title: Culturally Embedded Risk Factors for Cambodian Husband-Wife HIV Transmission: From Women's Point of View.
abstract: OBJECTIVE
  The purpose of this study was to use interview data to examine the validity of a recently published theoretical model of HIV transmission between husband and virginal wives in rural Cambodia.
  
  
  METHODS
  This study used a qualitative description method with a sample of women diagnosed with HIV/AIDS in Phnom Penh, Cambodia.
  
  
  METHODS
  Data were collected through in-depth interviews conducted with 15 women who self-identified as having contracted HIV from their HIV-positive husbands. Interviews were conducted in Khmer, translated and back-translated for accuracy, and then coded using deductive content analysis. Trustworthiness of study results was protected through peer debriefing, coding to consensus, and maintaining an audit trail.
  
  
  RESULTS
  Each conceptual domain of the prior published theoretical model of HIV transmission was validated and further elaborated by current study data: wives' acceptance of their husbands' involvement with commercial sex workers, the common practice of unprotected sex between HIV-infected spouses and uninfected wives, and wives' beliefs about the value of the ideal Khmer woman. In addition, the current study findings identified a new domain that substantially distinguished between the beliefs and attitudes held about marriage and sex by wives and spouses.
  
  
  CONCLUSIONS
  Women were not passive recipients of HIV transmission; they reciprocated with behaviors that were consistent with being a good Khmer woman in rural Cambodia, all of which increased their vulnerability to HIV transmission from their HIV-infected spouses. Future interventions or programs should consider all these factors and not overly rely on simplistic educational messages about wearing barriers for HIV transmission during sex.
  
  
  CONCLUSIONS
  The refined theoretical model of HIV transmission from this qualitative research can be used to formulate culturally sensitive and embedded programs for curbing intramarital HIV transmission in Cambodia among the rural poor.
authors: Assistant Professor, School of Nursing, Research Institute of Nursing Science, Chonbuk National University, Jeonju, Republic of Korea.
authors: Youngran
authors: Y
authors: Yang
authors: School of Nursing, University of Washington Medical Center Endowed Professor in Nursing, Family and Child Nursing, Seattle, WA, USA.
authors: Frances Marcus
authors: FM
authors: Lewis
authors: Associate Professor, College of Nursing, Seattle University, Seattle, WA, USA.
authors: Danuta
authors: D
authors: Wojnar
mesh_terms: D000328:Adult; D002160:Cambodia; D003466:Cultural Characteristics; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D008393:Marriage / Q000523:psychology; D008962:Models, Theoretical; D011203:Poverty; D036301:Qualitative Research; D012307:Risk Factors; D012424:Rural Population; D011477:Sex Work / Q000523:psychology; D018454:Spouses / Q000523:psychology* / Q000706:statistics & numerical data; D047568:Unsafe Sex / Q000523:psychology
keywords: HIV/AIDS; marriage; qualitative research; risk factors; transmission