4. Re-marriage decisions

Journal of Aids and Hiv Research, 2013

This study explores re-marriage decisions of people living with human immunodeficiency virus (HIV) in matrilineal Chiradzulu and patrilineal Chikhwawa communities in Malawi. Specifically, it analyzes reasons and circumstances that come into play as they re-consider marriage relationships. Data were collected from July to December, 2010 using in-depth interviews from eighteen informants purposively sampled and was analyzed using content analysis method. Findings show four main issues; irrespective of kinship organization and despite resistance from kin, women decide to re-marry for financial support while men for physical care and emotional support. In the absence of widow inheritance, widows from patrilineal communities are not receiving the expected support from the deceased husband's relatives leading them to seek support through re-marriage. New marriages in patrilineal communities are supported through traditional marriage formalities. Suggesting that decisions to re-marry are influenced by socio-economic factors. Therefore, we recommend cultural sensitive health programmes embedded in these local realities that accept people living with HIV to remarry and continue to access prevention of mother to child transmission of HIV and antiretroviral therapy services without reprisal.

AIDS Research and Treatment, 2013

WITH WIDER ACCESS TO ANTIRETROVIRAL THERAPY, PEOPLE LIVING WITH HIV ARE RECONSIDERING THEIR REPRODUCTIVE DECISIONS: remarrying and having children. The purpose of the paper is to explore sources of information for reproductive decision used by couples living with HIV in patrilineal and matrilineal districts of Malawi. Data were collected from forty couples from July to December 2010. Our results illuminate five specific issues: some of the informants (1) remarry after divorce/death of a spouse, (2) establish new marriage relationship with spouses living with HIV, and (3) have children hence the need for information to base their decisions. There are (4) shared and interactive couple decisions, and (5) informal networks of people living with HIV are the main sources of information. In addition, in matrilineal community, cultural practices about remarriage set up structures that constrained information availability unlike in patrilineal community where information on sexual and reproductive health, HIV, and AIDS was disseminated during remarriage counselling. However, both sources are not able to provide comprehensive information due to complexity and lack of up to date information. Therefore, health workers should, offer people living with HIV comprehensive information that takes into consideration the cultural specificity of groups, and empower already existing and accepted local structures with sexual and reproductive health, HIV, and AIDS knowledge.

Tropical Medicine & International Health, 2008

objective To assess the social and economic impact of HIV-related illness and death on the spouses of HIV-infected individuals. methods From population-based surveys in the 1980s in Karonga district, northern Malawi, 197 'index individuals' were identified as HIV-positive. A total of 396 HIV-negative 'index individuals' were selected as a comparison group. These individuals, and their spouses and children, were followed up in 1998-2000, in a retrospective cohort study. All analyses compared spouses of HIV-positive indexes with those of HIV-negative indexes. results By 1998-2000, most marriages involving an HIV-positive index individual had ended in widowhood. Twenty-Six percent of the wives of HIV-positive index men experienced household dissolution precipitated by widowhood, compared with 5% of the wives of HIV-negative index men.

Malawi Medical Journal the Journal of Medical Association of Malawi, 2013

The rapid scale-up of free antiretroviral therapy has lead to decline in adult mortality at the population level and reduction of vertical transmission. Consequently, some couples living with HIV are maintaining their reproductive decisions; marrying and having children. This paper analyses policies and guidelines on HIV, AIDS and sexual and reproductive health in Malawi for content on marriage and childbearing for couples living with HIV.

Acta juridica (Cape Town, South Africa), 2013

This paper explores marriage attitudes and practices among Xhosa-speaking women living with HIV (WLHIV) in Cape Town, South Africa. It reports on a study that assessed the fertility intentions of a cohort of people living with HIV, aimed at informing an HIV care intervention. It draws on qualitative data generated from 30 successive interviews with WHLIV in wave 1, 23 interviews in wave 2 and 20 follow-up interviews in wave 3. Gender inequality, marriage and HIV are strongly intertwined. Broader layers of South Africa's history, politics and socio-economic and cultural contexts have consequences for the fluidity in intimate relations, marriage and motherhood for WLHIV. Key and conflicting themes emerge that impact on marriage and motherhood. Firstly, marriage is the 'last on a list of priorities' for WLHIV, who wish to further their children's education, to work, to earn money, and to achieve this rapidly because of their HIV-positive status. We demonstrate that the ...

Studies in Family Planning, 2014

Marriage and partnerships bring about non-negligible health risks in populations with generalized HIV epidemics, and concerns about the possible transmission of HIV thus often factor in the decision-making about partnership formation and dissolution. The awareness of and responses to HIV risk stemming from regular sexual partners have been well documented in African populations, but few studies have estimated the effects of observed HIV status on marriage decisions and outcomes. We study marriage dissolution and remarriage using longitudinal data with repeated HIV and marital status measurements from rural Malawi. Results indicate that HIV positive individuals face greater risks of union dissolution (both via widowhood and divorce) and lower remarriage rates. Modeling studies suggest that the exclusion of HIV positives from the marriage or partnerships market will decelerate the propagation of HIV.

Mediterranean Journal of Social Sciences, 2014

As the HIV/AIDS pandemic continues to wreak havoc in Zimbabwean communities, there is a noticeable trend of surviving spouses remarrying following the demise of their partners. This qualitative study, located in the interpretive paradigm, sought to establish remarrying partners' views on causes for remarriages and the extent to which they took precautionary measures to prevent infection and re-infection. A purposive sample of 2 males and 3 females participated in the study. Data were collected through phenomenological interviews with participants. Content analysis was used to analyse data. The study established that there were social, cultural and economic reasons that lead to remarriages of HIV positive surviving spouses. Participants did not disclose their status to their new partners and precautionary measures were not taking as some couples had children out of the new marriages. The study concludes that HIV/AIDS chances for infections were enhanced and promoted in remarriages and recommends that community programmes on HIV/AIDS awareness should be put in place to educate people on ways of HIV/AIDS transmission and ways to curb the rise of new infections.

2015

European Scientific Journal, ESJ, 2014

Till recently, serodiscordant couples were ignored though HIV negative sexual partners and children born in the relationship are at high risk of infection. Difficulty of making decision with respect to divorce, child bearing, and managing sexual patterns characterize serodiscordants. In Ethiopia, most infected married people are serodiscordant and do not mutually know their HIV status. Lack of adequate studies on serodiscordance necessitates this study to identify people's perceptions and practices concerning serodiscordance. In-depth interview with serodiscordant couples and key-informant interviews with health care providers, and thematic analysis were employed to gather and analyze the information respectively. Serodiscordant couples know their HIV status lately after they have developed health complications; practice unsafe sex and give birth to infected child. Confusions are observed among discordant couples and health care providers on the possibility of future infection of the negative partner and the etiology of serodiscordance in general. The explanations are inconsistent and some are erroneous. Difficulty of managing familial relationships, the dilemma of child bearing, risk of child infection, forced changes in patterns of sexuality, lack of social support, and unreliable livelihood are among the challenges they face. Negative HIV partners and children born to serodiscordant couples are at risk of infection. Yet serodiscordance is not given adequate attention in HIV/AIDS care and prevention public programs. Programs targeting married people and serodiscordant couples are necessary to curb Mother to Child Transmission.