title: Norms and practices within marriage which shape gender roles, HIV/AIDS risk and risk reduction strategies in Cabo Delgado, Mozambique.
abstract: Despite increasing HIV/AIDS rates among married individuals, minimal research has been conducted on how men and women respond to risk in a marriage. This paper examines strategies used by married individuals to combat HIV/AIDS risk against prevailing gender norms. Qualitative data were gathered in four villages of Cabo Delgado province, Mozambique. Group discussions were held with 160 men and women to explore gender norms, HIV/AIDS knowledge and risk determinants. From the group discussions, 29 individuals were selected for further in-depth interviews to explore relationships between gender norms and risk reduction efforts within marriages. Findings illustrate how infidelity and social limitations placed on condom use not only increase HIV/AIDS risk but also entrench gender disparities. Although power differences between genders can make it difficult to negotiate safe sex, men and women are taking measures to reduce perceived HIV/AIDS risk in their marriage. Married men are reconstructing norms and taking responsibility to protect their family from HIV/AIDS by remaining faithful. For women, responses to HIV/AIDS risk in a marriage are more closely related to their ability to generate an income. Financially dependent women tend to leave a risky marriage altogether in contrast to financially autonomous women who will negotiate condom use with their husband. Factors such as experience with a risky partner, the desire to maintain a good social standing, fear of HIV/AIDS acquisition and parental guidance and support influence men and women to reduce perceived HIV/AIDS risk, despite constraining gender norms and power imbalances in a marriage. Nuanced understandings of the ways in which men and women are already taking measures to decrease noted HIV/AIDS risk, despite gender norms that make this a challenge, should be incorporated into localised responses.
authors.affiliation: Department of Population Studies, London School of Hygiene and Tropical Medicine, UK. sarahbandali@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Bandali
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control; D000328:Adult; D005260:Female; D005783:Gender Identity; D015658:HIV Infections / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008393:Marriage / Q000523:psychology*; D008875:Middle Aged; D009073:Mozambique; D036301:Qualitative Research; D012307:Risk Factors; D040242:Risk Reduction Behavior