“I Can't Go Out”: Mobility Obstacles to Women's Access to HIV Treatment in KPK, Pakistan

We examined the role of outside mobility constraints as barriers to HIV treatment for Pakistani women living with HIV (WLWH) whose husbands were permanently living in other cities. We focused on Khyber Pakhtunkhwa (KPK), which adheres to conservative social and cultural values for female mobility. Open-ended interviews were conducted with 21 WLWH. We found that women's mobility outside the home was shaped by the system of parda (seclusion) and that a husband's lack of support by not being present for clinical appointments, distance to the HIV clinic, and ages of children emerged as crucial contributors to women's outside mobility and their subsequent abilities to access HIV care. These obstacles were more acute for women living with in-laws rather than in nuclear families. Policymakers need to better understand the nuances of local cultures in which women seek HIV treatment so that they can devise practical, culturally appropriate, and acceptable programs.