College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Glob Public Health. 2013;8(2):187-201. doi: 10.1080/17441692.2012.761261. Epub 2013 Jan 28.
The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.
马拉维是世界上艾滋病毒感染率最高的国家之一，其亲密伴侣关系中存在性别不平等，这使得婚姻成为女性感染艾滋病毒的一个重要风险因素。然而，很少有研究详细描述婚姻和风险之间的复杂相互作用。为了在这些社区中制定具有持久影响的艾滋病毒预防干预措施，我们需要更深入地了解妇女生活的复杂性，了解她们为何以及如何参与婚姻关系，以及这些关系对艾滋病毒传播或预防的影响。本文描述了妇女如何理解婚姻对其生活和艾滋病毒风险的影响。本文通过对马拉维 72 名参加抗逆转录病毒诊所的妇女进行焦点小组讨论，探讨了妇女为什么要结婚，她们在婚姻中的经历以及她们如何离开配偶与他人建立关系。根据她们的叙述，我们描述了妇女在分居、被遗弃或丧偶后的生活，并报告了她们在结婚两三次后的婚姻看法。然后，我们根据发表的关于艾滋病毒的研究，审查妇女的叙述，并提出建议，将与婚姻相关的艾滋病毒风险降到最低。
