Barriers to preventing spread of HIV in concurrent sexual partnerships
SEX
Pleasure
Karen says, “Sex should be fun as long as it is between one man and one woman.”However, the respondents believe that men tend to have sex for pleasure and fun as opposed to women who have sex at times as an obligation. The difference between men and women’s view on sex is that men think about it all the time. Jane says,“Women do not. Men relate sex to emotion and women don’t think of sex until men insist it on them. Men will do it for pleasure.” The women whose men have cheated on in the past lack interest in sex and report that their men have at times forced them to have sex against their will. Joseph says, “Sex is a way that I communicate and express myself to my wife. It is important for me to have sex because it is pleasing to me.”
Moreover, 28 year old Karen from Umoja says when asked for her thoughts on the reason men have sex, she says; “men take sex as fun and hilarious”. This shows clearly that most women view sex as a way of getting intimate with a lover, a way of bonding, while to men, it is fun. From the responses of the women interviewed, men enjoy sex more; the men even go as far as raping their wives when the women deny them sex because of family problems and cheating on the part of their wives. The married women give sex as a responsibility, an obligation or a trade-off, the man provides finances for the home while the woman rewards him with sex to keep him from having sex with other women. This shows a great dissatisfaction in having sex on the part of the women. Thomas says, “For me sex is for pleasure. It is a way of intimacy between my wife and me. We also use sex mainly for procreation.”
Sex in exchange for money
All of the women interviewed who lack a stable job and have children and family responsibilities believe that sex is a trade-off, the man provides finances and settles bills while the woman reward him with sex. Jane says, “Sex to me- in my marriage, I value sex very much. I see it as a tradeoff, sex for him and financial blessings for my son and for me”. On the other hand, 28 year old single mother Karen from Umoja says she lacks the ability to provide for her sick mother and her son. She depends on her cheating boyfriend’s contribution to fend for her family. Her priorities goes far beyond sex, she can give sex out to her boyfriend whenever he wants it so long as he provides for their seven year old and sickly mother. Karen says, “As long as he provides for the family financially…..we can use condoms all the time when we have sex.” Kenny on the other hand says, “It is a wife or a girlfriend’s duty to give up sex to her mate, especially when he provides for her and the family”
Procreation
The respondents revealed that unprotected was aimed at getting children. However, most men in marriages for example Jane’s marriage prefer having sex without protection regardless of cheating on her wife. This is a move placing the life of the wife in danger. Most of the respondents in marriages have exhibited distrust on the part of their men. Brigette says, “…mostly we discussed about procreation and having children. And how to make each other happy”
Cheating
Three women out of the five women interviewed complain of their men having cheated on them and losing trust in them. All of the married women interviewed complain that their men have cheated on them at some point in the relationship. Karen, Brigette and Jane complain that their men have been unfaithful to them. When Brigette is prompted with the question of having several sexual partners at the same time, she says, “No but my boyfriend did and I didn’t realize it until recently.” Jane also says, “. But my husband has had several sexual partners while being married to me.” Furthermore Karen also says, “My son’s father took advantage of me and cheated on me with another woman.”
Though Jane is the only married interviewed woman. All the men trust their wives and girlfriends while there are incidences of women lacking trust in their men. Jane has lost trust in her husband and prefers to use a condoms while engaging in sex with him. Though she feels that the husband is putting her life at risk by having many sexual partners she maintains to be with him because he provides. This is a barrier preventing the hindrance of the spread of HIV infection. This is an example of a couple with many other sexual partners of which the wife lacks knowledge whether the husband engages in protected sexual behaviors with the multiple sex partners or not. Karen, Jane, and Brigette are women who are victims of the men in their lives cheating on them while Thomas admits to cheating with another woman three times while in a relationship though the sex was protected. Thomas says, “I did it three times with another lady” when asked about having any other sexual encounters within the past year.
Margaret accepts that she will stick by her fiancé even if she notices that he cheats and contracts HIV Aids. She admits that she would take care of him but ensure that she has protected sex with him but she has no idea of how to have children while with a partner who is HIV positive. Moreover, Karen’s boyfriend and the father of her son, has another child with another woman while still in a relationship with Karen. She insists that she would forgive the cheating boyfriend because he is the sole provider of the home. Family responsibility bar her from taking the bold step of quitting on a relationship that is full of cheating and might lead to contraction of HIV/Aids. Willie says, “I take care of all her expenses. If she was to cheat on me, she would lose out on benefits big time. I wouldn’t respect or trust her anymore. Not at all.”
Economic inequality
Thomas known as Kenny confesses serving his wife with no-sex—no money ultimatum. His financial power grants him the ability to mold his wife into some kind of sexual machine, getting sex from the wife whenever he wants and to his satisfaction. Thomas says, “if she doesn’t give me sex, then I would leave her and she won’t have any money” This is very risky because the women lack a say on the sex, men have full control on their health and can infect their wives with HIV without the control of the wife. Jane’s position makes her vulnerable to HIV/Aids infection.
Condom resources
The respondents accept that condoms are available for free in the clinics, though most men do not prefer to use condoms citing such reasons as culture or the belief that married couples should not use condoms except when one is cheating in the marriage. Willie says, “Honestly, I didn’t use condoms much.” Jane says the use of condoms is against her culture, when she proposes the use of condom to her husband, she fails to execute her words. She says, “… then we fight about it. If he forces me to have sex, then he won’t put a condom on.” Jane is forced to have sex without a condom with her husband. Men like Thomas, accept cheating on their wives but using condoms.
The condoms are available but the men refuse to wear condoms while having sex with their wives. Men cling to a belief that unprotected sex is to be exercised by married couples only. This shows the extent of knowledge of having unprotected sex with any individual who is not married to a party without protection. Thomas says, “I used condoms with her because she wasn’t my wife.” On the other hand when Joseph is asked his thoughts regarding the use of condoms he says, “Condoms are helpful when you don’t want to have a baby and even to protect yourself from getting an STD. I don’t like the way it feels but my wife and I use it when we have it around. ”Moreover, all the interviewed respondents confirm that their parents never taught them about sex and the use of condoms, they got to know it through the interaction with people of the opposite sex. However, all the respondents affirm that they would teach their children on the need to use condoms and what sex is all about.
Managing finances
The responsibility of the man is to settle bills for the family and provide for the basic needs of the home. This gives the man a very important role making him the decision maker of the home. Financial management gives the man command over their wives as stated by the wives and girlfriends, they dictate how to have sex, when to have the sex and the frequency of the sex. This is a risk factor because a cheating partner can easily transmit the infection to the other. When Annett is asked the responsibility of the man in her home she says, “To provide for his family financially.” This role of provision is accepted by all the respondents as the responsibility of the man. Donald says, “My role is to take care of my family and provide the finances for the family” when prompted with a question. This showsthat the man is tasked with the responsibility of taking care of the finances.
Gender responsibility
When Joseph is asked a question on his gender responsibility he says that, “I must take care of my family financially, protect my family”. Willie says, “My job in the house is to provide money for my family”. Women for example Annette respond to the question on gender roles on her responsibility on the household as a woman, she says, “I take care of the household. I do laundry.” This means the men cater for financial obligations of their families while the women take care of the house hold on such matters as cleaning and cooking.
Beliefs
Attitudes and knowledge of knowledge of Kenyan males and females concerning HIV risk reduction techniques
Transmission
All of the respondents have knowledge of ways of transmission of the HIV/Aids infection. They do have knowledge that the transmission and infection of HIV comes about in the form of having unprotected sex with an infected person, and body fluids of an infected person getting into contact with that of a healthy individual. All the respondents exhibited knowledge on ways of transmission of HIV/Aids
HIV testing
90% of the respondents have knowledge that the only sure way of knowing if an individual is HIV positive is through HIV testing. Donald accepts that they have HIV testing once every year with his girlfriend to know their status. All the respondents keep check of their HIV status as a way of knowing their status and preventing the possibility of infecting their partners.
The responses from interviewees show knowledge of HIV testing and transmission, however, family obligations maintain them in abusive relationships that could lead to the contraction of HIV/Aids infection. Moreover, habits such as drug use and alcohol bars them from protecting themselves and their spouses, they end up exposing their wives and girlfriends to the danger of being infected with HIV/Aids. Karen, Margaret, Donald and Thomas admit to taking HIV tests as a way of knowing their status and protecting their spouses from getting HIV.
Trust
Majority of the interviewees do not trust their spouses, especially those who are married. Jane distrusts her husband and complains of long trips but she still engages in unprotected sex with the husband, she lacks the ability to contain the situation and concentrates on her health first before responsibilities in the home. Of all the women interviewed, Jane is the only person who has been married for 17 years. This shows that most of the married women cling to abusive relationships because of providence from the man and lack of an alternative to tackle the problems that they do have. This has an effect of encouraging the spread of HIV/Aids.
Karen on the other hand has a cheating boyfriend and opts to stay with him even if he has another child outside their relationship. The interviewed women are mature and in the age brackets of mature adults with the least age being 28 years of age. This is a representation of the society and what happens in Kenya in regards to HIV infection and transmission. The women remain in the relationships without trust focusing on the man’s ability to provide negating important facets such as fidelity and health. This can further fuel HIV prevalence because it encourages cheating in relationships.
Condoms
The female respondents prefer to use condoms to prevent being infected by their men with the HIV/ Aids virus and as a way of preventing pregnancies. However, the men do not like the use of condoms. Donald says they formerly used to engage in sex with the girlfriend using condoms but they use “pulling out” as a way of avoiding pregnancy. The men detest the use of condoms with Willy saying condoms ought not to be used by married couples. He describes condoms as a way of protecting one’s self when cheating on a spouse. On the other hand, Jane’s husband refuses to heed his wife’s request to have sex while wearing condoms. The men have much control over their spouses and makes the use of condoms difficult because they detest using it too.
Cultural practices such as polygamy and gender inequality on infection rate of married and cohabiting couples in Kenya
MARRIAGE
Polygamy
According to the interview the married couples such as Jane detested polygamy. All of the respondents reflected a distaste of the practice but pointed out to some individuals in their lineage who participated in polygamy. Polygamy increases the number of sexual partners in a marriage. The Christian faith is against polygamy according to Jane but other religions such as Islam accepts polygamy and encourages it among the Muslim men. With increased number of sexual partners, there is little trust in such a setting.
Force
Two of the female respondents during the interview reported that their men forced them to have sex with them even when they lacked the drive to have it. Thomas uses force to have sex with the wife by giving her ultimatums taking advantage of her vulnerable financial status. When Jane is prompted to answer a question on men using force she says, “He will force the woman to have sex whether she want to or not.” This shows that some Kenyan men are brutal in their marriages, they see themselves as the owner of their women and use them as sexual toys to fulfill their sexual desires. Nevertheless, Thomas claims that he grants his wife with an ultimatum that should she refuse to give him sex he would not give her money. The wife therefore accepts to have sex whenever he wants it and in whichever way he deems fit. This is rape.Jane is an example of such a woman whose husband, as she puts it, cheats on her this makes her lose trust in the sex between her and her husband. She prefers to have protected sex with her husband but lacks control to execute her decision.
Control
In the marriages the picture created by the interviewed men and women is that the men are in full control of the home. They control the finances as well as the way and when to have sex. These men are not custodians of the use of condoms in the prevention of infection against HIV/Aids.Moreover, they take the use of condoms in a marriage as a taboo especially in the Islam religion. This has the effect of increasing the spread of HIV/Aids among married couples. The use of force in marriage in order to have sex with a spouse is also under man’s control. 20% of the female respondents have confessed to being forced to have sex with their men.