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AJPH First Look, published online ahead of print Apr 26, 2007
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AJPH.2005.075705v1
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June 2007, Vol 97, No. 6 | American Journal of Public Health 1015-1022
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2005.075705

FRAMING HEALTH MATTERS

"He Won’t Use Condoms": HIV-Infected Women’s Struggles in Primary Relationships With Serodiscordant Partners

Patricia E. Stevens, PhD, RN and Loren Galvao, MD, MPH

Patricia E. Stevens and Loren Galvao are with the College of Nursing, University of Wisconsin, Milwaukee, and also with the Center for Urban Population Health, Milwaukee.

Correspondence: Requests for reprints should be sent to Patricia E. Stevens, PO Box 413, University of Wisconsin College of Nursing, Milwaukee, WI 53201 (e-mail: pstevens{at}uwm.edu).

We investigated the sexual behaviors of 55 HIV-infected women in Wisconsin who narrated their lives in 10 interviews over 2 years during 2000 to 2003. We sought to examine the interpersonal situations in which sexual risk occurred. During the prospective period, 58% (32) were abstinent and 24% (13) practiced safe sex exclusively. The remaining 18% (10) engaged in unprotected sexual intercourse, but only in primary partnerships, almost all of which were with serodiscordant partners. We focused on experiential detail and narrative depth of 10 women who had sex without condoms. These narratives demonstrate how the women attempted to initiate condom use but engaged in unprotected sexual intercourse regularly at the insistence of their partners. Consequently, these women lived in trepidation of causing their partners’ sickness and death.




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