Paper: Sociocultural Influences on the Transmission of HIV From Husbands to Wives in Cambodia: The Male Point of View

 

Sociocultural Influences on the Transmission of HIV From Husbands to Wives in Cambodia: The Male Point of View

Yang, Y., & Thai, S. (2017). Sociocultural influences on the transmission of HIV from husbands to wives in Cambodia: The male point of view. American journal of men's health, 11(4), 845-854.

https://journals.sagepub.com/doi/full/10.1177/1557988317690079

Abstract

The purpose of the study was to explore, within cultural and societal contexts, the factors of spousal HIV transmission as described by the experiences of HIV-positive Cambodian men. Using qualitative research methods, the researchers collected data from in-depth interviews with 15 HIV-positive Cambodian men of seroconcordant couples recruited from an HIV/AIDS clinic in Phnom Penh. Using a model of HIV transmission from husbands to wives, the questions were designed to elicit the men’s perspectives on the topics of promiscuity, masculinity, condom use in marriage, the image of the ideal Cambodian woman, and attitudes toward sex and marriage. Directed content analysis was used to analyze the interview data. The main results were as follows: (a) men involved with sex workers perceived this as a natural behavior and a necessary part of being an approved member in a male peer group, (b) married men never used condoms during sex with their wives prior to their HIV diagnosis, (c) men perceived a good wife as one who is diligent and loyal to her husband, and (4) men’s attitudes toward sex and marriage (e.g., sex perceived as a part of life pleasure) differed from those of their wives. Promoting honest spousal communication about sexuality, maintaining men’s marital fidelity, and increasing women’s comfort in the use of sexual techniques are suggested as strategies for reducing HIV transmission within marriage in Cambodia. Future interventions should focus on reshaping men’s behaviors and changing cultural norms to protect them and their spouses from HIV infection.

Keywords 

Cambodia, HIV, marriage, men, transmission

The main topics explored were the environment of promiscuity, perceptions of masculinity, condom use in marriage, the image of the ideal Cambodian woman, and attitudes to sex and marriage. The findings of this study will guide effective and culturally acceptable couple-based HIV prevention programs.

Figure 1. Model of HIV Transmission Between Husbands and Wives: Male Perspectives.

Research suggests that cultural and societal expectations and norms of what constitutes a “real man” can create an environment where HIV transmission is a high risk. Men in this study reported making an effort to be approved as a member of their male peer group by joining in their friends’ drinking and visiting of sex shops.

In conclusion, efforts to change those factors that influence Cambodian men’s perspectives on gender roles, marital infidelity, masculinity, and condom use in marriage need to be changed; otherwise, it will be difficult to reduce their wives’ HIV risk. The findings of this study can guide couple-oriented prevention efforts. One of this study’s main strengths is that it is the first study exploring culturally embedded factors of HIV transmission from the perspective of Cambodian men in HIV-concordant couples. A major study limitation is the timing of the study; there is the possibility that perspectives changed after HIV diagnosis because the participants may have already undergone some changes in attitudes and behaviors while living with HIV. Another limitation could have occurred from using the previously developed model. Yang’s model guided the study well by informing in detail the topics dealt with in the study; however, it also may have limited the ability to find cultural factors that are absent in the model.