Abstract
Sexuality and gender relation within family context : implication and strategies for community-based program for sexually trasmitted diseaese and HIV prevention among rural married womenThis study was a pilot study which employed anthropological methods. The study site was selected through purposive sampling. A village in Chiang Rai province was selected because this is an area where there is a high prevalence of HIV transmission and a large number of male migrant labourers. The study sample consisted of married women and their partners who were living in the study villge, as well as well as key informants including health workers at the district level and village leaders. The study obiectives were to describe 1)meanings and forms of conjugal relations among married rural couples, with a focus on idecology and the practice of gender roles and sexuality, 2)the magnitude and forms of womens sexual negotiation power, 3)perceptions of Sexually transmitted diseases and HIV risk among married rural women and men, and 4)recommendations for community-based Sexually transmitted diseases and HIV prevention program for rural married couples. It was found that married women played major roles in both the domestic and economic spheres. The sexual division of labor was not rigid. The meanings of sexuality among married couples included love, emotion, feeling, warmth and reproduction. Sexual communication between couples was non-verbal rather than verbal. The extent to which married women could negotiate within their sexual relations with their husbands varied from one woman to another. Factors which determined married womens sexual negotiation power were 1)women's economic status and roles, 2)number of years in marriage, 3)age difference between husband and wife and 4)women's personalities. The author reveals that women's sexual negotiation relates to their relative position of power in other domains of life. It was also found that the most effective sexual negotiation strategy with the husband involved asking him nicely about extra-marital sexual activity, leading to a confession extra-marital affairs. From this study, the author describes four factors which exacerbate the risk of married women contracting sexually transmitted diseases and HIV. These are 1)women's low perception of the extra-marital sexual activity of their husbands, 2)the perceived social risk (risk to social relationship, personal identity and status) that influences women's actions/inactions associated with the risk of sexually transmitted diseases and HIV transmission, 3)the lack of knowledge among married women of early symptomsand appropriate treatment-seeking for sexually transmitted diseases, 4)extra-marital unsafe sex among married women, and 5)the lack of familiarity among couples with the use of condoms in the context of marrisage. Strategies for Sexually transmitted diseases and HIV prevention among rural married couples 1)education women about their own bodies and sexuality as well as about reproductive tract infections and HIV, 2)action research to find appropriate starategies to promote women's sexual negotiation power, by using real case stories of women who face the risk of Sexually transmitted diseases and HIV transmission that match the level of negotiation power that women have, and 3)promotion of sexual and family responsibility in programs targeted at men, i.e. emphasizing fatherhood for married men and using role model, approaches which model responsible male behaviour.
