Chasing HIV out of the marital bed

By Nancy Njagi-Bbithi

I remember facilitating a training on HIV and giving a case study of a family where the husband was a truck driver and the wife, a stay-home mum. The man had several sexual partners, something his wife suspected.

The task to my trainees was to help this woman negotiate safe sex within her marriage. This included visiting a VCT and introducing the use of a condom during sex.

As the trainees tried to come up with suggestions that would help this woman negotiate safe sex, I began to think that I was asking too much of them. Negotiating for safe sex felt like an impossible task especially in the African context. The woman would try to avoid sex for two or three days but on day four, she would run out of excuses and would have to give in to her husband’s advances. After all, that is what a woman should do — she should not deny her husband.

There are great risks of HIV within marriage and women bear the greatest challenges. This is made even more complex by the fact that HIV prevention strategies do not meet the needs of married women who cannot abstain, who find it difficult to negotiate for safe sex and who cannot control how faithful their husbands will be.

Abstinence: Most women even on realising that their husbands may be having sexual affairs outside marriage, may not be confident enough to say no to sexual advances for fear that the man will use the refusal as a licence to have more extra marital affairs.

Marital rape

There is also the socialisation that if a woman wants to keep her man at home, she should meet his needs. Also, if a woman refuses to have sex willingly, there is a possibility of being raped by her husband.

Negotiating safe sex: How do you ask your husband to go for VCT or worse, use a condom? it is likely that his first question would be: "Why the change? You are either being unfaithful or you are accusing me of infidelity."

Condoms are not synonymous with marriage; I even doubt their success as a means of family planning within marriage. They are mainly associated with short-term sexual encounters. With this kind of thinking, how then do you initiate a condom discussion?

Controlling the man’s faithfulness: If anyone has a technique of controlling the faithfulness of their husband, I would love to hear it. Women have tried so many techniques but men’s socialisation has been working against them. We have heard men boast of the number of women they have in their fold and emphasis on the significance it gives them in society. We are almost convinced that polygamy is the way to go.

What say, therefore, does the woman have other than lay low, pray and get into the system especially if she is depending on this man to provide for her family? What can she do especially if she wants to keep her family together?

Because of all these challenges, HIV slowly finds its way into the marital bed. A 2008 report by the National Aids and STI Control Programme stated that in 10 per cent of married couples in Kenya, at least one partner was living with HIV. Further still, among married people living with HIV, 45 per cent have a partner who is uninfected.

Way forward

If this partner, mostly the woman, is not in a position to prevent HIV transmission (through first, the man disclosing his status and second, through using a condom during sex), then chances are that she will sooner than later be infected.

There is need for us all to come up with appropriate strategies for HIV prevention within marriage. It is important to openly talk about what is happening and in so doing solutions can be sort. It is also prudent to give women economic independence and thus giving then a voice and options.

Be enlightened and enjoy your marriage.