Love, Marriage, and HIV: Gender and HIV Risk

描述(申请人提供)：目的：对于世界上许多地区的妇女来说，使她们感染艾滋病毒风险最大的行为是无保护措施的婚内性行为。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不同阶段的国家的五个地点参与建立这些关系的男女的性做法和艾滋病毒预防做法。通过详细描述环境因素塑造女性婚姻感染艾滋病毒风险的过程，这项研究将有助于我们理解降低异性传播艾滋病毒风险的方法。背景和意义：这项研究以三个前提为指导：已婚男性在维持异性恋传播艾滋病毒方面的作用尚未得到充分研究；传播一夫一妻制伴侣婚姻的意识形态可能会使已婚女性处于特别危险的境地；关于性关系的社会、经济和情感背景的特定文化知识可以提供重要的洞察，了解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，将妇女置于婚姻传播艾滋病毒的风险之中。方法：选择了5个代表HIV流行不同阶段的发展中国家地点进行研究：德戈拉多、哈利斯科·塔里、巴布亚新几内亚、越南SOC SON、尼日利亚乌巴卡拉和乌干达布卢班迪。在每个地点，研究人员将使用人种学方法来检查艾滋病毒婚姻传播风险的社会和文化决定因素。我们预计总共有200个半结构化的人种学访谈和系统的男女人种学样本(每个站点40个)和100个婚姻案例(每个站点20个)，将在6个月的参与者观察中收集。对于每个实地地点，人种学数据将使用多层次编码过程进行分析，以便将具体的态度和行为与关系和宏观因素联系起来。民族志调查结果将汇集在一起，对各地点的关键主题和调查结果进行分析。暗示：婚姻等同于一夫一妻制的假设可能会让女性付出生命代价。该项目的数据将被用来追踪男女建立性关系并暴露于艾滋病毒风险的社会和意识形态背景，并为减少这种风险提出文化上适当的、对性别问题有敏感认识的干预措施的建议。

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.