The Social Context of HIV Transmission in Afirca: A Review of the Historical and Cultural Bases of East and Central African Sexual Relations
Abstract
The literature relating to the social context of sexual
relations in East and Central Africa has several
implications for the heterosexual transmission of human
immunodeficiency virus (HIV) . Colonially-created cities in
the region still discriminate economicall y and socially
against women . Rapid urbanization is occurr ing but migrants
maintain strong ties with rural areas . Traditional
attitudes towards marriage and sexuality affect urban
behavior in the extent of marital stability, frequency of
polygyny and the emotional bond between couples . Ethnic
groups in Kampala and Nairobi demonstrate the cultural
foundations of two forms of sexual re l ations found in the
region : one characterized by prostitution and the other by
small circles of interchanging lovers . The first results in
a more rapid spread of HIV through the urban population and
outwards into rural areas . Each pattern has unique
constraints on behavioral change and require different
prevention campaigns .
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NCEPH Health Transition Centre Working Paper
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