A very proactive wife in Lusaka charged her HIV positive husband $140 per sexual encounter as a risk allowance. They got married in 2005 and in 2010, the husband tested positive for HIV. After the husband tested positive, the wife allowed him to have sex with a condom, but after a while she started charging him a risk allowance. Her reason for charging him a risk allowance was “a way of keeping him off me and also to save money for me instead of squandering it on prostitutes”. She had not received any payment and was having consensual sex with her husband on credit but was seeking a divorce.
Increasing divorce rates have been linked to risky sexual behaviour and likelihood of HIV transmission. Divorce is a strategy some women to prevent HIV transmission from their unfaithful husbands. In fact, women-initiated divorce is becoming more culturally acceptable when husband’s infidelities pose an HIV transmission risk to the woman.
It is common to find women moving from one marriage to another searching for economic support and or to escape violence or risk of HIV transmission. But at the same time, wives who test positive live in fear of disclosing a positive status to their husband because they are afraid of violence or abandonment.
Prevention of Mother-to-Child Transmission (PMTCT) have been called “divorce programmes”. PMTCT programmes demand partners disclose their status to their husband. A number of women dread joining this programme because they fear family problems, abandonment, stigma and hostility. During group discussions in a Malawian study, divorced women advised other women who had violent husbands not to disclose their HIV status for fear of violence.
When men were asked about wives disclosing their HIV status, men explained they felt powerless and experience hostility from the wife’s family because of the HIV positive result. Some men said that how the result is communicated by their wives also affects them, adding that their wives’ angry accusatory outbursts may cause them to leave. For men who had no prior knowledge of their status finding out their wife had tested positive resulted in shock, fear and denial.
A recent Malawian study investigated how married couples knowledge of their HIV status affected divorce, the number of sexual partners and condom use in the marriage. They found that contrary to most community beliefs, knowledge of HIV status does not affect chances of divorce for either HIV negative or HIV positive respondents. Knowledge of HIV status among married couples also reduces the number of sexual partners among the spouse who is HIV positive and increased condom use.