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    070571
    Peer Reviewed

    African women and AIDS: negotiating behavioral change.

    Ulin PR

    Social Science and Medicine. 1992 Jan; 34(1):63-73.

    Data from eastern and central sub-Saharan Africa suggest that women in countries of the region are increasingly at risk for HIV infection. Poverty, malnutrition, uncontrolled fertility, complications of childbirth, and sex behavior associated with male/female rural-urban migration are contributory factors. While much may go into preventing the transmission of HIV, the cooperative participation of both sex partners is certainly required. Further, while campaigns may educate both men and women of the need to limit the number and choice of sex partners, and use condoms during intercourse, they may fail to recognize the highly unfeasible nature of these behavioral changes for the majority of sub-Saharan African women. Marginally included in the development process, and poorly empowered to make decisions regarding male or female sexuality, women are largely subject to the sexual demands and economic rewards of their male sex partners. Husbands and/or other sex partners may strongly resist or refuse to employ condoms during sexual intercourse. Social expectations and/or economic necessity, however, often dictate a woman's compliance with the man's choice despite her desire to use a condom. HIV transmission and the risk to women and children, national development and the status of women, accommodation to economic scarcity, altering high-risk behavior, symbolic approaches to behavior change, and methodological issues in the study of these issues are discussed. Research is then proposed on understanding the meaning of AIDS, the context and norms of decision making, the norms of sexual behavior, the gatekeepers of sexual behavior change, the economic determinants of sexual risk, womens perceptions of control, and gender-sensitive strategies for reducing the risk of AIDS. Such research will provide a better understanding of how women perceive and respond to AIDS prevention interventions, and will constitute a necessary 1st step toward increasing male participation in protecting themselves and their families.
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