title: Assessing the importance of gender roles in couples' home-based sexual health services in Malawi.
abstract: To more effectively address individuals' and couples' sexual and reproductive health needs, innovative service delivery strategies are being explored. These strategies are logistically and ethically complicated, considering prevailing gender inequalities in many contexts. We conducted an exploratory study to assess the acceptability of couples' home-based sexual health services in Malawi. We collected qualitative data from six focus group discussions and 10 husband-wife indepth interviews to gain a more thorough understanding of how gender norms influence acceptability of couples' sexual health services. Findings reveal that women are expected to defer to their husbands and may avoid conflict through covert contraceptive use and non-disclosure of HIV status. Many men felt that accessing sexual health services is stigmatizing, causing some to avoid services or to rely on informal information sources. Gender norms and attitudes toward existing services differentially impact men and women in this setting, influencing the perceived benefits of couples' sexual health services.
authors.affiliation: Department of Community Health Sciences, University of California, Los Angeles School of Public Health, 650 Charles E. Young Drive South, CHS 46-071B, Los Angeles, CA 90095-1772, USA. jgipson@ucla.edu
authors.forename: Jessica D
authors.initials: JD
authors.lastname: Gipson
authors.forename: Carie J
authors.initials: CJ
authors.lastname: Muntifering
authors.forename: Felluna K
authors.initials: FK
authors.lastname: Chauwa
authors.forename: Frank
authors.initials: F
authors.lastname: Taulo
authors.forename: Amy O
authors.initials: AO
authors.lastname: Tsui
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Hindin
mesh_terms: D000328:Adult; D005193:Family Planning Services; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006699:Home Care Services; D006801:Humans; D007407:Interviews as Topic; D008295:Malawi; D008297:Male; D012737:Sex Factors; D012747:Sexual Partners