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The management of the risk of HIV and AIDS in marriage and cohabiting relationships: reflections from a study in a rural Eastern Cape setting.

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This study explored the risk of HIV infection to married and cohabiting partners in a rural setting in the Eastern Cape. This study focussed on the personal, relationship, and cultural demands and expectations in marriage and cohabitation, and power inequality in relationships, and their effect on HIV prevention. A qualitative research approach was adopted in this study. The study used data from a broader study including interviews with eight men and women between the ages of 26 and 60 years, as well as five focus group discussions with men and women within this age range and two mixed groups of adult members of the community. Thematic analysis was utilised to analyse data using the integrated theory of gender and power. Findings revealed that condom use is not a common practice in marriage and cohabiting relationships. Many factors influence condom use in marriage and cohabiting relationships, such as unequal gender positions, power inequality, and cultural expectations. For one, power differences between married and cohabiting men and women influenced the womens’ ability to protect themselves from HIV infection by their partners. Furthermore, gender norms prescribed by culture allowed men to have more sexual partners and to use condoms less often, thereby increasing the risk of HIV infection. Additionally, societal norms guided women to accept their partners’ promiscuity, to be tolerant and obedient, resulting in silence and an increasing vulnerability to HIV infection. In this study, most men and women acknowledged that there are power inequalities in heterosexual relationships and that they are aware that this affects HIV prevention. Findings also suggested that women who lack the power to control sexual activities did not always consent to sex. Policies that focus on protecting women’s rights are therefore of utmost importance. Future research should focus on analysing the effects of power inequalities in married and cohabiting partners. Community leaders, older community members, traditional leaders and men should also be encouraged to partake in future research projects that will focus on analysing the negative effects of gender norms on women’s sexuality. This will help raise awareness about the effects of gender norms on HIV prevention in marriage and in cohabiting relationships.


Masters Degree. University of KwaZulu-Natal, Pietermaritzburg.