Dar es Salaam. A new Ifakara Health Institute study has found “a significant association between lifetime (proxy) extramarital affairs and HIV infection among women only,” with the risk being significantly higher in Village Community Bank (Vicoba) members, among other groups.
One of the lead scientists in the project, Dr. Sally Mtenga (pictured) of Ifakara Health Institute, says the study, which investigated the link between gender, extramarital affairs and HIV, was conducted in the rural settings of Ifakara in Morogoro Region involving over 3,800 married partners.
“The most interesting part is how being a member of Vicoba relates to the risk of engaging in extramarital affairs. The implication of this particular observation is provided in the last lines of the abstract,” she says, elaborating:
“Vicoba could be a platform for HIV prevention interventions so that there is an interface between economic empowerment programs and HIV prevention interventions. And those individual centered approaches to HIV vulnerability such as health promotion are no longer adequate to address the multiple dimensions of sexual behaviors. Instead, approaches should be tailored within the broader determinants of risk behaviors including the context that contribute to it.”
In conducting the study, whose results have been published in the AIDS Research and Therapy journal on June 7, 2018, Dr. Mtega teamed up with other scientists – Constanze Pfeiffer, Marcel Tanner, Eveline Geubbels and Sonja Merten – from IHI, the Swiss Tropical and Public Health Institute (Swiss TPH) in Basel, Switzerland and University of Basel, Switzerland.
Apart from Vicoba members, other groups in extramarital affair whose risk is deemed significantly higher are: the re-married, consumers of alcohol, those from southern regions, non-Muslims, and those with older age.
“In the case of recent extramarital affairs (12 months prior to survey), associations were significant for the same variables except for religion, having an income was also associated with the outcome. Qualitative narratives reflected that, desire to prove manhood (masculinity) supported by societal normative beliefs such as; ‘it is not realistic for a man to stay without extramarital partner’ and religious beliefs; ‘a man shall dominate a woman’ encouraged men’s extramarital affairs,” reads the study findings, in part.
The scientists recommend that future programs seeking to address risk sexual behaviors in Tanzanian marriages should consider context-sensitive interventions which address aspects beyond ‘individual risk’ and women’s financial uncertainties.
The strongly recommend for the future programs to include couple’s relationship quality, excessive alcohol behaviors, normative masculinity ideology and societal norms, that encourage women’s economic dependence and men’s engagement in multiple sexual partnerships.
The researchers are optimistic that microfinance projects, such as Vicoba, could be a platform for gender-transformative approaches, combining economic empowerment and HIV risk protection strategies. #
Read Sally’s profile here.
Learn more about her research interests and publications here.