HIV Transmission from Husbands to Wives in Cambodia: the Women's Lived Experiences

Abstract

In spite of an impressive overall decline since 1997, HIV transmission among married women has emerged as a new threat in Cambodia. The purpose of this interpretive phenomenological investigation was to understand the culturally and socially embedded meanings and lived experience of Cambodian women whose HIV infected spouses transmitted HIV to their wife. The theoretical framework and assumptions of Heidegger phenomenology guided this inquiry. Fifteen married women, who were infected with HIV from their husbands, completed grade 12 or less, and were sexually active with their husbands, participated in the investigation. The women's narratives revealed cultural beliefs and practices in marriage, as well as the experiences of discovering HIV and living with the virus. The overarching theme was The Loss of the Past, the Loss of the Future as a Life Journey of a Khmer woman before and after her HIV diagnosis. From the view of the woman as a person, women lost their sense of self in their past and were forsaken ones in their future. Analysis yielded four main themes: (a) Adhering to Traditional Khmer Family Values and Fulfilling the Role of a Khmer Wife; (b) Becoming a Person with HIV, (c) Undergoing Changes, and (d) Moving on with Life. The participants reported their lives had been focused on the adherence to cultural Khmer gender values since they were young girls. However, their husbands lived only for their own happiness, ignoring their societal role of head of household, engaging in risky sex both within and outside the marriage. The women's lives of faithfulness were rewarded with HIV infection. After learning of the HIV diagnosis, the women and their families underwent many changes including in their social relationships and economic consequences. In spite of enormous losses, the women had hope for their lives. Conclusion. The women's lived experiences in becoming HIV positive from their spouse adds to our understanding of the gender, social, and cultural mechanisms by which HIV is transmitted within marriage. Study results provide suggestions for future needed research and programs that are culturally acceptable and potentially effective in curving intra-marriage HIV transmission.