A Qualitative Exploration of HIV Risk Factors among Serodiscordant Married Couples in Gujarat, India Open Access

Patel, Sajani (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/jh343t16t?locale=en
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Abstract

India has the third largest HIV epidemic in the world. About 40% of new infections in India occur among married women ages 15-49. Over 85% of HIV transmission in India is via unprotected sex and the main risk factor for married women has been sexual contact with usually just their spouse, suggesting that women in India are contracting HIV from their husbands. However, few studies have examined HIV transmission risk factors among serodiscordant married couples in India and only a couple have examined these factors among couples in the state of Gujarat. This study aimed to conduct a secondary data analysis of qualitative data collected during the Positive Jeevan Saathi study to determine what HIV risk factors for serodiscordant married couples in Gujarat are and to determine to the extent to which the Theory of Gender and Power fits to this specific context. Key HIV risk factors included the desire to have a child, intimate partner violence, and husband's alcohol use. Some protective factors against HIV included women's greater economic contribution, joint-sleeping arrangements, and knowledge of non-penetrative sex methods. The Theory of Gender and Power was not a perfect fit to this context and there was counterevidence present for each structure of the theory.

Table of Contents

Introduction................................................................................................................... 1

Purpose..........................................................................................................................2

Background.................................................................................................................... 3

HIV in India.................................................................................................................... 3

Country-Context.............................................................................................................. 4

Directionality of HIV Risk.................................................................................................. 5

HIV Risk Factors.............................................................................................................. 7

Theoretical Framework.................................................................................................... 10

Conceptual Model........................................................................................................... 13

Methods........................................................................................................................ 15

Research Design............................................................................................................. 15

Study Location................................................................................................................ 16

Participant Recruitment.................................................................................................... 17

Study Instrument and Data Collection................................................................................ 18

Data Analysis.................................................................................................................. 19

Results........................................................................................................................... 20

Participants..................................................................................................................... 20

Deductive Themes............................................................................................................ 21

Sexual Division of Labor.................................................................................................... 21

Sexual Division of Power................................................................................................... 24

Social Cathexis................................................................................................................ 29

Inductive Themes............................................................................................................ 36

Discussion....................................................................................................................... 42

Future Directions.............................................................................................................. 51

Strengths & Limitations..................................................................................................... 54

Conclusion....................................................................................................................... 56

Appendix A...................................................................................................................... 64

Interview Guide................................................................................................................ 64

Appendix B...................................................................................................................... 67

Coding Tree and Codebook................................................................................................ 67

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