Professional Documents
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AFRICAN
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Pergamon Press Ltd
SEXUALITY
words-Africa,
HIV/AIDS, STDs, womens health, womens autonomy, sexual relations, spousal
relations, morbidity, mortality
INTRODUCTION
Because sub-Saharan
Africa has been more affected
by the AIDS epidemic than any other part of the
world, and because heterosexual transmission of the
disease is dominant in this region, probably fivesixths of all the HIV-positive women in the world are
found there. Although the kinds of relationships
which give rise to the disease are still being identified
and quantified, it is almost certain that the greatest
risk to women is provided by their husbands or stable
partners and that the majority of seropositive women
in Africa have been infected by their partners. This
has almost equally certainly long been the case with
sexually transmitted diseases, which are a serious
problem in the region [I, 21.
In these circumstances a major social and health
concern in sub-Saharan Africa must be the extent to
which women can control their sexual activity, either
by refusing sexual relations or insisting on safe sexual
practices, when their partners are infected with STDs
or HIV/AIDS. The emphasis on STDs as well as
HIV/AIDS arises in two ways: firstly, the STD
epidemic has a longer history and womens rights to
refuse sex in high-risk circumstances may well have
evolved with regard to relationships threatened by
STDs; and, secondly, a reduction of STD transmission by the adoption of suitable measures probably reduces the chances of HIV transmission.
The purpose of this paper is to report a 1991
investigation, carried out in a Yoruba area of south-
859
860
I. 0.
ORUBULOYE
She also quoted the conclusion of the First International Workshop on Women and AIDS in Africa,
held in Zimbabwe, that women have limited power
to negotiate or enforce strategies to reduce their risk
of HIV infection.
Ankrah saw this situation
as
arising from The low status of the African woman
3
... .
The rural woman in particular in Africa may find herself
economically dependent on her husband, but without any
leverage at all, such as independent income. Lacking the
right of ownership, control over, or adequate access to land
and cash, the rural African woman is highly disadvantaged
..
Husbands
who have gone to the towns, often
setting up new households and having multiple sexual
et
861
I. 0. ORLJBUU)YE et al.
862
IN ZAIRE
863
864
I. 0. ORUBLMWE et al.
RIGHT
865
Table 1. Reasons given by respondents who had refused their partners sexual relations
CA= 580)
Response
Major category
(1) Forbidden time:
(2) Antagonism:
Subcategory
Menstruation
Postpartum sexual abstinence
Too soon after birth for sex
without contraception
Punishment for his behaviour
Punishment (or decision not to
have sex) when husband has
taken another wife
Fight
Unhappy (usually with the
husband or the marriage)
Husband drunk
Tired or sick
Too much sex
The wife also has a right of
choice
Percentage
of all
responses
10
10
21%
2
9
4
1
23%
20
2
34
56%
100%
I. 0.
866
Table 2. Reported
immediate
ORUBULWE et al.
Percentage
of all
responses
Major category
Subcategory
Hostile:
Turned
to other women:
Accepted
Cannot
the refusal:
remember,
cannot describe,
3. Responses
1
21
8
5
6
1
42%
1
her again
5%
4
1
21
32%
no response
Table
21%
lluV/.
if a woman
Percentage
of all
Major category
Subcategory
Negative
3;
1
61%
Partner
Partner
8
28
36%
Neutral
reactions:
reactions:
No response
usually understands
ignores the situation
3%
100%
Told by partner
Told by doctor after partner had infected
respondent
Told by co-wife or other partner of partner
after she had been infected by him
Suspected from partners symptoms
No response
34
70
7
3
1
14
6
2
49
100
HAD
867
4
4
37
2
8
8
76
4
49
loci
868
I. 0. ORUBUWYE et al.
have other partners. Interestingly, STDs are associated with sexual networking rather than specifically
going to prostitutes, an accusation that has frequently
been made in the West. Only four (8%) of the women
mentioned prostitutes or bar girls as the likely source
of infection, further evidence of a diffused rather than
focused pattern of sexual relations [57]. However, it
is noteworthy that 34 (69%) of the women employed
derogatory phrases (some equivalent to the contemporary English cheating) when referring to the
behaviour that had resulted in infection.
An important question is whether women prefer to
maintain secrecy about these problems of their conjugal relationship or whether they need social and
emotional support. Only one-third of the respondents
discussed the problem with anyone other than their
partner or health personnel. This would appear to
provide solid evidence that most were quite clear
about their right to adopt the courses they did, and
indeed that their husbands usually accepted the situation. Of those who did tell others, half told their
parents, seeking a traditional form of support, half
told their women friends, seeking a more contemporary form of solidarity, and a few felt it their duty to
warn co-wives.
WOMEN WHO
Of the 48 women who knew that they had contracted an STD, almost all gonorrhoea, exactly half
told their partners while the other half did not.
Clearly, disclosure failures on this scale limit the
capacity of partners to take action. Those who told
their partners usually did so because they believed
that their partners were the source of infection and
wished to allocate blame and share responsibility for
doing something about it. In nearly all cases their
doctors had told them that both would have to be
treated. We do not know how many men failed to tell
their female partners, but we believe it was a lower
proportion and evidence that husbands are less afraid
of wives than wives of husbands, at least in these
circumstances, because a polygynous society is much
more likely to condone men having multiple partners.
In these 24 relationships where the women had
revealed the disease, 17 of the male partners refused
any more sexual relations until the woman was cured.
Most of the rest were not so much brave or chivalrous
as convinced that they had the disease themselves and
had brought it into the relationship. Most went for
treatment at the same time as their wives or girlfriends. Of the 24 male partners, only one demanded
a divorce, four more were angry, while another gave
his wife long lectures. Three said or did nothing. But
the rest confined themselves to practical steps, arranging treatment or advising on it. The reactions
among the 17 women who were refused sex until cure
by their partners were in agreement by 11, and
sadness and insecurity in three more cases. Two
The research now turned back to what the reactions of all the respondents would be to their partners
having a sexually transmitted disease. Their reactions
are shown in Table 6, which should be interpreted in
the sense that the respondents assume that they
themselves are not infected with the disease.
The table certainly shows a future determination
by the respondents to protect themselves from infection. Actual experience, as we have seen, sometimes
proves to be different, although even most of these
women claim they would refuse sex next time. Often
a woman may not realise that her husband has a
sexually transmitted disease or may not be able to
convince him that that is what he is suffering from.
Others may take the risk of infection rather than see
the marriage deteriorate or other wives come into it.
What is most striking is that not even all those
women who had experienced condoms would be
prepared to employ them to continue having sex with
partners who contracted a venereal disease. We explored this reluctance fully with the results set out in
Table 7.
869
Table 6. Responses to the question If your husband/boyfriend becomes infected with a venereal
disease, would you refuse to have sex with him? and subsequent questions (N = 601)
PCXentag
of all
responses
Response
Question
(1)
(a)
(b)
(2)
(1)
(2)
YES
So as not to become infected
99
99
(3)
YES
82
YES
46
YES
36
legitimation offered to contraception by the govemments population policy, and the easy availability of
contraception [54].
TO WHAT EXTENT DO URBAN EKITI WOMEN
THEIR OWN BODIES?
CONTROL
Table 7. Responses to the question Why wouldnt you be prepared to employ a condom and so continue having sex with
a partner who had a venereal disease? directed only to respondents who said they would not employ a condom to allow
sexual relations to continue (N = 216)
Percentage distribution
of responses
Responses
Major category
Subcategory
(1)
Fear of infection
(a)
(2)
(a)
(3)
Aversion to condoms
ii;
(4)
(5)
Aversion to partner
(a)
(b)
Subcategory
Major category
73
73
100
100
870
I. 0.
ORUSULOYE
et al.
tomatic stage where he would probably trade abstinence for care) or becoming threatening or violent, in
which circumstance most wives would leave. A growing trust in condoms would probably mean that a
number of marriages, but probably a minority, where
the husband was seropositive, would remain intact.
Where only the wife is seropositive in most cases she
would probably be driven away.
What is clear from the research is that most
Yoruba women have undisputed control of their
sexuality when their partner suffers from STDs or
AIDS. The refusal of sex may result in the breakup
of a marriage but is unlikely to result in a continuing
marriage dominated by violence or forced sex, or by
pressure from their own relatives for the husband to
be allowed his conjugal rights or for the wife to stay
with him.
It appears probable that in an AIDS epidemic most
Yoruba women with a seropositive husband will
break off the marriage, refuse sex, or agree to it only
with condoms-although
the proportions adopting
these choices cannot be predicted from the STD
research. The exceptions will be those women,
whether seropositive or seronegative, who have convinced themselves that they are probably already
infected or those who do not believe the disease is
incurable.
The situation described here for STDs and implied
for AIDS is probably representative of most of
coastal West Africa. If women know that their husbands (or stable partners) are suffering from STDs or
AIDS they can demand sexual abstinence, safe sex or
leave the marriage. Their ability to refuse sex or
demand safe sex rests on the ease with which they can
leave a marriage. This in turn depends partly on their
access to resources, namely their ability to trade, to
retain their own budget, and, probably, to get access
to farming land from their families of origin. This
access to resources is vital, but not fundamental.
What is fundamental-and
what provides the contrast with East and Southern Africa-is the unique
lineage structure of West Africa with its assumption
that no child of the lineage ever leaves it. Women do
not break with their families of origin when they
marry. It is this which gives them the unchallengable
right to return home from an unsatisfactory marriage and to secure access to land, which allows them
to become independent market women and also to
keep much of the product from their farming and sell
it, to keep and control their own savings, to suffer no
loss of face when they leave a marriage for their
parents or brothers houses, and to weaken any claim
by their ex-husbands or the husbands relatives on the
custody of the children. This is a vast array of
resources which makes their situation very different
from women elsewhere in Africa.
Of course, they may not want to break up the
marriage. The husband may have more resources and
the wife may feel affection for him and a fondness for
the home and family life. She may feel he needs care.
1983.
871
13.
14.
IS.
16.
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21.
812
I. 0.
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