Marriage, monogamy and HIV: a profile of HIV-infected women in south India

Abstract

A retrospective study was conducted on 134 HIV-infected females evaluated at an HIV/AIDS centre in south India to characterize their sociodemographics, HIV risk factors and initial clinical presentations. The mean age was 29 years; 81% were housewives; 95% were currently or previously married; 89% reported heterosexual sex as their only HIV risk factor; and 88% reported a history of monogamy. The majority were of reproductive age, thus the potential for vertical transmission of HIV and devastating impacts on families is alarming. Nearly half of these women initially presented asymptomatically implying that partner recruitment can enable early HIV detection. Single partner heterosexual sex with their husband was the only HIV risk factor for the majority of women. HIV prevention and intervention strategies need to focus on married, monogamous Indian women whose self-perception of HIV risk may be low, but whose risk is inextricably linked to the behaviour of their husbands.

Barriers to Free Antiretroviral Treatment Access for Female Sex Workers in Chennai, India

“…Most women infected in South India report a history of monogamy, with heterosexual sex with their husband as their only risk factor for HIV infection. 45 HIV-positive married FSWs are more likely than HIV-positive married women who are not FSWs to be blamed by their husband and in-laws for introducing HIV infection into the family and thereby may face increased risk of rejection, domestic violence, and loss of shelter and financial support. As a result, married FSWs face additional barriers to accessing ART.…”

Male alcohol use and unprotected sex with non-regular partners: Evidence from wine shops in Chennai, India

“…Heterosexual risk in India arises from both lack of condom use and having multiple sexual partners (Solomon, Ganesh and Yepthomi, 2004 (Bhattacharjee et al, 2000) and over 45% of unmarried men have multiple partners (Bhatia et al, 2005). Male extramarital relationships lead to married women becoming infected by their spouses and it is now evident that being married to a man who has multiple partners is one of the single most important risk factors for a monogamous woman with respect to HIV acquisition (Newmann et al, 2000). Understanding the role that male heterosexual behavior plays in fuelling the further spread of HIV in India is key to developing interventions that will meaningfully involve men in prevention efforts.…”

Gender differences in perceived stigma and hope in people living with HIV / AIDS: an exploratory study

“…This is in keeping with many Indian studies which show that 90% of women with HIV were in a monogamous relationship. [18][19][20] In fact, research shows that the biggest risk factor for HIV infection in women is being married. 30 Interestingly many health policies in India for HIV are directed at monogamy and safe sex, and are hence less relevant for women whose infection rates are on the rise.…”

“…17 Indian studies reveal that the majority of infected women had a monogamous relationship and were infected by their partners. [18][19][20] However, women may encounter more stigma related to sexually transmitted diseases as sexual adventures are perceived to be a male domain resulting in affected women being blamed as immoral and accused of bringing HIV in the family. 21 This study contributes to the literature on perceived stigma and hope among PLWHA.…”