Mexico-U.S. migration, sexuality and HIV/AIDS : perspectives from the women who stay behind

The relationship between Mexico-U.S. migration and the spread of HIV/AIDS in rural Mexico has recently received increasing attention. This study explored the HIV/AIDS knowledge, risk perceptions and coping strategies of Mexican women who stay behind while their husbands temporarily migrate to the United States. I conducted in-depth, open-ended, individual interviews with 14 women living in two rural communities in Morelos, Mexico. Results revealed that participants possess accurate information about how HIV/AIDS is transmitted and prevented. Confusion, however, still exists with regard to the difference between seropositive status and AIDS. The asymptomatic seropositive phase challenges traditional notions of illness in which disease is manifested in physical symptoms. This misconception can lead to a lack of preventive measures before the disease becomes visible. Participants' risk perception is influenced by their familiarity with HIV/AIDS and other sexually transmitted infections, their notions of hygiene and disease prevention, and their ideas of high risk populations (homosexuals and sex workers). Qualitative analyses also revealed that gender selectively shapes participants' risk perceptions and their strategies to cope with the threat of infection. Personal risk assessment is influenced by the interplay between the husbands' migratory experience and participants' perceptions of masculinity. Informants who perceive their husbands as responsible and fearful men feel safe whereas women who think of their partners as hypersexual and "macho" men see themselves at risk. There is a general belief that hypersexual men inevitably need to have extramarital sex when they live in the United States. Participants perceive these men's behavior as the source of their high risk of infection. Gender inequality also limits participants' attempts to practice safe sex, even when they have an accurate risk perception. Some participants use irony and humor to facilitate communicating their fear of infection to their husbands. This strategy helps them to refuse having sex after their partners return. Others request that their husbands' use condoms with them. Both strategies only work for a short period of time; women engage in unprotected sex with their husbands after a few days. Other women cope with their fear of infection by openly talking about infidelity and potential infection with their spouses. In this process, women's constructions of masculinity determine whether they "allow" their husbands to have protected extramarital sex in the United States or whether they discuss alternatives to sexual intercourse, such as masturbation. The findings have implications for HIV prevention programs with women married to migrant men from Mexico and other countries. Beyond focusing on empowerment for negotiating condom use, messages have to be tailored to women's learned constructions of gender, sexual relationships, and heterosexual intimacy.