Mugweni Esther, Omar Mayeh, Pearson Stephen
Department of Infection and Population Health, University College London, Mortimer Market Centre off Capper Street, London WC1E 6JB, UK and Nuffield Centre for International Health and Development, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK
Department of Infection and Population Health, University College London, Mortimer Market Centre off Capper Street, London WC1E 6JB, UK and Nuffield Centre for International Health and Development, University of Leeds, 101 Clarendon Road, Leeds LS2 9LJ, UK.
Health Educ Res. 2015 Jun;30(3):388-99. doi: 10.1093/her/cyu073. Epub 2014 Dec 12.
Against the backdrop of high human immunodeficiency virus (HIV) prevalence in stable relationships in Southern Africa, our study presents sociocultural barriers to safer sex practice in Zimbabwean marriages. We conducted 36 in-depth interviews and four focus group discussions with married men and women in Zimbabwe in 2008. Our aim was to identify barriers faced by married women when negotiating for safer sex. Participants identified individual, relational and community-level barriers. Individual level barriers made women voiceless to negotiate for safer sex. Being voiceless emanated from lack sexual decision-making power, economic dependence, low self-efficacy or fear of actual or perceived consequences of negotiating for safer sex. Relational barriers included trust and self-disclosure. At the community level, extended family members and religious leaders were said to explicitly or implicitly discourage women's safer sex negotiation. Given the complexity and multi-levelled nature of barriers affecting sexual behaviour in marriage, our findings suggest that HIV prevention interventions targeted at married women would benefit from empowering individual women, couples and also addressing the wider community.
在南部非洲稳定关系中人类免疫缺陷病毒（HIV）高流行率的背景下，我们的研究揭示了津巴布韦婚姻中安全性行为的社会文化障碍。2008年，我们对津巴布韦的已婚男女进行了36次深入访谈和4次焦点小组讨论。我们的目的是确定已婚妇女在协商安全性行为时所面临的障碍。参与者识别出了个人、关系和社区层面的障碍。个人层面的障碍使女性在协商安全性行为时无法发声。无法发声源于缺乏性决策权力、经济依赖、自我效能感低或担心协商安全性行为的实际或感知后果。关系层面的障碍包括信任和自我表露。在社区层面，据说大家庭成员和宗教领袖会明确或含蓄地劝阻女性进行安全性行为协商。鉴于影响婚姻中性行为的障碍具有复杂性和多层次性，我们的研究结果表明，针对已婚妇女的HIV预防干预措施将受益于增强个体女性、夫妻的权能，并解决更广泛的社区问题。
