Exploring marital safety: three South African wives living with HIV in nonmutual monogamous marriage

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For wives who have been sexually monogamous, their being infected with HIV disrupts the cultural assumption of sexual safety in marriage. This phenomenological interview study shows how three married South African women, who were diagnosed with HIV and had reported being monogamous, experienced gendered distress while contemplating the failures of married coupledom in offering safety and familial stability. Constructionist thematic analysis showed three themes to represent changes in the marital unit. The first theme, HIV as Demarcation of Enduring Disruption, pointed to infection as the harbinger of distressing relational dynamics. The second theme, Feeling Controlled, reflected domains in which the wives felt trapped: restricted freedoms and obligatory intimacy. The third theme, Relational Deterioration, showed meanings about infidelity, fights or arguments, and distress about partner disengagement. Highlighted in this analysis is that, for two women, male control and disempowerment after having been infected with HIV added to their experiences of feeling trapped because they felt pressured into regressing into subservient spousal roles. They were required to retreat into household, mothering, and child care duties. The study’s practice implication is that, to address the aftermath of the discovery of HIV infection in heterosexual married couples, wherein sexual monogamy remains the unquestioned norm, health psychology and clinical interventions should incorporate a gendered approach in counselling formulation.