.

Other info: B9 Questionnaire & intervention protocol (implemented via RedCap on tablets); B9 Health information sheets.

RedCap Dictionary: B9 Questionnaire & intervention protocol (csv/pdf).

RCT Registration: AEARCTR-0004965.

2017: MLSFH Round 9 (M9)

Follow-up survey of MLSFH mature adults aged 45+

Survey data: Anxiety, depression and well-being; cognitive function; physical health and performance; alcohol and tobacco use; subjective risk assessments and probabilistic expectations; household/family rosters and intergenerational transfers; work efforts and productivity.

Measured health indicators: Blood pressure, grip strength (both hands), height, weight and BMI.

Biomarkers: Testing and counseling for HIV; (random) blood glucose.

Questionnaires: M9 Main Survey (implemented via RedCap on tablets); M9 Survey Cards; M9 HTC Survey.

RedCap Dictionary: M9 Main Survey (csv/pdf).

Other info: M9 Blood glucose collection protocol; M9 High blood pressure referral form; M9 High blood glucose referral form.

Cohort Profile: Summary of MLSFH M7-M10 Mature Adults Cohort (2012-18), including Supplemental Materials with details about sampling, attrition, study procedures, etc.

2017-18: MLSFH ACE Round 1 (ACE1)

Round 1 of MLSFH Adverse Childhood Experiences (ACEs) and Adolescent HIV Risk Project

MLSFH ACE cohort members were selected based on household rosters of MLSFH respondents in 2008-10 (M5+M6); the MLSFH cohort was surveyed in 2016-17 when members were adolescents aged 10-16 years. Caregivers were also surveyed.

Survey data: Adverse childhood experiences (ACEs) during childhood and adolescence, HIV-related behavioral risk, mental and physical health, cognitive development and education, intimate partner violence (IPV), marriage and aspirations, early transitions to adulthood, and protective factors. 

Measured health indicators: Height, weight and BMI.

Biomarkers: Testing and counseling for HIV.

2013: MLSFH Round 8 (M8)

Follow-up survey of MLSFH mature adults aged 45+ focused on mental heath, cognition and well-being

Survey data: Similar to MLSFH 7 (2012).

Measured health indicators: Blood pressure, grip strength (both hands), height, weight and BMI.

Questionnaires: M8 Survey; M8 Survey Cards; M8 High blood pressure referral form.

2013: Migration Follow-up

Focus migration, health and HIV risk

Migration follow-up with all ever-interviewed MLSFH respondents not interviewed during MLSFH 6 (10) due to migration and/or temporary absence.

Survey data:  Health, health-related behaviors, migration histories, reasons for migration, smoking and alcohol use, family and household structure, financial and non-financial transfers, marriage and sexual behaviors, economic situation.

Biomarkers: Testing and counseling for HIV. 

Questionnaire: MLSFH 2013 Migration and health survey; MLSFH 2013 Migration tracking survey.

Cohort Profile: Summary of MLSFH 2007 and 2013 migration and health studies.

2012: MLSFH Round 7 (M7)

Follow-up survey of MLSFH mature adults aged 45+ focused on mental heath, cognition and well-being

Survey data: Similar to MLSFH 6 (2010), plus measures of depression, anxiety and cognition (including measures of spatial/temporal orientation and language, measures of memory/recall and executive functioning), alcohol consumption.

Measured health indicators: Grip strength (both hands), height, weight and BMI.

Biomarkers: Testing and counseling for HIV

Questionnaires: M7 Main Survey; M7 Survey Cards; M7 HTC Survey.

2010: MLSFH Round 6 (M6)

Focus on consequences of high morbidity and mortality

Survey data: Same as MLSFH 5 (2008).

Questionnaire: M6 Main Survey.

Cohort Profile: Summary of MLSFH M1-M6 (1998-2010), including Supplemental Materials with details about MLSFH sampling, attrition, study procedures, etc.

2009: Biomarker STudy

Focused on selected subset of MLSFH respondents residing in Balaka and collected biomakers of inflammation, cardiovascular risks, metabolic processes and organ function

Survey data: Health; illnesses and pain experienced by respondent, and household members; illnesses experienced by family members; water source; diet/nutrition.

Biomarkers: Biomarkers for wide-range CRP, total cholesterol, LDL, HDL, total protein, urea, albumin, blood urea nitrogen, creatinine, random blood glucose and HbA1c, collected using the LabAnywhere (previously Demecal) System (LabAnywhere, Haarlem, The Netherlands)Other: Height, weight and BMI.

Questionnaire: 2009 Biomarker Collection Survey.

2008: MLSFH Round 5 (M5)

Focus on consequences of high morbidity and mortality

Survey data:  Human capital, including schooling, self-reported SF-12 questionnaire module on physical and mental health, subjective well-being; household production and consumption, including standard of living, household assets, time use, health expenditure; social capital, including intergenerational/intrafamilial transfers and help relationships, transfer relationships with community members, participation in community associations; expectations, risk perceptions and attitudes, including probabilistic expectations about HIV risks and survival, and AIDS-related attitudes and knowledge; biographic information, including marriage and partnership histories, extra- and pre-marital relationships, partner characteristics. No longer included: conversational networks about AIDS.

Biomarkers: Testing and counseling for HIV.

Questionnaires: M5 Main Survey; M5 Voluntary Testing and Counseling (VCT) Survey

2007: Migration Follow-up

Focus migration, health and HIV risk

Migration follow-up with all ever-interviewed MLSFH respondents not interviewed during MLSFH 4 (2006) due to migration and/or temporary absence.

Survey data:  Similar to MLSFH 4, plus detailed questions about migration history and migration reasons.

Biomarkers: Testing and counseling for HIV. 

Questionnaire: MLSFH 2007 Migration survey; MLSFH 2007 Main survey.

2006-2007: Sexual diaries

Focus on sexual behaviors and HIV risk taking

Survey data:  Four rounds of sexual diaries providing detailed day-to-day data on sexual behaviors during a 9-day period prior to the interview. 

Biomarkers: Testing and counseling for HIV in 2007 (after 3rd round of sexual diary collection). 

2006: MLSFH Round 4 (M4)

Focus on HIV risk, social networks and sexual relations

Survey data: Similar to MLSFH 3, plus: SF-12 self-reported health questionnaire; probabilistic expectations about health and HIV-risks; subjective discount rate; HIV testing history; audio-CASI interview for sensitive behaviors; intergenerational transfers and transfers with community members; mortality of household/family members. No longer included  were conversational networks about family planning and religion.

Biomarkers: Testing and counseling for HIV.

Other: Initiation of MLSFH Incentive Study, a randomized experiment offering financial incentives for maintaining HIV-negative status.

Questionnaires: M4 Women (ever married), M4 Women (never married), M4 Men (ever married), M4 Men (never married), M4 Household Listing, M4 Voluntary Testing and Counseling (VCT) Survey.

2004: MLSFH Round 3 (M3)

Focus on HIV risk, social networks and sexual relations

Survey data: Similar to MLSFH 2 (2001), plus: household rosters with data on household membership and health/schooling/morbidity and marital status of household members; measures of religious activities/affiliations; social capital and basic data on transfer and exchange networks; time use; household expenditures on health and schooling; AIDS-related stigma. No longer included: fertility histories and childbearing desires;  detailed data about use of and attitudes about family planning methods.

Biomarkers: Testing and counseling for HIV, gonorrhea, chlamydia and trichomonas

Other: Randomized experimental design offering financial incentives for learning HIV status

Questionnaires: M3 Adolescent Girls, M3 Adolescent Boys, M3 Women, M3 Men, M3 Health & STIs (Women), M3 Health & STIs (Men).

Other Info: M4 Adolescent sampling details, M4 biomarker testing protocol.

2001: MLSFH Round 2 (M2)

Focus on childbearing and fertility desires, HIV risk risk perceptions, social networks

Survey data: Mostly identical to MLSFH 1 (1998), plus social participation, marriage and sexual partnership histories.

Questionnaires: M2 Women, M2 Men, M2 Village Survey.

Other Info: M1+M2 Sampling details.

1998: MLSFH Round 1 (M1)

Focus on childbearing and fertility desires, HIV risk risk perceptions, social networks

Survey data: Childbearing and fertility desires; attitudes about and use of family planning methods; conversational networks about family planning and HIV/AIDS (see Appendix ); gender attitudes and female autonomy;  HIV/AIDS-related knowledge, and risk-perceptions; sexual behaviors and HIV risk reduction strategies. 

Questionnaires: M1 Women, M1 Men.

Other Info: M1+M2 Sampling details.