Title:
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Empowering married Zimbabwean women to negotiate for safer sex
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Zimbabwe has experienced one of the largest HIV/AIDS epidemics. Heterosexual
transmission accounts for the highest number of new infections. Current HIV
prevention strategies rely heavily on changing individual behaviour to take up safer
sex practices. However sexual activity is not just an individual attribute but behaviour
negotiated between two people in a wider socio-cultural context particularly in
marriage. There is thin literature on specific socio-cultural barriers that married
women face when they negotiate for safer sex in marriage or context specific strategies
to combat these barriers.
This three phase study used qualitative data, collected through 4 focus group
discussions, 36 semi-structured interviews with married men and women and 12
semi-structured interviews with HIV program implementers. Data were collected to
examine the socio-cultural context of sexuality in marriage and identify interventions
for empowering married women to negotiate for safer sex. The findings provide a
contextually embedded analysis of the determinants of sex and sexuality in marriage
and how these may shape powerlessness to negotiate for safer sex. Sexual satisfaction
was perceived as a crucial aspect of sexuality in marriage with orgasm, sexual
communication, sexual performance and frequency of sexual activity being crucial
overlapping factors that contributed to it. Gender norms affected achieving sexual
satisfaction in marriage, occurrence of forced sex and concurrent sexual relationships.
Personal, social and cultural meanings of sex in a marriage along with ineffective
communication and pressure from external social relationships were identified as
barriers to safer sex uptake in marriage.
Context specific interventions to address these barriers to safer sex practice in
marriage were identified and assessed for socio-cultural and organisational feasibility.
Future HIV interventions must go beyond narrowly advocating for safer sex strategies
but address the complex socio-cultural determinants of sex in marriage.
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