African Women Safe Sex Zimbabwe Hiv Prevention Study

Q1. What was the research question(s) that guided the investigation? In other words, what was the purpose(s) of the study?

Despite widespread knowledge of the importance of safer sex practices, including the use of condoms, AIDS/HIV remains a significant risk in Zimbabwe. This study by Mugweni (et al., 2015) attempted to identify personal and structural barriers which exist for married Zimbabwean women in the practice of safer sex.

Q2. Describe the subjects (target audience) of the research, including gender, number of each gender, the characteristics of the subjects (e.g., all were diabetic Hispanic women between the ages of 25-44 living in urban areas of the southeastern United States).

According to the researchers, 33 married Zimbabwean men and 31 women between the ages of 35-44 years of age were selected to participate in the study.

Q3. How was theory used to guide the research study? Be specific and clear.

The study did not explicitly make use of an overarching theory to guide its approach. Its specific intention to determine how better attempt to empower married women to act as self-advocates may be rooted in feminist or women’s theory. Its specific emphasis on cultural barriers to safe sex within marriage highlights a multicultural, community focused approach to health.

Q4. Describe the research techniques, procedures, methods used to conduct the research study; this includes the general plan of the study (e.g., what did the researchers do to whom).

This study was qualitative in its construction. It was Phase 2 of a larger research study. The phase encompassed 36 in-depth interviews and 4 focus groups with the participants. Individual, relational, and community-level barriers were identified over the course of both phases.

Q5. Describe the main results of the study as they relate to the research question(s). Were there any limitations noted in the study? If so, what were they?

Significant cultural barriers were identified in enabling women to act as self-advocates for safer sex within the context of marriage. This is significant in a society where a very high percentage of all individuals are married. Limitations included the fact that participants were interviewed as individuals, rather than in couples, limiting the extent to which the interpersonal and gendered dynamics could be fully unpacked. They also note the focus was upon women-specific limitations to negotiate for safer sex, even though men were interviewed, and men may face social and psychological barriers.

Q6. Use your knowledge of health education and health behavior theory to explain why the main results of the study occurred. Explain the implications of this study for a health educator.

Women’s inability to negotiate for safer sex, even in the face of a husband’s infidelity, was part of a larger problem regarding women’s empowerment regarding reproductive autonomy. Women were often afraid of their husbands, physically, and economically (given the significant social and financial burdens of abandonment). They often blamed themselves for their husband’s lack of sexual interest in them and the fac their husbands were unfaithful, reflecting negative internalized norms about gender relations. From a health educator standpoint, this reveals how simply focusing upon encouraging husbands to wear condoms is not enough to address the social inequalities relating to the spread of HIV/AIDS within marriage. It is a specifically women’s health-related issue.

Q1. According to the authors, what practices are considered “safer sex”?

Wearing condoms in non-monogamous relationships, even within the construct of marriage, is critical. Abstinence and mutual monogamy are also obviously ideal, important goals and can reduce transmission. Male circumcision, voluntary testing, and honest dialogue between individuals within the context of a marriage or sexual union can also reduce the risk of HIV/AIDS transmission and the transmission of other sexually transmitted diseases.

Q2. What factors at the intrapersonal level contribute to the high rates of HIV/AIDS among married persons and those in long-term relationships?

A lack of dialogue, fear of one of the partners (almost always the woman) in asking her partner to wear a condom or his or her monogamy status (and asking for testing, if medically prescribed given the partner’s behavior) is critical. Women may not feel as if they have a right to act as self-advocates. Culturally, there is little emphasis on male self-disclosure, and religious and family leaders may discourage rather than encourage women being equal partners in their marriages. Virility may be associated with a lack of condom use, having unprotected sex outside of marriage, and not getting circumcised.

Q3.What factors at the community level contribute to the high rates of HIV/AIDS?

The fact that respected elders within the community do not encourage women to demand full disclosure of their partner’s sexual history and to use condom contributes to the high rate of transmission. Divorce is culturally discouraged, and women often have little economic resource for self-support outside of marriage.

Q4. How do the authors suggest factors contributing to the high rates of HIV in this population might be used to develop culturally appropriate interventions?

Given the important cultural place of elders, gaining family and community leader support to support divorce and negotiating safer sex with husbands was deemed critical. It is important to communicate that safer sex is not a license for infidelity, but rather the better option than risking a serious illness.