'It is not expected for married couples': a qualitative study on challenges to safer sex communication among polygamous and monogamous partners in southeastern Tanzania.
Identifieur interne : 000868 ( PubMed/Corpus ); précédent : 000867; suivant : 000869'It is not expected for married couples': a qualitative study on challenges to safer sex communication among polygamous and monogamous partners in southeastern Tanzania.
Auteurs : Sally Mmanyi Mtenga ; Eveline Geubbels ; Marcel Tanner ; Sonja Merten ; Constanze PfeifferSource :
- Global health action [ 1654-9880 ] ; 2016.
Abstract
Background Behavioral change approaches for human immunodeficiency virus (HIV) prevention in Tanzania encourage married partners to observe safe sex practices (condom use, avoidance of, or safe sex with multiple partners). To implement this advice, partners need to communicate with each other about safer sex, which is often challenging. Although social-structural factors are crucial in understanding sexual behavior, only a few studies focus on understanding safer sex dialogue in a broader social context. Design Drawing on the WHO-Commission on the Social Determinants of Health (WHO-CSDH) framework, this study explored key social-structural constructs for studying health in the context of improving safer sex dialogue between polygamous and monogamous partners. Twenty-four in-depth interviews (IDIs) and six focus group discussions (FGDs) with 38 men and women aged 18-60 years were conducted in Ifakara town located in Kilombero district, Tanzania. The study was nested within the community health surveillance project MZIMA (Kiswahili: 'being healthy'). Partners' experiences of safer sex dialogue in polygamous and monogamous relations were investigated and the challenges to safer sex dialogue explored. Results The study revealed that open safer sex dialogue in marriage is limited and challenged by social norms about marriage (a view that safer sex dialogue imply that partners are 'not really' married); marital status (a belief that safer sex dialogue is not practical in polygamous marriages, the elder wife should be exempted from the dialogue since she is at lower risk of engaging in extramarital affairs); relationship quality (marital conflicts, extramarital affairs, trust, and sexual dissatisfaction); and gender power relations (the notion that females' initiative to discuss condom use and HIV couple counseling and testing may lead to conflict or divorce). Conclusions Implementing safer sex practices requires interventions beyond promotion messages. HIV prevention interventions in Tanzania should be carefully adapted to the local context including respective social norms, gender systems, marital context and relationship uncertainties as aspects that facilitate or hinder safer sex dialogue between partners. The WHO-CSDH framework could be strengthened by explicitly integrating relationship quality, marital status, and social norms as additional determinants of health.
DOI: 10.3402/gha.v9.32326
PubMed: 28156922
Links to Exploration step
pubmed:28156922Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">'It is not expected for married couples': a qualitative study on challenges to safer sex communication among polygamous and monogamous partners in southeastern Tanzania.</title>
<author><name sortKey="Mtenga, Sally Mmanyi" sort="Mtenga, Sally Mmanyi" uniqKey="Mtenga S" first="Sally Mmanyi" last="Mtenga">Sally Mmanyi Mtenga</name>
<affiliation><nlm:affiliation>a Ifakara Health Institute (IHI) Ifakara , Tanzania.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Geubbels, Eveline" sort="Geubbels, Eveline" uniqKey="Geubbels E" first="Eveline" last="Geubbels">Eveline Geubbels</name>
<affiliation><nlm:affiliation>a Ifakara Health Institute (IHI) Ifakara , Tanzania.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Tanner, Marcel" sort="Tanner, Marcel" uniqKey="Tanner M" first="Marcel" last="Tanner">Marcel Tanner</name>
<affiliation><nlm:affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Merten, Sonja" sort="Merten, Sonja" uniqKey="Merten S" first="Sonja" last="Merten">Sonja Merten</name>
<affiliation><nlm:affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pfeiffer, Constanze" sort="Pfeiffer, Constanze" uniqKey="Pfeiffer C" first="Constanze" last="Pfeiffer">Constanze Pfeiffer</name>
<affiliation><nlm:affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</nlm:affiliation>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="2016">2016</date>
<idno type="RBID">pubmed:28156922</idno>
<idno type="pmid">28156922</idno>
<idno type="doi">10.3402/gha.v9.32326</idno>
<idno type="wicri:Area/PubMed/Corpus">000868</idno>
<idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000868</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en">'It is not expected for married couples': a qualitative study on challenges to safer sex communication among polygamous and monogamous partners in southeastern Tanzania.</title>
<author><name sortKey="Mtenga, Sally Mmanyi" sort="Mtenga, Sally Mmanyi" uniqKey="Mtenga S" first="Sally Mmanyi" last="Mtenga">Sally Mmanyi Mtenga</name>
<affiliation><nlm:affiliation>a Ifakara Health Institute (IHI) Ifakara , Tanzania.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Geubbels, Eveline" sort="Geubbels, Eveline" uniqKey="Geubbels E" first="Eveline" last="Geubbels">Eveline Geubbels</name>
<affiliation><nlm:affiliation>a Ifakara Health Institute (IHI) Ifakara , Tanzania.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Tanner, Marcel" sort="Tanner, Marcel" uniqKey="Tanner M" first="Marcel" last="Tanner">Marcel Tanner</name>
<affiliation><nlm:affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Merten, Sonja" sort="Merten, Sonja" uniqKey="Merten S" first="Sonja" last="Merten">Sonja Merten</name>
<affiliation><nlm:affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pfeiffer, Constanze" sort="Pfeiffer, Constanze" uniqKey="Pfeiffer C" first="Constanze" last="Pfeiffer">Constanze Pfeiffer</name>
<affiliation><nlm:affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</nlm:affiliation>
</affiliation>
</author>
</analytic>
<series><title level="j">Global health action</title>
<idno type="eISSN">1654-9880</idno>
<imprint><date when="2016" type="published">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background Behavioral change approaches for human immunodeficiency virus (HIV) prevention in Tanzania encourage married partners to observe safe sex practices (condom use, avoidance of, or safe sex with multiple partners). To implement this advice, partners need to communicate with each other about safer sex, which is often challenging. Although social-structural factors are crucial in understanding sexual behavior, only a few studies focus on understanding safer sex dialogue in a broader social context. Design Drawing on the WHO-Commission on the Social Determinants of Health (WHO-CSDH) framework, this study explored key social-structural constructs for studying health in the context of improving safer sex dialogue between polygamous and monogamous partners. Twenty-four in-depth interviews (IDIs) and six focus group discussions (FGDs) with 38 men and women aged 18-60 years were conducted in Ifakara town located in Kilombero district, Tanzania. The study was nested within the community health surveillance project MZIMA (Kiswahili: 'being healthy'). Partners' experiences of safer sex dialogue in polygamous and monogamous relations were investigated and the challenges to safer sex dialogue explored. Results The study revealed that open safer sex dialogue in marriage is limited and challenged by social norms about marriage (a view that safer sex dialogue imply that partners are 'not really' married); marital status (a belief that safer sex dialogue is not practical in polygamous marriages, the elder wife should be exempted from the dialogue since she is at lower risk of engaging in extramarital affairs); relationship quality (marital conflicts, extramarital affairs, trust, and sexual dissatisfaction); and gender power relations (the notion that females' initiative to discuss condom use and HIV couple counseling and testing may lead to conflict or divorce). Conclusions Implementing safer sex practices requires interventions beyond promotion messages. HIV prevention interventions in Tanzania should be carefully adapted to the local context including respective social norms, gender systems, marital context and relationship uncertainties as aspects that facilitate or hinder safer sex dialogue between partners. The WHO-CSDH framework could be strengthened by explicitly integrating relationship quality, marital status, and social norms as additional determinants of health.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28156922</PMID>
<DateCreated><Year>2017</Year>
<Month>02</Month>
<Day>03</Day>
</DateCreated>
<DateRevised><Year>2017</Year>
<Month>02</Month>
<Day>03</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1654-9880</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>9</Volume>
<Issue>1</Issue>
<PubDate><Year>2016</Year>
<Month>Jan</Month>
</PubDate>
</JournalIssue>
<Title>Global health action</Title>
<ISOAbbreviation>Glob Health Action</ISOAbbreviation>
</Journal>
<ArticleTitle>'It is not expected for married couples': a qualitative study on challenges to safer sex communication among polygamous and monogamous partners in southeastern Tanzania.</ArticleTitle>
<Pagination><MedlinePgn>32326</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.3402/gha.v9.32326</ELocationID>
<Abstract><AbstractText>Background Behavioral change approaches for human immunodeficiency virus (HIV) prevention in Tanzania encourage married partners to observe safe sex practices (condom use, avoidance of, or safe sex with multiple partners). To implement this advice, partners need to communicate with each other about safer sex, which is often challenging. Although social-structural factors are crucial in understanding sexual behavior, only a few studies focus on understanding safer sex dialogue in a broader social context. Design Drawing on the WHO-Commission on the Social Determinants of Health (WHO-CSDH) framework, this study explored key social-structural constructs for studying health in the context of improving safer sex dialogue between polygamous and monogamous partners. Twenty-four in-depth interviews (IDIs) and six focus group discussions (FGDs) with 38 men and women aged 18-60 years were conducted in Ifakara town located in Kilombero district, Tanzania. The study was nested within the community health surveillance project MZIMA (Kiswahili: 'being healthy'). Partners' experiences of safer sex dialogue in polygamous and monogamous relations were investigated and the challenges to safer sex dialogue explored. Results The study revealed that open safer sex dialogue in marriage is limited and challenged by social norms about marriage (a view that safer sex dialogue imply that partners are 'not really' married); marital status (a belief that safer sex dialogue is not practical in polygamous marriages, the elder wife should be exempted from the dialogue since she is at lower risk of engaging in extramarital affairs); relationship quality (marital conflicts, extramarital affairs, trust, and sexual dissatisfaction); and gender power relations (the notion that females' initiative to discuss condom use and HIV couple counseling and testing may lead to conflict or divorce). Conclusions Implementing safer sex practices requires interventions beyond promotion messages. HIV prevention interventions in Tanzania should be carefully adapted to the local context including respective social norms, gender systems, marital context and relationship uncertainties as aspects that facilitate or hinder safer sex dialogue between partners. The WHO-CSDH framework could be strengthened by explicitly integrating relationship quality, marital status, and social norms as additional determinants of health.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mtenga</LastName>
<ForeName>Sally Mmanyi</ForeName>
<Initials>SM</Initials>
<AffiliationInfo><Affiliation>a Ifakara Health Institute (IHI) Ifakara , Tanzania.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>c Society Gender and Health University of Basel, Basel , Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Geubbels</LastName>
<ForeName>Eveline</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>a Ifakara Health Institute (IHI) Ifakara , Tanzania.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>d INDEPTH Network Accra , Ghana.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tanner</LastName>
<ForeName>Marcel</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>c Society Gender and Health University of Basel, Basel , Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>d INDEPTH Network Accra , Ghana.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Merten</LastName>
<ForeName>Sonja</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>c Society Gender and Health University of Basel, Basel , Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pfeiffer</LastName>
<ForeName>Constanze</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>b Swiss Tropical and Public Health Institute (Swiss TPH) Basel , Switzerland.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>c Society Gender and Health University of Basel, Basel , Switzerland.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Glob Health Action</MedlineTA>
<NlmUniqueID>101496665</NlmUniqueID>
<ISSNLinking>1654-9880</ISSNLinking>
</MedlineJournalInfo>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">HIV vulnerability</Keyword>
<Keyword MajorTopicYN="N">Tanzania</Keyword>
<Keyword MajorTopicYN="N">communication</Keyword>
<Keyword MajorTopicYN="N">marital relationship</Keyword>
<Keyword MajorTopicYN="N">marriage</Keyword>
<Keyword MajorTopicYN="N">polygamous</Keyword>
<Keyword MajorTopicYN="N">qualitative study</Keyword>
<Keyword MajorTopicYN="N">safer sex</Keyword>
<Keyword MajorTopicYN="N">social norms</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2017</Year>
<Month>2</Month>
<Day>4</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2017</Year>
<Month>2</Month>
<Day>6</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2017</Year>
<Month>2</Month>
<Day>6</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">28156922</ArticleId>
<ArticleId IdType="doi">10.3402/gha.v9.32326</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaGhanaV1/Data/PubMed/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000868 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/PubMed/Corpus/biblio.hfd -nk 000868 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= SidaGhanaV1 |flux= PubMed |étape= Corpus |type= RBID |clé= pubmed:28156922 |texte= 'It is not expected for married couples': a qualitative study on challenges to safer sex communication among polygamous and monogamous partners in southeastern Tanzania. }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/PubMed/Corpus/RBID.i -Sk "pubmed:28156922" \ | HfdSelect -Kh $EXPLOR_AREA/Data/PubMed/Corpus/biblio.hfd \ | NlmPubMed2Wicri -a SidaGhanaV1
![]() | This area was generated with Dilib version V0.6.31. | ![]() |