Spousal communication about the risk of contracting HIV/AIDS in rural Malawi

This paper uses qualitative and quantitative data from married men and women in rural Malawi to examine how they comprehend their risk to HIV/AIDS and what preventive strategies they consider within marriage. Program efforts to promote behavior change have consistently focused on promoting chastity before marriage and fidelity while married or using condoms. These behavioral prescriptions are suitable for extramarital contexts but not within marriage, where the condom is far from being accepted as a suitable preventive tool and spouses face the reality that one’s vulnerability to AIDS is not confined to his/her behavior alone. The survey data show, unsurprisingly, that those who have the most reason for concern (e.g. those worried about contracting the disease) and those who have greater program and informal social contacts are most likely to communicate. The semi-structured interviews show that husbands and wives use subtle and gendered strategies to encourage fidelity; they talk to each other about the consequences of HIV/AIDS on their children’s and their own lives as a prelude for highlighting and justifying joint sexual prudence. These results show that rather than giving up to fate, marital partners are actively challenging and persuading each other to reform sexual behavior to avoid the intrusion of HIV/AIDS into the home.