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揭示风险:印度尼西亚已婚女性中的婚姻欺骗与艾滋病病毒易感性

Unveiling Risk: Marital Deception and HIV Susceptibility Among Married Women in Indonesia.

作者信息

Najmah Najmah, Andajani Sari, Davies Tom Graham, Davies Sharyn Graham

机构信息

Department of Epidemiology, Faculty of Public Health, Sriwijaya University, Palembang, Indonesia.

Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand.

出版信息

Int J Sex Health. 2025 Mar 26;37(2):297-310. doi: 10.1080/19317611.2025.2481845. eCollection 2025.

Abstract

OBJECTIVES

The Indonesian Ministry of Health reports a significant three-fold increase in newly diagnosed HIV cases among women aged 15 and above, rising from 12,537 cases in 2015 to 35,415 in 2024. Over the past decade, the largest group of new HIV cases in Indonesia has been among women of reproductive age (15-49 years). This trend is largely driven by the widely held and fallacious belief that heterosexual, married women are not at risk of HIV. In this study we aim to challenge this misconception and investigate the complexity of HIV transmission, with a focus on HIV susceptibility among married women in Indonesia.

METHODS

Feminist Participatory Action Research was conducted with 24 women living with HIV (WLWH) in Palembang, South Sumatra, Indonesia. Interviews and focus group discussions were employed to assess the impact of the actions of women and men who partake in high-risk behaviors that could result in them passing HIV onto their spouses.

RESULTS

The study shows that among 24 women living with HIV, 14 contracted HIV from male partners who engaged in unsafe sexual behavior, and who often knowingly transmitted HIV. Those male partners may have had extra-marital affairs with women, women sex workers, or with other men or been involved in polygamous marriages. This article provides insight into the vulnerability of married women getting HIV from their spouse and highlights that healthy marital sexual relationships depend on respect, trust, and clear communication.

CONCLUSIONS

We argue that improving HIV health literacy in Indonesia, along with open discussions about sexual practices, are crucial. While these conversations may challenge deeply ingrained social, cultural and religious norms regarding sexuality, marriage and ideal gender relations, they are critical for halting the spread of HIV in Indonesia.

摘要

目标

印度尼西亚卫生部报告称,15岁及以上女性新诊断出的艾滋病毒病例显著增加了两倍,从2015年的12,537例增至2024年的35,415例。在过去十年中,印度尼西亚新增艾滋病毒病例最多的群体是育龄妇女(15至49岁)。这一趋势在很大程度上是由一种广泛存在且错误的观念驱动的,即异性恋已婚女性没有感染艾滋病毒的风险。在本研究中,我们旨在挑战这种误解,并调查艾滋病毒传播的复杂性,重点关注印度尼西亚已婚女性对艾滋病毒的易感性。

方法

在印度尼西亚南苏门答腊省巨港对24名感染艾滋病毒的女性进行了女权主义参与式行动研究。采用访谈和焦点小组讨论来评估参与可能导致将艾滋病毒传播给配偶的高危行为的男性和女性行为的影响。

结果

研究表明,在24名感染艾滋病毒的女性中,有14名是从从事不安全性行为且经常故意传播艾滋病毒的男性伴侣那里感染的。那些男性伴侣可能与女性、女性性工作者或其他男性有婚外情,或者参与了一夫多妻制婚姻。本文深入探讨了已婚女性从配偶那里感染艾滋病毒的脆弱性,并强调健康的婚内性关系取决于尊重、信任和清晰的沟通。

结论

我们认为,提高印度尼西亚的艾滋病毒健康素养以及就性行为展开公开讨论至关重要。虽然这些对话可能会挑战有关性、婚姻和理想性别关系的根深蒂固的社会、文化和宗教规范,但它们对于阻止艾滋病毒在印度尼西亚的传播至关重要。

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