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

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.