Study on HIV Prevention, Infertility and Concordance in Partner Selection among Couples Living with HIV and AIDS in Rural and Peri-Urban Contexts in Botswana

Using qualitative research techniques, this paper investigates marital partner selection and the significance of fertility status among HIV-positive couples. This research was carried out in Botswana’s Maun and Gaborone regions, where patrilineal marriage customs are prevalent and both civil and traditional marriage practises are practised. After new civil marriages and where HIV status was positive for both spouses, data was obtained from 32 respondents using in-depth interviews. The findings of the study show that HIV status has a social impact on the marriage partners chosen by HIV-positive couples. However, once new marital relationships are established based on HIV status compatibility, the cultural value of fertility and childbearing remains paramount, and unprotected sex rates remain high. Even when they were aware of mother-to-child transmission and increased viral loads in their own bodies, HIV positive and concordant couples engaged in unprotected sex in order to affirm positive social status through reproductive success. The importance of understanding cultural norms surrounding fertility desires and fears of infertility in developing effective HIV prevention programmes is demonstrated in this paper. In a context where HIV infection rates have remained high, HIV concordant couples still pursue fertility success with partners, and this paper adds to the literature on both partner selection with regard to HIV status and the importance of qualitative investigation to elucidate cultural challenges to HIV prevention. In order to help inform policies in the development of evidence-based preventive measures in Botswana with respect to people living with HIV and AIDS, the paper concludes with additional suggestions for recognising the frequently ignored cultural significance of infertility in areas with elevated HIV infection rates.

Author (s) Details

Rebecca L. Upton
Department of Sociology & Anthropology, DePauw University, Greencastle, IN 46135, USA

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