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.