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 .