HIV transmission from husbands to wives in stable marital relationships has increased. Our study explored women's perspectives on their life changes after being infected with HIV by their husbands. The interpretive phenomenological approach guided the study. Cambodian women (n = 15) who self-identified their infections as coming from their husbands participated in two in-depth interviews. The participants underwent significant changes in interpersonal and intimate relationships with their spouses, reporting that their partners became more devoted husbands and agreed to follow safer sex practices within the marriage. However, families suffered from hunger and poverty due to the parents' physical weaknesses. Both the husbands' changed behavior and their children gave these women the strength to not only go on with their life routines, but also to report that life was better than before the HIV diagnosis. These results inform health policies and programs targeting families where HIV affects both spouses.

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Background Public health leaders lack evidence for making decisions about the optimal allocation of resources across local health department (LHD) services, even as limited funding has forced cuts to public health services while local needs grow. A lack of data has also limited examination of the outcomes of targeted LHD investments in specific service areas. Purpose This study used unique, detailed LHD expenditure data gathered from state health departments to examine the influence of maternal and child health (MCH) service investments by LHDs on health outcomes. Methods A multivariate panel time-series design was used in 2013 to estimate ecologic relationships between 2000–2010 LHD expenditures on MCH and county-level rates of low birth weight and infant mortality. The unit of analysis was 102 LHD jurisdictions in Washington and Florida. Results Results indicate that LHD expenditures on MCH services have a beneficial relationship with county-level low birth weight rates, particularly in counties with high concentrations of poverty. This relationship is stronger for more targeted expenditure categories, with expenditures in each of the three examined MCH service areas demonstrating the strongest effects. Conclusions Findings indicate that specific LHD investments in MCH have an important effect on related health outcomes for populations in poverty and likely help reduce the costly burden of poor birth outcomes for families and communities. These findings underscore the importance of monitoring the impact of these evolving investments and assuring that targeted, beneficial investments are not lost but expanded upon across care delivery systems.

The refined theoretical model of HIV transmission from this qualitative research can be used to formulate culturally sensitive and embedded programs for curbing intramarital HIV transmission in Cambodia among the rural poor.