The gender inequalities that characterise intimate partner relationships in Malawi, a country with one of the highest HIV prevalence rates in the world, arguably place marriage as an important risk factor for HIV infection among women, yet few studies detail the complex interactions of marriage and risk. In order to develop HIV-prevention interventions that have lasting impacts in such communities, we need a deeper understanding of the intricacies of women's lives, how and why they are involved in marital relationships, and the implications of these relationships for HIV transmission or prevention. This article describes how women understand marriage's effects on their lives and their HIV risks. Drawing from focus group discussions with 72 women attending antiretroviral clinics in Malawi, we explore why women enter marriage, what women's experiences are within marriage and how they leave spouses for other relationships. Based on their narratives, we describe women's lives after separation, abandonment or widowhood, and report their reflections on marriage after being married two or three times. We then review women's narratives in light of published work on HIV, and provide recommendations that would minimise the risks of HIV attendant on marriage.

Nurse educators are calling for the transformation of nursing education toward curricula that promote clinical reasoning through reflective practice and understanding of patient experiences in an effort to motivate students to become change agents. Study abroad programs can play an important role in this transformation through educating nurses in the delivery of culturally safe health care in a diverse world. Exposing nursing students to study abroad experiences that are guided by critical approaches such as a postcolonial feminist framework provides nursing students with opportunities to be immersed in the life and culture of people who have a completely different positioning and location while reflecting on the “us” versus “them” phenomenon that is pervasive in modern Western society and generates negative cultural comparisons. Attention to the design and implementation of such programs is important if nursing schools in the Western world are to uphold ethical standards, promote equality in relationships with host communities and avoid inadvertent exploitation and marginalization of vulnerable peoples. We present the development and implementation of a community health study abroad program for American nursing students in Malawi, Africa using a postcolonial feminist framework.

Reflexivity is a central tenet of qualitative research. Engaging in self-reflexive praxis allows researchers to identify areas of tension in the research process that need to be further deconstructed. In this paper, we draw on our collective self-reflective experiences as qualitative health researchers whose scholarship is informed by critical and postcolonial feminist epistemologies to offer some guidance on how to approach the concept of insider versus outsider in the research process. Specifically, we analyze recurring methodological tensions related to positionality and outline how they were addressed. The lessons learned from our studies can be instructive to other qualitative researchers

This article is based on a critical ethnography about HIV and gender-based issues of power and violence conducted in Malawi in 2008. In all, 72 women living with HIV were recruited from four antiretroviral treatment clinics, three rural and one urban, to participate in 12 focus groups. Informed by a postcolonial feminist perspective, we analyze the process and products of these focus groups to interrogate their capacity to facilitate collective engagement with the social and structural realities confronting women in a resource-limited, highly AIDS-affected country. We present exemplars to show how women together created collective narratives to mobilize individuals to action. Findings indicate that focus groups can be used innovatively to benefit both the research and the participants, not only as a critical method of inquiry with marginalized groups but also as a forum in which validating dialogue, mutual support, and exchange of strategic information can generate transformative change to improve women’s lives.