This World AIDS Day, Population Action International is exploring a different side of the HIV/AIDS epidemic, one that many people might not even realize is an issue – the prevalence of HIV in marriage. Our new documentary, The Silent Partner: HIV and Marriage, explores this very issue. It tells the stories of women from different backgrounds who were infected with HIV in their own homes, in their own beds, from their own husbands.
Most people believe that if a woman makes it to marriage without contracting HIV, she is safe. However, the reality can be quite different. Judy Atieno, one of the women profiled in The Silent Partner, found out she was HIV-positive while she was pregnant with her fourth child. She says, "You have to depend on this man for everything – the husband, he pays the school fees for the kids, he buys food for the house… you don’t question where he walks, how many women he has outside – for the sake of these children."
Current research shows that, increasingly, marriage is not as protective as previously thought – for men or for women. In Rwanda and Zambia, for example, an estimated 55-93% of new infections occur within marriage or in cohabiting relationships. Condom use within marriage is infrequent, and rates of extramarital partners are higher among men than women in Africa. As Marita Barrassa, one of the women profiled in The Silent Partner, tells us, ".. As a woman I cannot tell my husband to use a condom; that’s just the way I cannot tell my husband not to have sex."
The institution of marriage cannot be considered a safe haven from HIV infection. With evidence-based HIV prevention as the foundation, we must look to integrate sexual and reproductive health and rights programs as well as broader social and economic policies to improve the lives of women and their families. Increasing the involvement of men in reproductive health decision-making, providing couples counseling and testing for HIV, and enacting and enforcing laws against domestic violence and rape are good ways to begin.
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As we mark the 20th anniversary of World AIDS Day, we need to recognize that everyone, no matter their social, economic or marital status, is at risk of HIV if they don’t have access to the education, services and supplies to protect themselves.
Watch a clip from The Silent Partner: HIV in Marriage: