Love, Marriage, and HIV: Gender and HIV Risk

描述（由申请人提供）：目的：对世界上许多地方的妇女来说，使她们面临最大感染艾滋病毒风险的行为是无保护的婚内性行为。拟议的比较人种学研究将探讨社会和文化因素如何影响婚姻和婚外亲密关系，并审查在艾滋病毒流行的不同阶段的国家的五个地点建立这些关系的男性和女性的性行为和预防艾滋病毒的做法。通过详细描述环境因素影响女性婚姻感染艾滋病毒风险的过程，本研究将有助于我们了解降低异性恋艾滋病毒传播风险的方法。背景与意义：本研究基于三个前提：已婚男性在维持HIV异性传播中的作用尚未得到充分探讨；一夫一妻制伴侣婚姻意识形态的传播可能会使已婚妇女面临特别的风险，而关于两性关系的社会、经济和情感背景的文化特定知识可以为性别不平等与经济组织和新兴的婚姻爱情意识形态相结合的途径提供重要的见解，从而使妇女面临婚姻中艾滋病毒传播的风险。方法：选择了五个发展中国家的HIV流行的不同阶段进行研究：Degollado，哈利斯科塔里州，巴布亚新几内亚，Soc Son，越南，Ubakala，尼日利亚和Bulubandi，乌干达。在每个地点，研究人员将使用人种学方法来检查婚姻传播艾滋病毒风险的社会和文化决定因素。我们预计将在6个月的参与者观察中收集200个半结构化人种学访谈，其中包括系统的人种学男性和女性样本（每个站点40个）和100个婚姻案例（每个站点20个）。对于每个实地站点，将使用多层分层编码过程来分析民族志数据，以将特定的态度和行为与关系和宏观层面的因素联系起来。人种学研究结果将汇集在一起，对各地点的关键主题和研究结果进行分析。启示：婚姻等于一夫一妻制的假设可能会让女性付出生命的代价。该项目的数据将用于追踪男性和女性建立性关系和暴露于艾滋病毒风险的社会和意识形态背景，并制定文化上适当的、对性别问题敏感的干预措施建议，以减少这种风险。

DESCRIPTION (provided by applicant): Objective: For women in many parts of the world, the behavior that puts them at greatest risk for HIV infection is unprotected sex within marriage. The proposed comparative ethnographic study will explore how social and cultural factors influence marital and extramarital intimate relationships and examine the sexual and the HIV prevention practices of men and women engaged in building these relationships across five locations in countries at different stages of the HIV epidemic. By detailing the processes through which contextual factors shape women's risk of marital HIV infection, this study will contribute to our understanding of ways to reduce the risk of heterosexual HIV transmission. Background and Significance: The study is guided by three premises: that the role of married men in sustaining heterosexual transmission of HIV has been insufficiently explored; that spreading ideologies of monogamous companionate marriage may put married women at particular risk, and that culturally specific knowledge about the social, economic, and emotional context of sexual relationships can provide important insight into the avenues through which gender inequality combines with economic organization and emerging ideologies of marital love to put women at risk for marital HIV transmission. Methods: Five developing country sites representing different stages of the HIV epidemic have been selected for study: Degollado, Jalisco Tari, Papua New Guinea, Soc Son, Vietnam, Ubakala, Nigeria, and Bulubandi, Uganda. In each site, researchers will use ethnographic methods to examine the social and cultural determinants of the risk of marital transmission of HIV. We anticipate totals of 200 semi-structured ethnographic interviews with a systematic ethnographic sample of men and women (40 per site) and 100 marital case histories (20 per site), to be collected over 6 months of participant observation. For each field site, ethnographic data will be analyzed using a multilevel hierarchical coding process to relate specific attitudes and behaviors to relationship- and macro-level factors. The ethnographic findings will be pooled to conduct an analysis of key themes and findings across sites. Implications: The assumption that marriage equals monogamy may be costing women their lives. Data from this project will be used to trace the social and ideological contexts within which men and women build sexual relationships and become exposed to HIV risk and to develop proposals for culturally appropriate, gender-sensitive interventions to reduce this risk.