The inevitability of infidelity: Sexual reputation, social geographies, and marital HIV Risk in rural Mexico

American Journal of Public Health

Volumn 97, Issue 6, 2007, Pages 986-996

  Hirsch, Jennifer S ^b   Meneses, Sergio ^c   Thompson, Brenda ^c   Negroni, Mirka ^c   Pelcastre, Blanca ^c   Del Rio, Carlos ^a  

^a EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b Och Spine at New York Presbyterian Hospitals   (United States)

^c NONE

Author keywords

[No Author keywords available]

Indexed keywords

ACQUIRED IMMUNE DEFICIENCY SYNDROME; CONDOM; GENDER IDENTITY; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INFECTION RISK; MARRIAGE; MEDICAL DECISION MAKING; REPRODUCTIVE HEALTH; REVIEW; RURAL AREA; SEXUAL BEHAVIOR; SOCIAL ASPECT; SOCIAL STATUS; SOCIAL STRUCTURE; SOCIOECONOMICS; ADULT; ARTICLE; CULTURAL FACTOR; DISEASE TRANSMISSION; FEMALE; HIGH RISK BEHAVIOR; INTERPERSONAL COMMUNICATION; INTERVIEW; MALE; MEXICO; PREVALENCE; PSYCHOLOGICAL ASPECT; RISK FACTOR; RURAL POPULATION; SEXUALLY TRANSMITTED DISEASE; SOCIAL ENVIRONMENT; UNSAFE SEX; UTILIZATION REVIEW; WOMEN'S HEALTH;

ADULT; COMMUNICATION; CONDOMS; CULTURAL CHARACTERISTICS; EXTRAMARITAL RELATIONS; FEMALE; HIV INFECTIONS; HUMANS; INTERVIEWS; MALE; MEN; MEXICO; PREVALENCE; RISK FACTORS; RISK-TAKING; RURAL POPULATION; SEXUAL BEHAVIOR; SEXUALLY TRANSMITTED DISEASES, VIRAL; SOCIAL ENVIRONMENT; UNSAFE SEX; WOMEN'S HEALTH;

EID: 34250844316     PISSN: 00900036     EISSN: 15410048     Source Type: Journal    
DOI: 10.2105/AJPH.2006.088492     Document Type: Review

References (90)

1. Pan American Health Organization. "Fact Sheet: Gender and HIV/AIDS," http://www.paho.org/english/hdp/hdw/GenderandHIVFactSheetI.pdf;
2. Sabin Russell, "Inequality Called Key in AIDS Gender Gap: UN Official Urges Empowerment of World's Women," San Francisco Chronicle (March 10, 2004): A4;
3. "Gender Dimensions of HIV/AIDS in India," in Summaries of Community-based Research on the Gender Dimensions of HIV/AIDS (New York: United Nations Development Fund for Women, 2001);
4. Women and HIV/AIDS: Confronting the Crisis (New York: Joint United Nations Programme on HIV/AIDS, United Nations Population Fund, and United Nations Development Fund for Women, 2004);
5. Young People and HIV/AIDS: Opportunity in Crisis (New York: United Nations Children's Fund, 2002);
6. J. R. Glynn et al., "HIV Risk in Relation to Marriage in Areas With High Prevalence of HIV Infection," Journal of Acquired Immune Deficiency Syndromes 33 (2003): 526-535;
7. J. R. Glynn et al., "Why Do Young Women Have a Much Higher Prevalence of HIV Than Young Men? A Study in Kisumu, Kenya and Ndola, Zambia," Journal of Acquired Immune Deficiency Syndromes 15 (suppl. 4, 2001): S51-S60.
8. J. Hirsch et al., "The Social Constructions of Sexuality: Marital Infidelity and Sexually Transmitted Disease-HIV Risk in a Mexican Migrant Community," American Journal of Public Health 92, no. 8 (2002): 1227-1237;
9. Daniel Smith, "Love and the Risk of HIV: Courtship, Marriage and Infidelity in Southeastern Nigeria," in Jennifer Hirsch and Holly Wardlow, eds., Modern Loves: The Anthropology of Romantic Courtship and Companionate Marriage (Ann Arbor: University of Michigan Press, 2006);
10. "HIV/AIDS Risk for Married Women," paper presented at the 133rd Annual Meeting of the American Public Health Association, December 2005, Philadelphia, PA;
11. J. S. Hirsch, "'You Get Tired of Eating Beans Every Day': Social, Cultural and Economic Aspects of Married Women's HIV Risk in Rural Mexico," paper presented at the 133rd Annual Meeting of the American Public Health Association, December 2005, Philadelphia, PA;
12. H. M. Phinney and Minh Huu Nguyen, "'Rice Is Essential but Tiresome, You Should Get Some Noodles': Social, Cultural and Economic Aspects of Married Women's HIV Risk in Hanoi, Viet Nam," paper presented at the 133rd Annual Meeting of the American Public Health Association, December 2005, Philadelphia, PA;
13. D. J. Smith, "Modern Marriage, Extramarital Sex, and HIV Risk in Southeastern Nigeria," paper presented at the 133rd Annual Meeting of the American Public Health Association, December 2005, Philadelphia, PA;
14. S. Parikh, "'Be Faithful': Cultural, Social, and Economic Contradictions of the ABC Message and Married Women's HIV Risk in Uganda," paper presented at the 133rd Annual Meeting of the American Public Health Association, December 2005, Philadelphia, PA;
15. H. Wardlow, "'There Is Nothing to Fence Us In': Men's Extramarital Sex and Married Women's HIV Risk in Rural Papua New Guinea," paper presented at the 133rd Annual Meeting of the American Public Health Association, December 2005, Philadelphia, PA.
16. "Promoting Healthy Relationships and HIV/STI Prevention for Young Men: Positive Findings from an Intervention Study in Brazil," in Horizons Research Update (Washington, DC: Population Council, April 2004);
17. J. Pulerwitz, G. Barker, and M. Segundo, "Measuring Gender Equitability Among Men," paper presented at the Reaching Men for the Reproductive Health of All Conference, September 2003, Dulles, VA;
18. "Young Men and HIV Prevention," in Horizons Report (Washington, DC: Population Council, 2004).
19. R. W. Connell, Gender and Power: Society, the Person, and Sexual Politics (Stanford, CA: Stanford University Press, 1987);
20. R. W. Connell, Masculinities (Berkeley, CA: University of California Press, 1995).
21. Elisa J. Sobo, Choosing Unsafe Sex: AIDS Risk Denial Among Disadvantaged Women (Philadelphia: University of Pennsylvania Press, 1995);
22. Hirsch et al., "The Social Constructions of Sexuality."
23. We credit Constance Nathanson for coining this phrase.
24. See Jennifer Hirsch, A Courtship after Marriage: Sexuality and Love in Mexican Transnational Families (Berkeley, CA: University of California Press, 2003).
25. Instituto Nacional de Estadistica, Geografia E Informatica (INEGI), "Working Population by County, Sex and Primary Occupation, http://www.inegi.gob.mx (accessed February 13, 2006);
26. Instituto Nacional de Estadistica, Geografia e Informatica, VII Censo General de Poblacion, 1960, Estado de Michoacan (Mexico City: Estados Unidos Mexicanos, 1960);
27. "El Frijol Prodedente de EU y Candada Inunda el Mercado Mexicano, a Pesar de que Aun No se Autorizan Cupos de Importacion," Mural, Seccion A. Negocios (March 15, 2004): 1;
28. "'Impactan Reglas de EU a Productos Nacionales': Hubo un Incremento de Importaciones de Maiz, Trigo, Frijoles, y Carne de Cerdo y Ave," Mural, Seccion Negocios (May 10, 2004): 7A;
29. "La Preferencia por Frutas y Hortalizas de USA y Chile en Mexico Esta Afectando a los Productores Mexicanos," Mural, Seccion B. Comunidad (June 14, 2004): 5.
30. Instituto Nacional de Estadistica, Geografia E Informatica, "Total Population by County, Sex and Five Year Age Groups," http://www.inegi.gob. mx (accessed February 13, 2006).
31. "La Secretaria de Turismo Promueve al Estado con Tasas que Llevan la Leyenda: 'Jalisco es Mexico,' pero las Tazas son Hechas en China," Mural, Seccion A. Nacional (March 27, 2004): 1;
32. "Los Productos Chinos Desplazan a los Productores Nacionales de Mexico," Mural, Seccion A. Negocios (April 21, 2004): 6;
33. "Mexican Handcrafts Are Produced in China and Expended as Poblanas in USA," Mural, Seccion A Negocios (May 24, 2004): 3;
34. "Recomiendan a las Empresas Mexicanas Reorientar su Mercado Exportador Hacia EU para Competir con los Productos Chinos," Mural, Seccion A. Nacional (June 7, 2004): 1.
35. "La Falta de Integracion de las Cadenas Productivas Agroalimentarias Engarzan Desempleo," Mural, Seccion Negocias (March 1, 2004): 8A.
36. C. Magis-Rodríguez, E. Bravo-García, and P. Uribe-Zúñiga, Dos Décadas de la Epidemia del SIDA en México (Mexico City: Central Nacional de la Prevención y Control del SIDA; 2002).
37. Ibid.
38. Ibid.
39. C. Magis-Rodriguez, C. Gayet, M. Negroni, R. Leyva, E. Bravo-Garcia, P. Uribe, and M. Bronfman, "Migration and AIDS in Mexico: An Overview Based on Recent Evidence," Journal of Acquired Immune Deficiency Syndromes 37 (suppl. 4, 2004): S215-S226;
40. M. A. Sanchez, G. F. Lemp, C. Magis-Rodríguez, E. Bravo-García, S. Carter, and J. Ruiz, "The Epidemiology of HIV Among Mexican Migrants and Recent Immigrants in California and Mexico," Journal of Acquired Immune Deficiency Syndromes 37 (suppl. 4, 2004): S204-S214.
41. Angeles Cruz Martínez, "Tienen VIH 1 por Ciento de Migrantes: Censida," La Jornada (November 23, 2005).
42. Sanchez et al., "The Epidemiology of HIV."
43. H. R. Bernard, Research Methods in Cultural Anthropology: Qualitative and Quantitative Approaches, 2nd ed. (Newbury Park, CA: Sage, 1994).
44. This earlier research had also made clear the necessity of having a man on the research team (see Hirsch, A Courtship after Marriage), and so the second member of the field team was a Mexican physician and medical anthropologist in his mid-20s, Sergio Meneses, who hails from a middle-class town in southern Mexico that is similar to Degollado in size and provincial tone. The third member of the team was Brenda Thompson, an American MPH student who was conducting a supplemental study on adolescent girls' notions of sexuality and HIV risk. The team also counted on the assistance of 2 local helpers: Alan Lujambio, a wellrespected, college-educated, recently married member of the town's upper class, and Estela Mata, a mother of 7 who helped with the study when she was not working part-time cleaning at a local primary school. Lujambio and Mata provided entrée into their respective social worlds within the broader Degollado community; they also located prospective informants for the marital case histories, shared stories about notable cases of infidelity, and provided critical commentary on the vagaries of life in Degollado.
45. Hirsch, A Courtship after Marriage, 30-34.
46. Katherine A. Forrest et al., "Exploring Norms and Beliefs Related to AIDS Prevention Among California Hispanic Men," Family Planning Perspectives 25 (1993): 111-117;
47. Bruce Caldwell, "Barkat-e-Khuda The First Generation to Control Family Size: A Microstudy of the Causes of Fertility Decline in a Rural Area of Bangladesh," Studies in Family Planning 31 (2000): 239-251;
48. Sheri B. Kirshenbaum et al., "'Throwing the Dice': Pregnancy Decision-Making among HIV-Positive Women in Four U.S. Cities," Perspectives on Sexual and Reproductive Health 36 (2004): 106-113;
49. Sarah Castle, "Factors Influencing Young Malians' Reluctance to Use Hormonal Contraceptives," Studies in Family Planning 34 (2003): 186-199.
50. On the possible relevant dimensions of local variations in receiving contexts, see Caroline Brettell, "Bringing the City Back In: Cities as Contexts for Immigrant Incorporation," in N. Foner, ed., American Arrivals: Anthropology Engages the New Immigration (Santa Fe: School for American Research Press, 2003),
51. and J. S. Hirsch, "'Que, Pues, con el Pinche NAFTA?: Gender, Power and Migration between Western Mexico and Atlanta," Urban Anthropology 31 (2002): 351-387.
52. Hirsch et al., "The Social Constructions of Sexuality"; see also Hirsch and Wardlow, Modern Loves.
53. As described in the sections on reputation and in the final section, there are many factors other than marital affect that shape men's participation in extramarital sex. Among the couples included in the marital case studies, for example, there were some older men who expressed little warmth and intimacy toward their wives but who nonetheless denied having had extramarital sex; these men refrained from extramarital sex out of a desire to demonstrate public respectability and restraint. Don Carlos (names are pseudonyms), for example, beat his wife Doña Esperanza quite severely in the early years of their marriage - at one point, she recounted that he might have killed her had her brother not intervened - but he also vigorously asserted that to have been unfaithful would have been to be no better than an animal.
54. This is described elsewhere in terms of public perceptions of adolescent sexual behavior (see Hirsch, A Courtship after Marriage, 95-111).
55. See Hirsch, A Courtship after Marriage, 100.
56. The comment "small town, big gossip" refers to a telenovela, Pueblo Chico, Infierno Grande" (small town, big hell), that focused on the scandals and suffering simmering just below the surface in small-town Mexico.
57. See Hirsch, A Courtship after Marriage, 95-102.
58. The disco is an exception to this rule: respectable young women do go to the disco, as long as they leave, for example, by 10 PM on a Sunday night (see Hirsch, A Courtship after Marriage);
59. Brenda Thompson, "Protecting Your Image: An Ethnographic Look at Courtship and Sexuality From the Perspective of Muchachas in a Mexican Migrant-Sending Town" (master's thesis, Emory University, 2005).
60. The fundamentally gendered nature of reputation is further underlined by gender differences in how women manage sexual gossip and the ways in which women deploy information against other women to their own advantage (see Thompson, "Protecting Your Image").
61. All names are pseudonyms, and some details have been changed to prevent identification of informants.
62. Men's economic power comes into play in other ways in cases such as that of our informant Juan, who sanguinely reported having taken advantage of the power he had over his young female factory employees to dole out work opportunities in exchange for sex.
63. At the heart of this association between mobility and sexual misbehavior is the belief that fear of gossip provides a crucial brake on bad behavior, and thus the opportunity to do things without harming one's local reputation provides a temptation too great to resist. P. Hondagneu-Sotelo, Gendered Transitions: Mexican Experiences of Immigration (Berkeley: University of California Press, 1994);
64. Hirsch, A Courtship after Marriage;
65. but see M. Cerruti and D. S. Massey, "On the Auspices of Female Migration from Mexico to the United States," Demography 38 (2001): 187-200;
66. Roberto Suro, "Survey of Mexican Migrants, Part One: Attitudes about Immigration and Major Demographic Characteristics," http://pewhispanic. org/reports/report.php?ReportID=41 (accessed February 13, 2006).
67. International labor migration poses challenges to fidelity even for those who remain behind; that is, the distorted population structure creates an intense local competition for men, leading to many marriages of desperation among young women in their late 20s and creating a semipermanent pool of available young women, some of whom are all too willing to flirt with a married man in the hopes of stealing another woman's husband (such women are typically referred to as "leftover women"). These marriages of desperation can be in and of themselves reasons that men end up seeking out extramarital sex: they are not always founded on deep emotional intimacy, but men can find this intimacy elsewhere through extramarital relationships.
68. We cannot answer the question of what approximate percentage of men in the study community engaged in this behavior because the goal of this type of research is to assess local forms and meanings of phenomena rather than their distribution; see J. Pulerwitz et al., "Extrarelational Sex Among Mexican Men and Their Partners' Risk of HIV and Other Sexually Transmitted Diseases," American Journal of Public Health 91 (2001): 1650. However, according to our observations, approximately half of the men with whom we spoke and got to know well - perhaps 50 in all - had engaged in extramarital sex. We focus here exclusively on men's extramarital sexual behavior; we will address the behavior of married women, who also engage in extramarital sex despite the much higher reputational risks, in a subsequent article.
69. Although the norms regarding acceptable behavior for "decent" women have changed, the persistent classification of women into "those of the house" and "those of the street" also facilitates men's access to extramarital sex by ensuring the availability of partners: a group of women who, having lost access to the resource of a good reputation, face limited options in terms of respectable partnerships, few moral opportunity costs to continued disrespectable behavior, and a solid local niche as a seller of sex. Once a woman's reputation is sullied, there is virtually no social salvation (although women do, of course, manage to live satisfying lives in spite of these reputations). Women's participation in transactional sex is often attributed to the plight of single mothers and women's limited options for supporting their children, but what is less frequently traced out as part of this explanation is the way in which the ideals of womanhood constrain women's relationship and economic options. A woman with a bad reputation is virtually unemployable as a domestic servant and is even undesirable as an employee in a family-owned business; thus, once a woman slips off the straight and narrow, she is virtually forced to specialize in being a bad woman. The virgin-whore dichotomy serves not only to scare women into preserving their sexual reputation but also to ensure a steady stream of women with whom men can transgress.
70. One of the veiled threats behind men's requests for sexual variety - and the reason, perhaps, for Mariana's comment that "you have to be willing to be a little bit of a whore for your husband" - is that women fear that if they do not hold their husband's sexual attention through variety, men will look for it elsewhere. As reported by women, the main areas of focus of these increasingly common marital discussions in which men press their wives for more sexual variety and a more modern, intimate life are anal sex and fellatio. Many women reported that their husbands requested anal sex "to see what it feels like." Given how common sex between men appeared to be, we suspect rather that many men already knew what it felt like and liked it. It is difficult to determine the extent to which anal sex was common in married couples, because most women did not want to provide such information. Oral sex, which was somewhat less contentious, seems to have moved clearly into the range of the permitted for younger couples (e.g., "After all, as long as they are well bathed, what's wrong with it?").
71. Demographic evidence bears out this point; divorce rates are increasing throughout Mexico, but rates in rural areas lag considerably behind those in urban areas (see "Mexico en Corto: Matrimonios y Divorcios en México," http://www.inegi.gob.mx/inegi/contenidos/espanol/prensa/ contenidos/estadisticas/2005/matrimonios05.pdf (accessed July 20, 2006.)
72. Adrienne Rich, "Compulsory Heterosexuality and Lesbian Existence," in Blood, Bread, and Poetry: Selected Prose 1979-1985 (New York: W. W. Norton & Company, 1986).
73. Residents of large urban centers such as Mexico City and Guadalajara can join growing communities of gay-identified men (and women), but these identities and communities barely exist at the local level. In fact, the level of discrimination in rural areas and provincial cities against men who are perceived to be homosexual has been recognized and is being addressed through a national HIV prevention program that frames gay rights as a critical element of effective HIV prevention. More information on the Mexican Program on HIV and Human Rights, including the media spots used in the campaign, is available on the Web site of the Mexican Commission on Human Rights, http://www.cndh.org.mx/ progate/vihsida/vihsid2.htm (accessed March 12, 2007).
74. See also Fátima Estrada Márquez, Carlos Magis Rodríguez, and Enrique Bravo Garcia, "Estigma y Discriminació n en Hombres que Tienen Sexo con Hombres," in Carlos Magis Rodríguez, Hermelinda Barrientos Bárcenas, and Stefano Michele Bertozzi Kenefick, eds., SIDA: Aspectos de Salud Publica, http://www.salud.gob.mx/conasida/otraspub/manualsida/cap08.pdf (accessed March 12, 2007).
75. Although this may strike the reader as a somewhat crude aphorism, the fact that it is widely known suggests that norms for talking about sex among men in rural Mexico assume a shared set of values about the value of pleasure-oriented sexual interactions, regardless of partner choice. For more on language as a critical lens for learning about social values, see Jennifer Hirsch, "Between the Missionaries' Position and the Missionary Position: Mexican Dirty Jokes and the Public (Sub)Version of Sexuality," Critical Matrix: Princeton Working Papers in Women's Studies 5 (1990): 1-27, on Mexican scatological humor;
76. see also Richard Parker, Bodies, Pleasures and Passions: Sexual Culture in Contemporary Brazil (Boston: Beacon Press, 1991), particularly the discussion of sacanagem, roughly translated as sexual misbehavior, in Brazil.
77. Hector Carrillo, "Cultural Change, Hybridity, and Male Homosexuality in Mexico," Culture, Health, and Sexuality 1 (1999): 223-238;
78. Hector Carrillo, The Night Is Young: Sexuality in Mexico in the Time of AIDS (Chicago: University of Chicago Press, 2002);
79. Gloria González-López, Erotic Journeys: Mexican Immigrants and Their Sex Lives (Berkeley: University of California Press, 2005);
80. J. M. Carrier, "Mexican Male Bisexuality," Journal of Homosexuality 11 (1985): 75-85;
81. J. M. Carrier, "Sexual Behavior and the Spread of AIDS in Mexico," Medical Anthropology 10 (1989): 129-142.
82. This case was not only confirmed by his wife but commented on by several of our other informants, both male and female.
83. See also González-López, Erotic Journeys, 62-97.
84. Given the small number of marital case studies and the likelihood that individuals from this community will have access to published materials resulting from our study, it is not ethically possible to provide specific data stratified according to social class.
85. See, for example, M. C. Gutmann, The Meanings of Macho: Being a Man in Mexico City (Berkeley: University of California Press, 1996).
86. One story, for example, admiringly reported on how a Mexican movie star bragged about staying up all night with his baby and - heroically - learning to distinguish between a healthy "poopy" diaper and diarrhea; see "Cumplen su Rol mas Padre!, Entrevistas Sobre la Experiencia de ser Padre en Primera Pagina," Mural, Seccion D Gente (June 20, 2004): 1.
87. See Hirsch, A Courtship after Marriage, 147-156.
88. Holly Wardlow, "Men's Extramarital Sexuality in Rural Papua New Guinea," American Journal of Public Health 97 (2007): 1006-1014;
89. Daniel Jordan Smith, "Modern Marriage, Men's Extramarital Sex, and HIV Risk in Southeastern Nigeria," American Journal of Public Health 97 (2007): 997-1006;
90. Shanti A. Parikh, "The Political Economy of Marital HIV Risk in Uganda: The ABC Approach, Unintended Risk, and 'Safe' Infidelity," American Journal of Public Health 97 (2007): In press.