In Their Own Beds: HIV and Marriage

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. 

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:

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  • invalid-0

    I think sometimes that HIV prevention discussions and solutions in the past have sometimes focused to much on the women who contracts the disease. More attention, education must be applied to the males as well in order to really make a difference. With the success of marriages in this day and age, I fear this particular problem may become increasingly worse.

  • invalid-0

    I don’t understand the statistics behind this. Are you saying that new infections are from couples?…. what im asking is, do both party’s know they have contracted Aids or is there one of them that does not know till they are diagnosed? and if they both know are they still having children or un-protected sex?
    I would like to see some other stats on this subject, something everybody needs to know about!

  • invalid-0

    I agree , it’s a little hard to swallow but something must be done to protect married women from HIV , ideally they should be safe because they will be in a monogamous relationship, but sadly in several cases there will be instances in many marriages that cheating will occur and this is where HIV infection might occur.

    However these policies can be fashioned so that they will be more palatable and not so difficult to face.

    -Dino Delellis

  • invalid-0

    I think the real problem is education. In order to combat HIV is absolutely essential that children are educated at a young age. It needs to become ingrained in society that condoms, even within marriage, are the only thing that will ultimately combat HIV.

  • invalid-0

    Though I agree that there should be support systems that will help protect women from HIV infection inside marriage, we should be very careful with the handling of these cases , proper protective measures must be in place so that these women can be allowed to go through the process as painless and less traumatic as possible.

  • invalid-0

    After reading this article it becomes quite clear that HIV/Aids education/prevention should continue and be taken seriously by adults even in marriages. I find the statistic of 55-93% of new infections occuring in marriages in those African countries very concerning. I agree with other posts here that education is key…

  • equalist

    I agree that education is key, but we need to focus more on educating young men about HIV.  The focus has been too much on women, when the fact of the matter is, no matter how much we don’t like it, there are times and situations where if he’s not going to wear a condom, he’s not going to wear a condom, and this is more true in marriage, when often a woman, thinking she’s safe because she’s in a committed relationship, or thinking she has no right to force him, does not insist. 
    In addition, in the united states at least, the idea that HIV is a "gay disease" is far too prevalent, even in today’s tolerant society.  It gives heterosexual couples far too much of a false sense of security.  The school of thought seems to be, "I’m not having homosexual encounters, my partner isn’t having homosexual encounters, so we’re safe from aids."  The fact is, this isn’t true, and far too many are surprised by HIV because of it. 

    Another factor to this, and I may be mistaken, so please correct me if I’m wrong, but aren’t arranged marriages prevalent in the areas of Africa where HIV is so rampant?  It leads one to wonder if that could perhaps be a contributing factor here.  When one’s marriage is a matter of business or family requirement and not a matter of the heart, there is far less incentive to remain faithful to that one person, and less incentive to protect that one person from such harm.


    Equal rights, equal responsibilities.

  • invalid-0

    Nobody thinks about this aspect or at least nobody thought about it so far. Being married does not guarantee safety against HIV, not as long as you allow your spouse to be unfaithful. I know, those women didn’t have many choices, they had to accept the situation still just because of that I think they deserve protection and support.

  • invalid-0

    nice post and great information thank you very much.

  • invalid-0

    It is impossible to change the attitudes of promiscuous migratory workers who return home to their families and pass the disease onto the community. A continent of alpha males will be difficult to educate on these matters.

  • invalid-0

    The sex education in the school aims for completion of the character of a child / the student and the rich human being formation and I arrest you generally, and I accept it for stages of development, and the side of the body, the side of the mind, the side of the society give knowledge of the science and because a child / a student has outlook on opposite sex based on life respect, human being respect, the mind of the gender equality, I think by oneself and judge the human nature and wear ability of the decision-making, and it is to be able to take the appropriate action.

  • invalid-0

    It’s true, that in most third world countries, the man cannot be asked of what he does outside as he is the sole bread earner for the family. I guess 80% of married women getting HIV are from these men who have other women outside of marriage or visit brothels. Really eaducation and literacy is the only solution to this problem.