A Grounded Theory Study of How Muslim Wives Adapt to Their Relationships with Husbands Who Are HIV-Positive

Main Article Content

Agnes Yeni L.N
Praneed Songwathana
Pajongsil Perngmark


                Staying in marital relationships with husbands who are HIV-positive is a challenge for wives, especially in the Muslim context. The purpose of this study was to explore how Muslim wives managed to maintain their HIV-negative status and marital life with their husbands being HIV-positive. A grounded theory approach was conducted using in-depth interviews of 15 married women who were known to be HIV-negative and were recruited from voluntary counselling and testing clinics, local non-governmental organizations and peer group leaders from five towns in East Java Province, Indonesia. Each interview was conducted in places that were mutually chosen by both participants and the researcher. Transcription of interviews, analysis and interpretation were undertaken simultaneously using a constant comparative analysis.

                 The findings revealed that “Sharing control in maintaining marital relationship and HIV sero-negative status” was the core category. Three themes were identified as Muslim wives’ strategies to be with their husbands who were HIV-positive: 1) Learning to maintain the difference of their HIV status, 2) Adjusting to married life without fear, and 3) Managing daily risk for sexual safety under contract. These findings point to the importance of married life relationship and the choice-making skill to be safe from HIV infection when facing dilemmas. The findings can promote the understanding of the wives’ protective and safe ways of living with husbands who are HIV-positive. They can be used to guide nurses at clinics and family nurse practitioners in the counseling of married Muslim wives under the context of HIV prevention in married life.

Article Details

How to Cite
Yeni L.N A, Songwathana P, Perngmark P. A Grounded Theory Study of How Muslim Wives Adapt to Their Relationships with Husbands Who Are HIV-Positive. PRIJNR [Internet]. 2020 Mar. 14 [cited 2022 Aug. 16];24(2):187-201. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/184512
Original paper


UNAIDS. UNAIDS data 2017. Switzerland: Geneva; 2017.

Ditjen P2P. Situation report: HIV-AIDS & PIMS progress in Indonesia January - March 2017. Jakarta; 2017 [in Bahasa].

Komisi Penanggulangan AIDS Nasional. National HIV and AIDS strategy and action plan 2010-2014. Jakarta: Komisi Penanggulangan AIDS Nasional; 2010 [in Bahasa].

Green EC, Halperin DT, Nantulya V, Hogle JA. Uganda’s HIV prevention success: The role of sexual behavior change and the national response. AIDS Behav [Internet]. 2006; 10(4): 335-46. Available from: https://www.ncbi.nlm. nih.gov/pmc/articles/ PMC1544373/

Muessig KE. & Cohen, MS. Advances in HIV prevention for serodiscordant couples. Curr HIV/AIDS Rep. 2014; 11:434–46. DOI 10.1007/s11904-014-0225-9.

Popoola BI. Sex-negotiation strategies and safer-sex practices among married women in South-western Nigeria. Sex Relatsh Ther [Internet]. 2009; 24(3–4):261–70. Available from: http://search.ebscohost.com/login.aspx? direct= true&db=rzh&AN= 2010510178&site=ehost-live

Tenkorang EY. Negotiating safer sex among married women in Ghana. Arch Sex Behav. 2012;41:1353–62.

Wolff B, Blanc AK, Gage AJ. Who decides? Women’s status and negotiation of sex in Uganda. Cult Health Sex. 2000;2(3):303–22.

Rispel LC, Cloete A, Metcalf CA, Moody K, Caswell G. ‘It [HIV] is part of the relationship’: exploring communication among HIV-serodiscordant couples in South Africa and Tanzania. Cult Health Sex [Internet]. 2012 Nov 14;14(3): 257–68. Available from: http://dx.doi.org/10.1080/ 13691058.2011.621448

Ridwan ES, Syafar M, Natsir S. Barriers of prevention behavior of HIV and AIDS in serodiscordant couples in Makassar. J Promosi Kesehat Nusant Indones [Internet]. 2013;11(11). Available from: http://pasca.unhas.ac.id/ jurnal/files/ 49980be8ebb54ee7ca468070fd9d0b86. pdf [in Bahasa].

World Health Organization. Guidance on pre-exposure oral prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV [Internet]. World Health Organization; 2012. Available from: http://www.ncbi.nlm.nih.gov/books/ NBK132003/pdf/Bookshelf_NBK132003.pdf

Gitonga M, Ballidawa J, Ndege S. Challenges and coping strategies among couples of mixed HIV status presenting at a large comprehensive care centre in Eldoret, Kenya. J Biol Agric Healthc. 2012;2(8).

Dogarawa AB. Marriage and divorce in Islam [Internet]. Zaria; 2009. Available from: https://mpra.ub.uni-muenchen. de/23194/1/Marriage_and_Divorce_in_Islam.pdf

Parker L, Creese H. The stigmatisation of widows and divorcees (janda) in Indonesian society. Indones Malay World [Internet]. Routledge; 2016 Jan 2;44(128):1–6. Available from: https://doi.org/10.1080/13639811. 2015.1111647

Krier SE. Our roots, our strength: The jamu industry, women’s health and Islam in contemporary Indonesia. ProQuest Diss Theses [Internet]. 2011; Available from: http://search. proquest.com.ezp-prod1.hul.harvard.edu/docview/ 908423828? accountid=11311%5Cnhttp://sfx.hul. harvard.edu/sfx_local?url_ver=Z39.88-2004& rft_val_ fmt=info:ofi/fmt:kev:mtx:disserta tion&genre= dissertatio ns+&+theses&sid=ProQ:Pr oQuest+Dissertations +&+T

Morita A, Saktiawati I, Worth H, Lazuardi E, Spooner C, Subronto YW, et al. I just trust Him: The notion of consideration as a barrier to condom use amongst women who inject drugs in Central Java. 2013;2013(December):298–304.

Birks M, Mills J. Grounded Theory: A practical guide. London: Sage Publications Ltd; 2011.

Johnson L. Adapting and combining constructivist grounded theory and discourse analysis: A practical guide for research. Int J Mult Res Approaches [Internet]. Maleny: Taylor & Francis Ltd.; 2014 Apr;8(1):100–16. Available from: http://search.proquest.com/docview/1545506503? accountid=28431

Kementerian Kesehatan RI. Report of HIV-AIDS & STIs in Indonesia January - March 2017. Jakarta; 2017 [in Bahasa].

Lincoln SY. & Guba EG. Naturalistic inquiry. Thousand Oaks, CA: Sage, 1985.

Kusujiarti S. Hidden power in gender relations among Indonesians: A case study in a Javanese Village, Indonesia. University of Kentucky; 1995.

Li L, Wu S, Wu Z, Sun S, Cui H, Jia M. Understanding family support for people living with HIV/AIDS in Yunnan, China. AIDS Behav [Internet]. 2006 Sep;10(5):509–17. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC2795327/

Bunnell RE, Nassozi J, Marum E, Mubangizi J, Malamba S, Dillon B, et al. Living with discordance: knowledge, challenges, and prevention strategies of HIV-discordant couples in Uganda. AIDS Care. England; 2005 Nov; 17(8):999–1012.

Andayani B, Ancok D, Wulan R. From love to family happiness: A theoretical model for Javanese Family. Eur J Soc Sci [Internet]. 2018;12(1):24–34. Available from: http:// journals.euser.org/index.php/ejser/article/view/3215

Ruark A, Green EC., Nunn A., Kennedy C., Adams A., Dlamini-Simelane D., et al. Navigating intimate sexual partnerships in an era of HIV: dimensions of couple relationship quality and satisfaction among adults in Eswatini and linkages to HIV risk. J Social Aspects of HIVAIDS. 2019: 16(1): 10–24. https://doi.org/10. 1080/17290376.2019.1604254

Villar-Loubeta OA, Bruscantinia L, Shikwaneb ME, Weissa S, Peltzerb K, Jones DL. HIV disclosure, sexual negotiation and male involvement in prevention-of-mother-to-childtransmission in South Africa. Cult Health Sex. 2013; 15(3): 253–68.

Hallal RC, Raxach JC, Barcellos NT, Maksud I. Strategies to prevent HIV transmission to serodiscordant couples. Rev Bras Epidemiol. 2015;18(1):169–82.

Liu H, Su Y, Zhu L, Xing J, Wu J, Wang N. Effectiveness of ART and condom use for prevention of sexual HIV transmission in serodiscordant couples: A systematic review and meta-analysis. PLoS One [Internet]. Public Library of Science; 2014 Nov 4;9(11):e111175. Available from: http://dx.doi.org/10.137 1%2Fjournal.pone. 0111175

Most read articles by the same author(s)