Women face the dilemma of condom use in marriage

By The NewsDay | Nov. 1, 2014 | 7 Min read

MARRIAGE is depicted by many as an institution where freedom of sexual intimacy is a must and free for a couple.

Feluna Nleya

Sex seals love between a man and a woman, but then what happens when it comes introducing protective methods in the relationship?

That is no doubt perceived as taboo or something out of the ordinary because that is a declaration that could mark the end of trust, love and ultimately mark termination of a marriage.

“Condoms in a marriage are not for me. If I condomise in my marriage, where will l get the sexual pleasure I so much desire?” queried a married woman.

While married women are being pressed to negotiate for safer sex with their spouses whom they suspect of infidelity, they say it is unworkable especially where there exists domestic violence. However, a few say they can successfully negotiate for safer sex if they still feel that they are at risk.

Health and Child Care minister David Parirenyatwa recently encouraged married couples to have protected sex in a bid to minimise preventable new infections.

He said although condom use had increased over the years, it was still low among married couples.

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The National Aids Council (NAC) says most of the new HIV infections stemmed from married couples which they described as worrisome.

NAC chief executive officer Tapuwa Magure said most of the new HIV infections were being found in long-standing relationships.

“Findings have revealed that the steady relationships, those married and those who have normal casual sex contribute above 50% of new HIV infections,” Magure said.

A number of women interviewed said it was difficult to introduce condoms during intimacy as this may destroy their marriages. They said it was not practical to do so, questioning how far a couple can continue using condoms.

The women said there was need for experts to come up with a cure for HIV soon or people would continue getting infected.

“That’s a non-starter my friend. I will get killed if I do that. The only sensible thing is to pray for him not to have extra-marital affairs,” a woman who identied herself only as Monica said.

“We need a cure for HIV and not a condom because it is not sustainable to use a condom,” another married woman said. “I can never ask my husband to wear condoms especially when we have gone for so many years together. He will think I have cheated on him instead. We have to be frank, how many of us have found our partners cheating and still do not ask them to use condoms?”

Another married woman Sithandazile Sithole said only those who are financially independent can negotiate for safer sex.

“The ones that have the financial independence know money is not everything and in the process of making money have tasted loneliness so they will compromise. When it comes to matters of the heart, we woman are rarely practical,” Sithole said.

Another woman, Susan Matata, said the issue of negotiating for sex depended really on the man one is married to.

“Once he pays lobola (bride price), he believes he owns you. So negotiating for condoms might be a problem. I think practicality it’s not possible for some women to persuade their husbands to use condoms.”

Another married woman said: “There we go, so no matter how we say we can try to make them to wear condoms, we probably can’t. We are lying to ourselves. We will die.

“Do men like condoms? Generally, it all ends when the relationship is made official.”

One woman said she could negotiate for safe sex: “Yes, if I suspect, I will definitely ask him to put on a condom while awaiting to go for testing.”

Some men interviewed by NewsDay said they would also question if they were to be asked by their wives for safer sex practices. “Why would she be asking me to put on a condom? That is unheard of,” one man said.

This problem, however, seems to be a worldwide phenomenon which cuts across the social divide.

Data from the National Aids Control Council in Kenya shows that of the more than 90 000 new annual infections, these two types of unions account for 44%, while short-term liaisons and commercial sex workers contribute about 20% and 14%, respectively.

“A recent study conducted by Uganda’s Makerere University found that although the country’s HIV and Aids prevention programmes primarily focus on younger, unmarried people, new cases of the disease are increasingly occurring among married couples ages 30 to 40,” the New Vision/AllAfrica.com reports.

The study, called Modes of Transmission, was led by Fred Wabwire-Mangen notes that about 650 000 Ugandans are unknowingly living with HIV-positive sexual partners and that almost 85 000 of these individuals, or 13%, will contract the virus if nothing is done to increase awareness.

So what is the best way forward, for the women who cannot negotiate for safe sex from their spouses?

According to Plus HIV Magazine, a website on the Internet, over half of HIV-positive people in the world are women.

Globally, the greatest cause of death among women ages 15-49 is Aids-related complications; Aids diagnoses have disproportionately tripled among women in the last 30 years.

“In Sub-Saharan Africa, women ages 15-24 now account for 75% of all new infections. Young women in sub-Saharan Africa are eight times as likely to be HIV-positive as men,” the website says.

The majority of women who contract HIV do so through heterosexual sexual contact and, in many cases (like 90% of women in Asia, for example) their husbands infected them after marriage.

There is one common denominator to all of these stats: Gender-based violence.

Plus HIV Magazine says it is the number one precursor to a woman being infected with HIV.

Right now at least 1 in 7 new infections in women can be directly attributed to either male partner violence or women’s lack of relational power; generally their main “risk factor” is having sex with their primary male partner, which means they fall outside of every parameter of who has been traditionally targeted as an “at-risk” group.

But make no mistake; women survivors of abuse are an “at-risk” group.

Women and girls who have experienced violence have a substantially increased risk of HIV infection, a risk that is both increased directly through sexual violence or indirectly through increased risky behavior or inability to negotiate safer-sex practices with a partner, the magazine says.

Women abuse survivors are in double jeopardy, as well: they are more likely to be infected by an abusive partner and then once positive, more likely to become a target of abuse.

Studies in Rwanda and Tanzania — in fact, study after study since 2004 — show that HIV-positive women were more likely to report a history of physical violence, sexual coercion, or gender inequality because women subjected to those forms of violence are less likely to request condom use, more likely to have partners who have risky sex behaviours outside their relationship, and more likely to have genital tract injuries associated with sexual violence (which increase HIV susceptibility).

“And once those women seroconvert and are HIV-positive, they are less likely to get treatment, more likely to go off their medication, and to miss health care appointments,” Plus HIV Magazine says.

“Even in the United States where access to medical care and medication are much easier than in other parts of the world, only 41% of women living with HIV are retained in medical care. “You’ve read the headlines earlier this year about the baby once thought functionally cured of HIV?

“The only way the doctors were able to make that breakthrough is because the mother had stopped getting care for her own HIV for a time and finally came back to the doctor for the sake of the child.”

It further reads: “Men are the root of the problem and men must be a part of the solution. We cannot solve this without them.” While there are a number of things we need to do, the first is to include men in the solution.

The links between violence, inequality, and risky behaviour are clear, but more must be done to find ways to reduce each of them.

Research on working men in South Africa, married men in India, and men in methadone treatment programmes in New York who admitted to being perpetrators of intimate partner violence found that this disparate group of men were all far more likely to report multiple sexual partners, thus increasing their risk for HIV.

Some researchers have postulated that abusive men are more likely than non-abusers to be HIV positive or to be infected with co-factors like genital herpes, which make women more vulnerable to HIV transmission.

How do we combat that?

“Altering gender-based abusive behaviours and sexual risk behaviors of men is not a pipe dream. There’s a pilot programme in South Africa that targeted young men, which successfully found reductions in both risky sexual behavior and abusive behaviour,” Plus HIV Magazine says.

“Every community needs a programme like this tailored to their own area’s cultural needs. Men who are violent are trapped in their own cycles that we need to uproot. It can be done.”