Culturally Embedded Risk Factors for Cambodian Husband-Wife HIV Transmission: From Women's Point of View
PURPOSE:
The
purpose of this study was to use interview data to examine the validity of a
recently published theoretical model of HIV transmission between husband and
virginal wives in rural Cambodia.
DESIGN:
This study
used a qualitative description method with a sample of women diagnosed with
HIV/AIDS in Phnom Penh, Cambodia.
METHODS:
Data were
collected through in-depth interviews conducted with 15 women who
self-identified as having contracted HIV from their HIV-positive husbands.
Interviews were conducted in Khmer, translated and back-translated for
accuracy, and then coded using deductive content analysis. Trustworthiness of
study results was protected through peer debriefing, coding to consensus, and
maintaining an audit trail.
FINDINGS:
Each
conceptual domain of the prior published theoretical model of HIV transmission
was validated and further elaborated by current study data: wives' acceptance
of their husbands' involvement with commercial sex workers, the common practice
of unprotected sex between HIV-infected spouses and uninfected wives, and
wives' beliefs about the value of the ideal Khmer woman. In addition, the
current study findings identified a new domain that substantially distinguished
between the beliefs and attitudes held about marriage and sex by wives and
spouses.
CONCLUSIONS:
Women
were not passive recipients of HIV transmission; they reciprocated with
behaviors that were consistent with being a good Khmer woman in rural Cambodia,
all of which increased their vulnerability to HIV transmission from their
HIV-infected spouses. Future interventions or programs should consider all
these factors and not overly rely on simplistic educational messages about
wearing barriers for HIV transmission during sex.
CLINICAL RELEVANCE:
The
refined theoretical model of HIV transmission from this qualitative research
can be used to formulate culturally sensitive and embedded programs for curbing
intramarital HIV transmission in Cambodia among the rural poor.
- 1Assistant Professor, School of Nursing, Research Institute of Nursing Science, Chonbuk National University, Jeonju, Republic of Korea.
- 2School of Nursing, University of Washington Medical Center Endowed Professor in Nursing, Family and Child Nursing, Seattle, WA, USA.
- 3Associate Professor, College of Nursing, Seattle University, Seattle, WA, USA.
- J Nurs Scholarsh. 2016 Feb 2. doi: 10.1111/jnu.12193.
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