The influence of leprosy and other disabilities on marital relationships and sexual health among married women in Indonesia: A qualitative study into experiences and coping

Objective: This study aims to increase the understanding of ways in which leprosy and other disabilities may impact the marital relationships and sexual health of married women living in Tegal regency, Indonesia.

Method: We used a cross-sectional comparative study design with a qualitative approach. Three groups of married women were interviewed in-depth: (1) women affected by leprosy, (2) women without leprosy, but with physical disabilities, and (3) women without leprosy or disabilities (a control group). The ABC-X Model of family stress and coping was used to develop the interview guide and to analyse the data. The data were analysed by two independent researchers by means of deductive thematic analysis.

Results: Twenty-four women participated in the study. Most women in all groups had positive experiences regarding their marital relationships and support received from their husbands. Negative (physical) effects of leprosy on sexual health were present: over half of the women said they were reluctant to have sexual intercourse, either because they felt unwell because of their condition or because they were afraid of infecting their husband. It appeared that leprosy-affected women were more dissatisfied with their sexual health compared to the other two groups. Coping strategies to deal with difficulties in the marital relationship included silence, venting, religion, positive thinking, humour and acceptance.

Conclusions: Most participants perceived their marital relationship as satisfactory. However, findings from this study show leprosy can negatively impact sexual health. The results point to a compelling need to develop interventions to address sexual health of persons affected by leprosy in Indonesia.