Unveiling Risk: Marital Deception and HIV Susceptibility Among Married Women in Indonesia.

Objectives: The Indonesian Ministry of Health reports a significant three-fold increase in newly diagnosed HIV cases among women aged 15 and above, rising from 12,537 cases in 2015 to 35,415 in 2024. Over the past decade, the largest group of new HIV cases in Indonesia has been among women of reproductive age (15-49 years). This trend is largely driven by the widely held and fallacious belief that heterosexual, married women are not at risk of HIV. In this study we aim to challenge this misconception and investigate the complexity of HIV transmission, with a focus on HIV susceptibility among married women in Indonesia.

Methods: Feminist Participatory Action Research was conducted with 24 women living with HIV (WLWH) in Palembang, South Sumatra, Indonesia. Interviews and focus group discussions were employed to assess the impact of the actions of women and men who partake in high-risk behaviors that could result in them passing HIV onto their spouses.

Results: The study shows that among 24 women living with HIV, 14 contracted HIV from male partners who engaged in unsafe sexual behavior, and who often knowingly transmitted HIV. Those male partners may have had extra-marital affairs with women, women sex workers, or with other men or been involved in polygamous marriages. This article provides insight into the vulnerability of married women getting HIV from their spouse and highlights that healthy marital sexual relationships depend on respect, trust, and clear communication.

Conclusions: We argue that improving HIV health literacy in Indonesia, along with open discussions about sexual practices, are crucial. While these conversations may challenge deeply ingrained social, cultural and religious norms regarding sexuality, marriage and ideal gender relations, they are critical for halting the spread of HIV in Indonesia.