For women, marriage is risk factor for HIV infection
Most of us women enter marriage confident of a lifetime of love, devotion, commitment, fidelity and financial security. The last thing we think of is the risk of HIV infection. Since the 1990s, there have been increasing numbers of studies on the link between marriage and HIV. Most married women use monogamy or abstinence as a way to prevent HIV infection. While women are being faithful, the same cannot be said for married men who have extramarital affairs, increasing the risk of HIV transmission to their wives.
The majority of marriages in Malawi are characterised by cheating husbands. Married men wrongly believe it’s their inalienable birth right to have “a spare tyre” ” a squeeze” or think it’s some sort of sign of virility to visit prostitutes. The reasons men cheat are in my mind silly, inexcusable and downright selfish!
In a paper published in the Global Public Health in January, Lucy Mkandawire-Valhmu and colleagues look at why Malawian women enter marriage, what their experiences of marriage are, why they leave their partners and women’s lives after separation, abandonment and widowhood. The authors of this study suggest that understanding the role that marriages play in women’s lives can help with HIV prevention efforts.
They conducted discussions with 72 women in southern Malawi. Most of the women in the study had been married at least once and it was common to find some women had been married two or three times. Poverty and companionship were the main factors women identified as drivers for marriage. Most of the women were living with HIV, most of the them reported remaining faithful and hence blamed their husband’s infidelity for their HIV infection.
UNAIDS reports that marriage and other long term monogamous relationships do not protect women from HIV. However, some researchers disagree with the link between HIV and marriage and suggest a number of factors are at play with the greatest risk of HIV infection in early marriages due to increased sexual activity, decreased condom use and husbands of married girls more likely to be HIV-positive than boyfriends of unmarried girls. A study in Zimbabwe found that being single was associated with HIV infection while a South African study found that having money and being married increased the chances of HIV infection.
In the Mkandawire-Valhmu study, the women suggested a number of cultural practices were to blame such as husband and wife abstaining from sex for a year after a baby is born. To fulfil their sexual desire men have sex outside of marriage. The women also reported that their husbands would refuse to disclose their HIV status often refusing to go to hospital and get tested.
A team of researchers predicted that in Rwanda nearly 93 percent of HIV infections transmitted by either men or women occurred within marriage and in Zambia, the figure for women was 77 percent.
So as women, what do we do when we know without a shadow of a doubt that our husbands are cheating on us? Divorce? Demand our husbands wear condoms? Or should we just never get married?
