Demography, Sexuality and Sexual Behavior Research in Nigeria
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Women from the
Akpamanya hamlet in the Nimbo community of Nigeria
engage in a health situation analysis activity
as a way to express their perceptions and experiences
related to women's health. Copyright © 2002 Serena Williams/CCP, Courtesy of Photoshare. |
INTRODUCTION
When HIV was first reported in1981, there was very
little concern that the disease will spread to Nigeria.
Nevertheless, there have been apprehensions about
the incidence and prevalence of sexually transmitted
disease long before the advent of HIV/AIDS. Despite
the near universal knowledge of STDs, earlier studies
on the incidence and prevalence of the disease were
clinically based. Hence research needs and the intervention
strategies were also clinically oriented.
Our earlier studies on the social
and behavior context of HIV/AIDS in Nigeria were undertaken
in the shadow of the AIDS epidemic in Nigeria on two
basic assumptions. The first was to increase social
science presence and research capacity available to
the AIDS epidemic. The second was to provide empirical
information that can assist in shaping possible intervention
and measuring their impact (Orubuloye et al, 1994).
These approaches were important because the major
protection available in much of sub-Saharan Africa
countries against HIV/AIDS, and probably most STDs,
in the foreseeable future, is sexual behaviour change.
Findings from research programmes
in Nigeria have shown that nearly every adult member
of the Nigeria society has heard of at least one type
of venereal disease, and know that it can be transmitted
by sexual relations. In one of the study about one-third
of all sexually active males and females reported
that they have been treated for a sexually transmitted
disease in their lifetime (Orubuloye, et al, 1994).
It is well recognized that many men and women will
eventually suffer from sexually transmitted disease
during the course of their active sexual life. It
is generally regarded as a form of social incompleteness
among the general population, if a sexually active
man had not experienced or had been treated for a
venereal disease in his sexually active life. Hence
venereal disease was not seen as posing a great danger
to society; hence little attention was devoted to
the social and behavioral context of the disease.
The situation has changed since
the AIDS epidemic began, especially with the evidence
that the disease is spread mainly through heterosexual
relations, and that STDs is a major co-factor in the
spread of HIV/AIDS.
It is now well recognized that in
many developing countries, a past history of STDs
is closely associated with AIDS. In sub Saharan Africa,
the proportion of AIDS patients with past history
of STDs varies from 35 percent in Tanzania to 50 percent
in Zaire (DRC). The figures range from 67 percent
in Rwanda to 75 percent in Zimbabwe, while the proportion
was as 71 percent in Haiti and 70 percent ion Martinique
(Pepin et al.1989). In Uganda, there is the evidence
that chancroid, syphilis and gonorrhea facilitate
the transmission of HIV (Berkley et al 1989). This
is partly because of the high prevalence of STDs in
the region, and mostly because of the growing importance
of STDs as co-factor in the spread of AIDS. Thus,
questions on the recognition of STDs symptoms are
now nested in general survey of sexual behaviors.
In STDs survey, respondents are
asked series of questions on the type of symptoms
experienced, whether and where treatment was sought,
type of treatment received and the outcome of such
treatment (Orubuloye, et al, 1994). In Nigeria, attempts
have also been made to study the health-seeking behavior
of STDs patients attending hospitals and health clinics
in an urban area of Southwest Nigeria (Akinnawo and
Oguntimehin, 1995)
These studies are aimed at developing
appropriate intervention strategies that will facilitate
the treatment of STDs patients and stem the spread
of the disease.
The first case of AIDS in Nigeria,
involving a sexually active thirteen year- old girl
was officially reported in 1984 (Nigeria, 1992). Subsequent
cases were found among commercial sex workers at the
major nodes of transport and commerce: Lagos, Ibadan,
Calabar, Enugu and Maiduguri. The initial reaction
to the epidemic was negative. Most people believed
that the disease originated from foreigners who brought
it to the women in the industry. It was also general
believed that the only way to avoid the disease was
to refuse contact with Europeans and the women working
in the sex industry. By 1991, HIV- positive truck
drivers were detected and concern arose in the industry
and among the general population.
The situation has change. AIDS has
now been detected in all segments of the Nigerian
population. Since the enthronement of democratic government
in May 1999 attention has focus on the AIDS epidemic.
The economic difficulties and political instability
of the last decade have largely drawn the attention
of government away from the AIDS epidemic.
The Nigeria 1999 sentinel survey
indicated that about 5.4 percent of the Nigerian population
may well be HIV positive. This translates to about
2.6 million people that are likely infected with HIV.
The year 2001 sentinel survey indicated a 5.8 percent
level of HIV positive cases in the country. These
figures are staggering and among the highest in sub
–Sahara Africa. In sub-Sahara Africa, the AIDS
epidemic has been identified as a heterosexual epidemic
and the degree of sexual networking (relations with
partners) has been confirmed to influence the level
of the disease, earlier researches were focused on
the determination of the degree and nature of sexual
networking. Research effort was first concentrated
on the general population and subsequent efforts focused
on high-risk groups and men’s sexual behavior.
SEXUAL BEHAVIOR AND SEXUAL
NETWORKING AMONG THE GENERAL POPULATION
In sub- Sahara Africa, sexual activity is defined
by social and economic context and cultural sanctions
and taboos exact behaviors to maintain the structures
of power, and there are taboos against discussing
sex with men of different generations, or in public
or with the opposite sex (Middle 1997 4:67). The AIDS
epidemic has gradually unraveled the mystery surrounding
sexuality. Men and women are equally at risk of begin
infected with HIV, with nearly 80percent of the risk
attributable to heterosexual transmission.
The nature and structure of the
African family system are important determinants of
patterns of sexual relations within and outside marriage
(Orubuloye et al 1997). Polygyny meant substantial
delay of male first marriage, and produces a situation
where half of adult males are single and sexually
active. It has also taught men that relations with
only one woman are not part of man’s nature.
Postpartum abstinence and low level of contractception
make the majority of women unavailable for sex for
a considerable of their reproductive life span.
An intensive study of multi-partnered
sexual relations undertaken in 1989 in the Ekiti District
(now Ekiti State) in Southwest Nigeria found that
three-quarters of single males, slightly more than
half of monogamously married males and a little over
a quarter of polygynously married males had extra-marital
sexual relations during the previous year (Orubuloye,
Caldwell and Caldwell 1991). The single and polygynously
married women reported high level of participation
in extra-marital relationships; nevertheless they
are more discreet in such relationships than their
male counterparts. Subsequently, a study of male sexual
behavior and its social and ideational; context was
carried out. It aimed at finding out the attitudes
of men and women toward men’s need for more
than one woman. It also investigated whether men are
thought to be biological different from women in need
for sexual variety, as well as reporting on men’s
actual sexual behavior and their wives’ reaction
to it.
Studies have indicated that women
are much likely than a man to believe that one woman
is sufficient for a man over a lifetime (Orubuloye
et al, 1991). This was especially the case among women
in monogamous unions than those in polygynous marriages.
Most women in polygynous marriages tend to start their
marital life in monogamous relationships and latter
end up in polygynous union as their husbands acquired
more wives. In traditional society most married women
believed that as the circumstance of their husband
changes, he is likely to acquire more women. Most
women look up to this as an inevitatable event in
their lifetime, and some may assist or encourage their
husbands towards this. Most women in the rural area
and the less educated one in the urban areas with
grown up children are not obsessed with their husbands
acquiring additional wives. Women in is situation
would welcome additional women as a co- wife than
the husband keeping girl friends outside. Once this
happens, the status of the woman changes and she becomes
less responsible to the man. Her attention will shift
to her children. Educated women and Christian are
far more likely to believed in insist on sexual monogamy,
and they are far more likely to succeed than the less
educated woman. Islamic religion considers extramarital
relations that do not end up in marriage as adultery
but approves of polygyny provided the man can make
adequate provision for the women and love them equally.
Men and women who believed that men will seek multiple
female partners explains this in terms of men’s’
fundamental nature and the culture, while Christians
see monogamous relationship as the Christian way of
life proclaimed in the Bible and preached in the Gospel.
Although Christianity preaches monogamy, it is flexible
on matter relating to multiple partnership and adultery.
Men who have more than one wife, and men and women
who engage in extramarital relationships may be denied
taking part in sacred activities such as the Holy
communion, they are less likely to be sent away from
the church on primarily because of sudden sexual urges
and the need for variety of sexual partners. The proportion
of men in this category was nevertheless below that
of those who believe that they can confine themselves
to one woman in their lifetime.
Because a range of social and economic
factors facilitates men’s extramarital sexual
transgressions, the control by their partners has
been difficult. Most husbands and wives do not eat;
sleeps go out together, and maintain a common budget.
Therefore there is no control of what men do with
their income, women are not expected to know or concern
themselves with this. In polygynous households, women
are not supposed to notice their husbands ‘
sexual activities or feel jealous about them; primarily
because their coming into the households derives from
such relationships in first instance. Most men believe
or pretend that their wives have no knowledge of their
extramarital affairs.
Although nearly all women with straying
husbands were aware that something was going on, they
often say nothing because both their husbands and
the society would detest their behavior. Nevertheless,
the more educated and Christian wives have most faith
in their husbands, and they are far more likely to
control their husbands’ sexual behavior and
complaint if their husband were leading a profligate
lifestyle. The majority of complaints were that the
men would become infected with sexual transmitted
disease or would bring disease, especially gonorrhea,
into the marriage. With the AIDS epidemic well underway,
majority of urban women believed that men could be
induced to confine their sexuality to marriage. This
is a dream not yet shared by the majority of men.
Most rural women believed and agreed that men often
need more than one wife, partly because polygyny is
part of the culture and mostly because of the need
for adequate farm labor force. In real life situation
the potentials of such labor force are no longer being
realized because of the jealousy and acrimonies that
now surround polygynous marriages. In rural life complaints
about men sexually straying are not just the business
of husband and wife but all of the relatives surrounding
them. Women in the rural area are often the scapegoat
if they press their complaints too hard. The phenomenon
of outside wife, a new variant of polygyny, is real
even among the high-educated urban middle class in
society (Karanja 1987).
Bigamy, the act of marring a second
time when one is already legally married, is also
not new. Although the act is an offence under the
marriage Act, women whose husband are involved in
this act seldom prosecute them for fear of bringing
shame to the family. Most women tend to leave with
the situation, while some opt for dissolution of their
marriage without pressing for damages against the
husbands, and may subsequently retain the name of
their husband. Certainly wives tradition have little
control over their husbands’ extramarital sexual
relationships; they are far more likely to try to
control their sons’ sexual activity or to see
that it is conducted in safety or that it does not
result in making girls pregnant. There are community
sanctions on wives monitoring their husbands’
behavior; there appear not to be parallel sanctions
on mothers watching their sons ‘sexual behavior.
Nevertheless, mothers consider monitoring their sons’
sexual behavior as their moral rights and social obligations
to them. In contrast the community experts mother
to monitor their daughters’ sexual behavior
and there are sanctions for failure to do so. Most
parents have the fear of their daughters’ becoming
pregnant before finishing at school; hence mothers
to enforce premarital chastity on their daughters
while their sons’ are given some degree of sexual
freedom.
Traditional society continues to
have a story influence on contemporary society and
its mores. Traditional religion did not impose sanction
on male and female extramarital and non-marital sexuality.
Discreet sexual access to women was allowed or tolerated.
Young wives often continued the relations they had
enjoy with men before marriage, and widows or separated
women maintained relationships with men for economic
reasons. The advent Christianity in the 19th century
had had some impact on the traditional sexual system.
The elites and women more widely, were attracted by
western compassionate marriage usually identified
as Christian marriage. The new religion preaches monogamy,
companionship and sexual fidelity. But it appears
that the majority of the followers have not taken
the messages very seriously. The level and intensity
of polygyny, and extramarital sexual may have declined
among the educated elites; they have not been eliminated
completely. Educated men and women are far more likely
to be more discreet about their extramarital sexual
transgressions than their less educated counterparts.
Educated women are far more likely to refused sex
to their infected or philandering husbands than the
less educated ones who lack the knowledge or the opportunity
to identify infection in their husbands. The African
sexual system has by and large passed through three
phases: the traditional system which allowed very
considerable sexual freedom for males and more discreet
freedom for females in certain circumstances; the
colonial and post-colonial system with its monetization,
urbanization and greater mobility of male and female,
and a new phase characterized by a major epidemic
in human history. Experience elsewhere has shown that
the AIDS epidemic is likely to lead behavioral modification.
The situation in Nigeria has not indicated a significant
change in multi- partner relationships. The situation
may change as the AIDS epidemic intensifies. Presently
only a few are really afraid of the disease and resistance
to the epidemic even among the high-risk population
is at present too low. Many people are pre-occupied
with the problem of the economy, while only a few
are apprehensive of the dangers pose by their sexual
behavior. Nevertheless the control of male sexuality
is important and may be an essential antidote for
stemming the spread of the epidemic.
There is now some evidence of changed
sexual behavior from countries that have witnessed
a high level of the epidemic but it will take some
time before this is realized in many parts of Africa,
and the death toll would have certainly been unprecedented
in history of epidemics. Before the advent of the
AIDS epidemic, there was very limited research on
sexuality and sexual relations from which to draw
upon. Earlier social science researchers were reluctant
to investigated sexual relations because of the sensitivity
of the topic and the fear of hurting the respondents,
and thus jeopardizing future social science research.
Because most of the earlier studies were on fertility,
infertility and family planning, researchers did not
possess the armonury of methodogies and body of knowledge
existing in other areas of social science research
when the AIDS epidemic struck. Because of the nature
and intensity of the epidemic, AIDS research has proved
in practice to differ from fertility and family planning
research than originally envisaged. There is substantial
premarital and extramarital sexual activity in much
of sub-Sahara Africa, and yet it is usually not widely
discussed and interviewers may be misinformed or refuse
information. There was and largely still is, extreme
reluctance to discuss sexual activity even within
groups where it is widely practiced. The issue of
sensitivity to providing information on matters that
are essentially private is therefore central to the
investigation of sexual relations outside marriage.
Initial research efforts in Nigeria and subsequent
ones were aimed at finding out the age at first sexual
intercourse, how many different sexual partners respondents
had both inside and outside marriage and how such
relationships were distributed over time. Descriptive
data were collected both on male and female respondents
and on different sexual partners.
Subsequent research attempted to
identify sexual partners and investigate perceived
sexual needs and male sexual behavior in greater details.
The surveys were often carried first by approaching
community leaders, the chiefs and other influential
people to convince them of the importance and the
need for the studies. Soliciting their cooperation
for the studies of the measures taken to ensure the
complete confidentiality of the studies and the materials
gathered. It was also an important means to allay
the fears and apprehensions of the respondents who
were not used to being asked question about affairs
that take place in private. Interviewers were often
from the same sub-ethnic group but not necessarily
from the immediate area, and were recognized when
visiting a household and all its members and neighbors
were aware of just what was taking place. Respondents
and their partners were not personally identified
in the sense of their names and addresses so as not
to damage the interview with refusals and deceitful
answers, and to avoid unwarranted invasion of their
privacy. Supervisors were employed mainly to check
with the interviewers the location of the sampled
household and their complete schedules, and to discuss
problems as they arose and the need for further interviewing.
Close supervision was necessary so as to avoid slippages
that could affect the quality and reliability of the
information gathered.
Although the response rate and the
quality of the data were high, there were some difficulties.
Women tended to understate their non-marital relations,
while men tended to overstate their, and there was
more understatement in rural than urban areas. There
was the difficulty of separating essentially commercial
sex from less commercial relations especially among
urban respondents where extramarital sexual relations
involve a high degree of financial and material support.
PERCEIVED MALE SEXUAL NEED
In sub-Sahara Africa, there is near-universal testimony
that, except in some prostitution, the male normally
takes the initiative for sexual activity. Studies
have also shown that men have unlimited sexual freedom
in and out of marriage, and that a man can be the
husband of several wives. This has raised the question
of perceived male sexual needs, by both men and women,
and the assumed basis of for these needs. An investigation,
which aimed at exploring the extent to which such
perceptions represent the situation in Nigeria, was
considered necessary. This was important for placing
male sexual behavior in the context of the society’s
social structure and belief systems, as well as suggesting
the possibility of change.
In order to achieve the objectives
of the study both male and female were surveyed on
their perception of male sexuality and asexual behavior.
A random sample of male and females over 15 years
of age was drawn in both urban and rural areas. Where
possible the sample was restricted to the same ethnic
group. Separate but related questionnaires were administered
to the male and female respondents; they contained
some common questions, which allowed lengthy answer
for subsequent study. Both young and old male and
female interviewers were engaged: each interviewed
only respondents of their own sex, and older interviewers
interviewed the older respondents. The interviewers
were paired so that both the husband and wife who
fell into the sample could be interviewed at the same
time. This strategy was important to secure accurate
information from women devoid of the influence of
their husbands.
Although the response rate high,
at least one or two callbacks were necessary in major
urban areas, after which any respondent not found
replaced with another one. Our original plan was to
limit the study to the major ethnic group in the region,
but because of a major political crisis on at the
time of the investigation all ethnic groups found
in the sample area were included. Nevertheless, more
than four-fifths of the respondents came from the
dominant ethnic group in Southwest Nigeria where the
research was undertaken, thus making it possible to
understand a single and dominant culture in what was
a cultural investigation. The methodological approaches
adopted in the study of male sexuality made it possible
for our understanding that wives have little control
over their husband’s extramarital relationships.
There was substantial evidence that the Nigeria system
of extramarital sexual relations, double less the
whole sub-Sahara Africa, operates as it dose, not
much because most of the society think that the male
need for sexual diversity is uncontrolled, but because
of the general perception that wives have no right
to comment upon or take notice of their philandering
husbands. Nevertheless, the study established a basis
for change in male sexual behavior as central to the
curtailment of the epidemic.
CONTROL OF FEMALE SEXUALITY
Attitude towards female sexuality varies across Africa,
among ethnic and religious groups. Some ethnic and
religious group suppresses and closets its women and
are punitive in their pursuit of even female sexual
extramarital affairs, in some women have some degree
of freedom and equality with men. Heterosexual transmission
of the disease is dominant in sub-Sahara Africa, and
the greater majority of all the HIV-positive women
in the world are found in this region. It is now clear
that their partners have infected the majority of
HIV seropositive women in Africa. This has been the
case with STDs. Therefore understanding female sexuality
and the extent to which they have control over it
are important for the dynamics of the epidemic and
the intervention strategies for mitigating its spread.
Before the AIDS epidemic broke very
little research was done on women’s control
over their sexuality in Africa, and the general assumption
was that the husband has right to his wife’s
person, and that most women in Africa were helpless
about changing their social situation. Events of the
last decade have clearly indicated that the situation
is changing. A survey of women in the era of AIDS
in Zaire did indicated that an increasing number of
number of women reported that they would stay with
a sero-positive husband to care for him but would
refuse to have sex with him or sharer the same bed.
This is a major departure from traditionally suppresses
and closets its women.
Studies from West African where
women have traditionally enjoyed some degree of autonomy
clearly shed some lights on the matter. Writing on
Ghana in 1931 Cardinal (1931:169) observed that the
status of women in the native household is equal to
that of the man and women do not hesitate to assert
their liberty. In this society it is believed that
women might have exercised their rights within marriage,
especially when there was conflict of interest (Awusabo-Asare
et.ai.1993).
In West Africa, the subsistence
economy is based on a division of labor by sex and
age. Women have traditionally traded and done household
work, they also have their own budgets, control resources
and make decision based on these resources. Although
marriage confers on a husband exclusive sexual right,
thecultutre has long expected women to have some control
over their bodies during certain periods in their
life-cycle: during menstruation and the postpartum
period, and after becoming a grandmother or reaching
menopause. Although the total period may have shrunk
in the last few years because of modernization and
increased use of contraceptives, twenty-five years
ago the duration of these events accounted for 60percent
of a women’s time between menarche and, menopause.
It was the responsibility and right of women to defend
these periods and the community sanctioned men women
who deliberately broke these traditional practices.
In 1990 study of women in the Ekiti
district of Southwest Nigeria (Orubuloye et. Al 1993),
nearly all women reported that they had refused sex
to their partners at least on one occasion in recent
times for a wide range of reasons. These include the
traditional forbidden period (menstruation, postpartum
abstinence and too soon after birth). Others include
punishment for bad behavior, quarreling, drunkenness,
sickness, wives’ right of choice and when the
partner has an infection. A significant proportion
of women reported that their partners were hostile
for refusing sexual advances from them, while some
turned to other wife or went out to other women, and
some accepted the situation calmly and regarded it
as inevitable. Domestic violence is rarely used to
resolve a matter of this nature; the men can turn
to other women, while the women can return to their
paternal homes temporarily. Divorce is not usually
an option.
Reactions of women to infected partners
present a different scenario. Nearly all the women
identified gonorrhea as their partner’s type
of infection. Many women were not aware of their partners’
infection because to a very considerable extent they
live separate lives with sexual intimacy at night
under poor illumination, and women often know little
about where and when their husband urinate. Nevertheless
a significant proportion of women who knew about their
partners’ infection refuse sex to them until
they underwent treatment, while only a few continued
sexual activities but with condoms suggested by partners
or insisted on by the women. Most Yoruba women are
able exercise this right because of the support they
will receive from the community, their family members
and because of their economic independence.
A significant proportion of Yoruba
women believe that they can refuse sex with infected
partners’ and only a few would continue sex
with condoms. Although a significant proportion of
women knew about condoms and had used them before
or currently using them, majority was not convinced
that condoms would guarantee against infection. Many
women have aversion to condoms and all contraceptives
as well. While many believe that condoms are too thin
to offer protection against sexually transmitted diseases,
other are apprehensive about the effects on other
contraceptives, especially the assumed reproductive
impairment. These are genuine reasons in a society
where there is little emphasis on sexual pleasure
and where emphasis is on high level of reproduction.
The among the major ethnic groups
in Ghana is similar to that of the Yoruba of Nigeria.
A 1991 study on women’s control over their sexuality
reveals that majority of women (60%) felt that a women
had the right to refuse sex with a partner who is
promiscuous, and 90% of women would do so when the
husband is disease; for fear of infection. More than
one half of the women had actually refused sex with
a husband on at least on one occasion on account of
jealously and to attract attention to themselves.
Among women whose partners had STDs, half had unprotected
sex, partly because of the belief that they could
not be infected and partly because of the misconception
that having sex with an infected person could cure
the disease. This poses a danger if extended to AIDS
cases (Awusabo-Asare et al 1993).
In Eastern and Southern Africa,
women are at a relatively greater economic and decision-making
disadvantage to their husbands than is the case many
parts of West Africa. In this region, as evident in
Uganda (Ssekiboobo 1992), and in Kenya (Muange 1998),
women are seen primarily as farmers with only very
limited access to urban trading and on physical separation
of what they themselves produce from that of their
husbands. Wives ‘ inability to refuse husbands
sex, insist on safe with them or force them to curtail
their extramarital sexual relations is an indication
their powerlessness. Women in this region compared
to those in West Africa are constantly oppressed by
a society in which they so finally break ties on marriage
with their families of origin that they are not welcome
back as a matter of right after a separation from
their husbands. They cannot demand access to farming
land on their return, and neither their own families
nor those of their husbands will expect them to bring
their children. The women’s refusal of sex would
be highly likely lead to divorce and to the loss of
access to the resources that her marriage had provided.
Women seemed relatively defenseless against their
partners if infected with sexual transmitted disease
or HIV.
A wide range of factors, which are
external to women, often influences sub-Sahara African
women’s ability or inability to control their
sexuality. The economic difficulties of the few years
meant economic insecurity and increased dependence
of women on their husband for support to them and
their children; women are therefore under pressure
to remain in unions that pose great danger to their
lives. The fear of losing the partner and the pressure
of the family members to remain in a union that poses
danger to the woman have become important more than
before. The assistance from the family to the relatively
poor members has shrunk to an all time low because
of the current economic difficulties. This may compound
the epidemic situation, as many young women across
the region have now taken to commercial sex to generate
income for their survival. Investigation reveals that
many of those women return to their place of origin
when they fall sick and subsequently infected men
who latter infect their partners.
Nevertheless, women need support
from the community and possibly from government to
be able to refuse sex from partners who are leading
dangerous sexual lives or infected with HIV. Women
must be convinced that although this may not be culturally
acceptable but it is morally justified.
STUDYING HIGH-RISK GROUPS
Female Commercial Sex Workers
Our first attempt at studying people in high-risk
occupations was that of female commercial sex workers.
In much of sub-Sahara Africa, there is a substantial
male demon for sex outside marriage, and this has
led the growth of commercial sex industry in the region.
The growth of the commercial sex industry has long
exposed and many women employed in it and their clients
to increased risk of sexually transmitted diseases,
and in the last one decade presents the danger of
infection with HIV/AIDS. Opinions tend to converge
regarding the origin, nature and causes of commercial
sex in Africa. In a recent publication, pellow (1997)
wrote that prostitution has been prevalent and visible
in Africa cities since the nineteenth century, rooted
in the colonial past and poverty; a way in which women
have used and manipulated their sexuality because
they have been denied active participation in the
economy. Writing on the Hausa Muslim w omen of Northern
Nigeria, where according to pellow, marriage is normative
but rarely stable, women become prostitutes out of
economic need because they do not want to be married,
and prostitution provides an alternative lifestyle
(p.70). in a similar vain white (1997) wrote that:
prostitution in Africa like prostitution anywhere
else is not a form of social pathology or cultural
predisposition. She also went further that it is one
of the ways women’s work supports their families
and that the ways women in Africa has prostituted
themselves have to do with the kinds of families they
are supporting and creating, and the kinds of support
their families required at that time.
Pittin (1983) discussing the house
of women in Katsina in Nigeria, observed that there
are houses that accommodate women on their own, who
support themselves completely or in part by selling
their sexual services. Oppong (1983) identified and
reported on a group of white-collar women in Accra
Ghana whom she described as single wealthy and potentially
mobile, who chose to content themselves with the steady
improvement of their economic resources and enhancement
of theirs bargaining positions by exchanging sex for
money. In Gambia, the economic incentives were powerful
motivations to prostitution (Pickering et al.1992).
The economic difficulties faced
by many of the Africa countries since the early 1980s
have resulted in the growth of commercial industry.
Many poor families encourage their young girls to
migrate to the major towns and commercial centers
for wage employment, which is not easy to come by
quickly thereby putting pressure on them to go into
commercial sex. The movement to the major towns and
commercial centers was facilitated by the rapid growth
of the educational system and of the transport network.
The growth of the commercial sex industry has longed
exposed many women in it as well as their clients,
to increased risk of sexually transmitted diseases,
which were know to affect one third of the population,
and now presents the danger of infection with HIV/AIDS.
Over two-thirds of all the people now living with
HIV in the world –nearly 21million men, women
and children are reported living in sub-Saharan Africa
the home of 9percent of the worlds population (UNAIDS1998).since
the advent of the epidemic, HIV in sub-Sahara Africa
has mostly spread through sex between men and women
and the commercial sex industry and the people working
in it have played a major role in the course of the
epidemic.
Across sub-Saharan Africa, prostitution
takes place in large towns or cities where there is
demand for it. The majority of sex workers work in
places where alcohol i9s sold and where dancing is
also a common feature. The young women in the trade
live a more restricted and institutional life in the
place where they work. They isolate themselves to
retain their anonymity and maintain close contact
with their hometown by sending money regularly to
their family and where they plan to return at the
end of their sojourn in the city (Orubuloye,et al.1994).
Nowadays the sex workers are young,
mostly single less than30 years of age, better educated
and do not seem to stay a lifetime in the trade. The
majority of the young women now in the trade appear
to have no real occupation between leaving school
and taking up prostitution, and the unemployment situation
has driven many to seek alternative jobs. Prostitution
for this new generation of sex workers is an opportunity
for intensive savings, in order to establish themselves
in small business for the rest of their lives. Nearly
all the women in commercial sex trade do make substantial
savings beyond their remittances, expenditure on health,
cosmetics, and deductions for board and food. Prostitution
guarantees an income level higher than what people
of the same qualification earn in government employment.
Many sex workers tend to remain
anonymous, and there are no great disabilities connected
with profession. Most keep contact with their relatives
and many relatives probably have some ideas of what
the young women are doing for a living in the city.
Many return to their homeland at the end of their
sojourn in the city to establish businesses and lead
respectable lives for the rest of their lives. In
addition, those who had retired from the business
provide necessary information for young recruits into
it, and sometimes act as recruitment agents for the
managers of hotels, brothels and bars in the cities.
There are no clear socio-economic
groups from which the sex workers come. They are likely
to come from both urban and rural areas as well as
from all the ethnic groups in a country. A significant
aspect of commercial sex in recent years is the spread
across international boundaries, and the trade is
almost synonymous with migration. Commercial sex workers
are highly mobile, so are their clients. It is also
unique that most of the sex workers do not practice
their trade among their ethnic groups or where they
can easily be recognized. Most sex workers see the
trade as a stage in life and an investment for later
life, and inability to make a substantial saving leave
them in the profession for a considerable length of
time.
The AIDS epidemic has raised the
issue o f safe sex for the sex workers and their clients.
A significant number of the sex workers had adequate
knowledge of condom and the potential effects on minimizing
the infection of HIV. Sex workers had effectively
used condoms as protection against STDs and pregnancy,
and about one-third of those in the cities now attempt
to use condoms regularly, while over one half now
regularly suggest the use to their customers. Trust
in the condom has significantly increased among sex
workers and their clients a situation, which can largely
be attributed to the massive campaign currently going
on and the regular supply condoms. Nevertheless, the
current economic difficulties and political instability
are jeopardizing the supply of cheap condoms. A significant
number of the clients of the sex workers who normally
provide condoms during sexual encounter are no longer
able to afford them. Many are now willing to trade
in free condoms for cash to pay the sex workers. This
may well pose a serious danger of the spread of AIDS
and other sexually transmitted disease to the sex
workers, their clients and the general population.
The sex workers and their clients
are now sufficiently aware of AIDS, as has been the
case for STDs for generations. They would be receptive
to any organized program to combat them. Nevertheless,
neither the AIDS epidemic, nor the government information
program has done anything to reduce the flow of young
and attractive women and their clients into the trade
or to alter its essential nature. The economic difficulties
faced by many families and the high level of unemployment
among high school graduates that now dominant the
trade may continue to guarantee the supply of new
comers into it. Increased supply and promotion of
highly subsidized condoms will be a critical factor
in slowing or halting the AIDS epidemic. Government
legislation against prostitution or constant police
raids on sex workers cannot provide a quick solution
to the dangers posed by those involved in the trade
and the general population around them. The study
of commercial sex workers in the hotels, bars and
brothel entails a different methodologically approach
from the study of the general population. In the study
of rural and small towns in Southern Nigeria, the
number of institutions and the sex workers was small
hence all the institutions and the sex workers were
included in the sample. Whereas in the large urban
centers and cities, the number of institution was
so great that they had to be sample and then appropriate
weighting was achieved within establishment by interviewing
a fixed proportion of the young women working in the
sex industry. The cooperation of the managers was
secured before gaining access to the women and young
male interviewers who agreed to pose as potential
customers were employed to interview them. Cigarettes
and drinks were provide and in a substantial number
of cases the interviews were completed only by additionally
making a payment for time lost as a result of the
interview. This was the only way to gain the total
support of the sex workers whose chief aim was to
maximize earnings in a very highly competitive trade.
The approach yielded a robust type of sample but excluded
a substantial number of the high-class prostitutes
who solicit for customers in the street and around
the hotels.
In the Northern Muslim area the
approach was different, more of the commercial sexual
activity is unconnected to institutions, and a substantial
numbers of sex workers who are from Southern Nigeria
roam around the major hotels and streets in the major
cities soliciting for customers every night. Matured
women health workers who succeeded in gaining interviews
by emphasizing their concern with sex workers’
health interviewed many of these street prostitutes
in a snowball kind of sample. The introduction of
stiff laws and penalties in the Muslim regions of
Nigeria is likely to drive the sex workers under ground
and make it a well nigh impossible task to identify
and study them.
A recent project focused on interventions
among the sex workers in Ado-Ekiti, a process that
was rendered easy by our previous contact with them
and their managers. A one-day seminar was first organized
in one of the hotels for all the sex workers and their
managers working in the town. The seminar aimed at
educating the sex workers and the manager about sexually
transmitted diseases including HIV/AIDS and the need
to protect the sex workers against being infected
by their clients or they infecting their clients.
Condoms were distributed free at the end of the meeting,
and subsequently fortnight for a period of six months
during which records of use and problems associated
with it were identified and solutions found to them.
The project has increased the use of condoms by the
sex workers and their clients, and many sex workers
are now able to refuse sex with clients who refuse
condom, and many clients now bring their own condom.
Nearly all the young women who engage in commercial
sex go the city to make quick money, and most intending
to stay only long enough to make enough money to set
themselves up in business back home and to secure
a good marriage and become respectable members of
their communities. This raises a difficult survey
methodological question, for most intend to go back
home and make on mention of their actual occupation
to their families and future husbands. This will pose
a serious methodological problem of identification
in any attempt to survey this will group of people
as has successful been done in the case of return
labor migrants.
Truck Drivers
Across Africa, long-distance haulage drivers play
important role in the economies of the countries.
Similarly the drivers are a major source of STD and
now HIV/AIDS infection and the levels of disease are
considerably higher along they ply frequently. The
research project undertaken in the early stage of
the epidemic aimed at investigating and identifying
those aspects of the drives’ behavior and way
of life that made them vulnerable to infection and
thus pose dangers to themselves, their wives and the
society. A major methodological obstacle arose from
the mobility of the drivers. In order to overcome
this interview were conducted at highway truck stops
along the major highway that run from the Southwest
part to the Northwest of Nigeria where the drivers
stop for meals, serviced or repair their truck, sleep
and have sex. The truck stops are large laces often
filled with huge trucks parked for half a mile, producing
a great deal of noise and movement as engines oil
and tyres are changed, and where mechanics and hawkers
are everywhere. The truck stops are often busy, rough,
tough and dangerous places. The fluid situation at
truck stops made it impossible to obtain a complete
listing of all drivers stopping there from which to
draw a sample. All drivers who stopped and willing
to be interviewed were interviewed.
It was more appropriate to use attractive
young ladies who are rarely seen in the truck stoops
and whom the drivers were willing to give some attention
to while doing other things and whom the drivers think
they can establish some kind of relation with. The
drivers soon discovered that most of them were university
undergraduate students who were less likely to accede
to their request. Because the drivers were always
in haste, the questions were short and were best to
memorize them as well as the answers and complete
the questionnaire later. The response rate was high
and the drivers who refused to be interviewed were
only those who were too busy to give up their time
to be interview or in haste to meet up with some specific
requirements of their employers.
A later project among truck drivers
included an intervention program preceded by a one-day
open seminar in one of the major lorry parks on safety
on the highway. The seminar was to sensitize the driver
to the dangers, which unprotected sex, can pose to
them and their wives in the course of their daily
activities. The intervention included demonstration
on proper use and distribution of condoms. Subsequent
follow-ups confirm a general rise in the use of condoms
among the drivers, especially with sex workers itinerant
traders.
The great majority of African women
farm or trade. Most of the trading is in raw foodstuffs;
cooked food, textiles, palm oil, kola and groundnuts,
cooking utensils, jewelry and a wide range of other
locally manufactured and import goods. In the rural
areas, most trading activities are in front of the
houses or from house to house or in the markets on
every fives days. In urban areas, most trading is
far more likely to take place far away from the usual
place of residence of the traders. Most girls have
traditionally assisted their mother in hawking goods
from house to house or at market places. The advent
of motor vehicles created new market places at the
lorry parks or at the bus and truck stops along the
road. Female hawkers, who sell few items from portable
tray, from a fly- proof box made of glass and wood,
or from a temporarily erected stand, are common in
sub-Sahara Africa. The investments and returns in
this type of trading are usually small. Most of these
young women hope to have a small stall in the market
some day, perhaps capitalized by a future husband.
Investigation among the itinerant traders in Ibadan
shows that the majorities of the traders are usually
single, sexually experienced, practice contraception
and has multiple sexual partners. The goods they sell
range from cooked food items, ice water mineral drinks
to chewing gums, coconuts, sugar and kola nuts. These
are items that are often in high demand by drivers
and their passengers.
Because of the nature of the lorry
parks and bus stops, the drivers, bus maids and passengers
often regard young women who trade there as potential
sexual partners. They frequently make suggestive advances,
and the women often offer sex to them in return for
money or goods, to supplement their income and increase
their savings. Women who sell goods along the road
and in lorry parks have been identified as playing
a role in the spread of infection because of their
way of life. Many have multiple partners and have
sex with men who themselves often have sexual relations
with many women including sex workers. The young women
are becoming increasingly worried about the risks
posed by having sexual relations with many men now
that the campaign about STDs and AIDS has been extended
to the lorry parks, bus stops and the major highways
where the women trade. A significant number of them
had suffered from STD, usually gonorrhea, while nearly
all had heard of AIDS. The women are in a serious
danger because many of their sexual partners especially
the drivers assume that they are less likely to have
HIV because they are young, because many have had
little sexual experience and because they are less
likely to be full-time commercial sex workers. This
may become a major root for the spread of AIDS, as
has been the case for STD. The contribution of the
itinerant hawkers is important to the efficiency of
the transport system by selling a wide range of goods
at the windows of buses and trucks. The lorry parks
and the bus stops offer employment and provide income
for many families. The chance of the traders to make
a sale depends on maintaining good relationships with
the drivers, the bus maids, the porters and regular
passengers who dominate the transport system. Offering
sex is a way of developing acquaintance with drivers
or passengers. Some of the relationships often become
permanent and some of the young women may end up as
additional wives to the drivers. Because of the nature
of the young women educational campaigns about AIDS
and other STDs at the lorry parks and bus stops are
important for disseminating information to all those
who work to support the transport system as well as
those who work in it. Such campaign should aim at
changing sexual behavior and use of condoms. Unfortunately
the economic difficulties which most of the sub-Sahara
African countries are currently going through have
made it difficult for such campaign to have its desired
effect.
The sex workers and the truck drivers
are closely related to the young itinerant female
hawkers who sell goods in the lorry parks, truck stops
and from house to house. These women sell a few items
from portable tray frequently balanced on their heads,
from a fly-proof box made of glass and wood, or from
a temporarily erected stand in the lorry parks, truck
stops and along the highways. They sell goods that
are in high demand by the drivers and the passengers
as truck, buses and vans disgorge passengers or as
people wait for transport or trucks and buses slow
down during traffic hold ups. This is a common phenomenon
in West Africa. Because of the economic difficulties
now faced by many African countries and the high rate
of unemployment, a significant number of young males
has infiltrated into the trade that was an exclusive
preserver for the women. This often leads to stiff
competition and conflicts between men and women trading
in these areas. The young men tend to outwit the young
women when chasing their customers most of the young
women are unmarried, and in the past such women usually
assisted their mothers in trading. An increasing number
of young women are now selling on their own, and most
of them hope to have a stall in the market when they
get married. Because the lorry-parks, trucks stop
and the highways are rough and tough places, most
of the interviewers were males: the questions were
short and the interviews were conducted fairly rapidly
often by memorizing the question and answers. All
female hawkers in each lorry-park or truck stop were
identified in the records to avoid interviewing the
same women twice. The response rate was high and a
lure in traffic moment, usually in the mid-afternoons,
provided opportunity for more interactions between
the women and the interviewers.
SURVEY OF YOUNG PEOPLE 15-24
YEARS OLD
In 2002, the federal ministry of health carried out
a behavioral sentinel survey among 7902 young people
15-24 years old consisting of 3946 female in 14 states
in Nigeria. The survey describes the characteristics
of Nigerian young people spread across all geopolitical
zones and many ethnic groups with regards to their
sexual behavior, knowledge and attitude to HIV and
condoms use. Their profile is that of young people
aged 15-24 with a mean age of 19.1 years and a high
level of education. Only 0.5% lacked formal schooling
while more than 57%had attained secondary education
and majority (83%) of whom were single. More young
people in the Northern Zones were married compared
to those in the Southern zones.
About one-half of all respondents
had had sexual experience. The median age at first
sexual experience was 17 years. However the females
than males had reported sexual experience in the last
12 months. The lowest rate of sexual activity was
reported in Jigawa State, which incidentally also
had the lowest HIV prevalence in the 2001 national
survey. The most common reason given for the first
sexual experience for females was the desire to have
children while that for the males was for fun. In
terms of age mixing, the disparity in age between
sex partners of male and female respondent ranged
from 1- over 20 years. For about two-thirds of all
respondents the range of age disparity was 1-9 years
and for about one0third it was 10years and over. About
one-fifth of the females had partners who were en
years and above older than them. Among the 3811 respondents
who were sexual experience 53.6% did so with regular
partners, 21.8%with casual partners and 17.6% had
engaged in transactional sex. By gender, 56% of all
male and 77% of all female respondents who were sexually
active within the last one month reported having only
one sex partner they considered as regular. For sex
partners considered as casual about 26% of male and
28% of female respondents sexually active admitted
to having sexual intercourse with at least one such
partner within the last one month. Those who admitted
to transactional sex with at least one partner within
the same period were 22%of the males and females who
admitted to transactional sex. Among male respondents
2.6% admitted to having sexual intercourse with males.
Multiple partnership and sexual intercourse with sex
workers and casual partners as well as men having
sex with men constitute risk sex behavior. It can
be inferred from these findings that a large proportion
of young people were involved in sexual activity involving
multiple partners and in relatively risk sexual practice.
This risk is greatest when the sexual intercourse
is unprotected with a condom.
The age at first sexual intercourse
is an important factor in the spread of HIV sexually
transmitted infections. It is also important as a
cause of teenage pregnancy. The younger the age the
more likely it is that such persons would be unable
to have enough information to protect them apart from
begin subject t to exploitation by older persons.
Young people are more likely to spend youthful time
at school and practice sex outside marriage. They
need information to protect them from begin infected.
Young people who use alcohol and drugs and engage
in multiple partners are at risk for HIV and other
sexually transmitted infections. So also are young
people who choose partners among those that may be
much older than them as such relationship may be transactional
and exploitative. The level of awareness of sexually
transmitted infections was generally high among both
male and females across the States. However, the level
of knowledge of STIs in men and women was general
poor. Knowledge of the specific signs and symptoms
of STI Between 20% and 33% of the respondent reported
that they knew specific signs and symptoms of STIs
in women compared to between 23% and 41% who reported
same for overall, 10% of the respondents reported
a genital discharge in the last 12 months and 3.6%reported
a sore or ulcer.
IDENTIFYING SEXUAL NETWORK
Perhaps to the most difficult aspect of the series
of our investigations on sexual networking was the
identifications of sexual partners and mapping sexual
networking conducted in Ondo Town in 1991. Research
on the subject is difficult and painstaking because
individuals are always reluctant to state the number
of sexual partners accurately, especially those that
are commercial sex. The original research described
sexual behavior and characteristics of individual.
Such information was by no means enough to provide
an adequate description of their sexual networks or
to determine the extent to which men’s sexual
activities are diffused through a considered part
of the society rather than focused on a small number
of women providing commercial se.
Earlier research had indicated that
men were more likely than women to disclose fair accurately
the extent of their sexual activities, and that men
would also provide more details than women about their
partner. Men were generally more aggressive than women
in seeking to identify their partners other partners,
primarily because men are more discreet about their
sexual behavior and that men believe that women should
keep to monogamously relationships than men. It was
also believe that men would suffer little or know
deprivation if their exmarital sexual affair becomes
public compared to women. Men could always argue that
they are seeking for another wife and the society
will approve of this explanation. Therefore it was
decided to interview men., and also important to carryout
the investigation in a relatively large urban location
where people are more open about sexual matters. The
obstacle was partly overcome by selecting an urban
area with a quarter of a million people, a place where
men were more discreet about sexual networking and
where there were substantial resources to support
it.
The methodological approach produced
a plausible result. Nearly all those men who reported
extramarital or non- marital sexual partners during
the year agreed to identify them. A significant proportion
of the partners was described as girlfriends or women
friends, fewer than one percent were described as
sex workers. The practicability of establishing how
many partners a man has the number and type of the
partner’s partners depends on the extent to
which the w hole sexual networking system is carried
out openly or surreptitiously. Despite the assumed
openness of the community selected for the investigation,
nine out of ten of all the married men currently having
extramarital relationships maintained that their wives
did not know of these liaisons. Traditionally wives
are not supposed to know or ask question about their
husbands’ extramarital affairs. With that extension
of western education to women and the movement towards
monogamous and companionship unions, women are increasingly
aware of their right to ask such questions from their
philandering husbands. Nevertheless, three- fifth
of the men reported that some of their relatives knew
of their extramarital sexual relations. This is a
common pattern across Africa, relations and friends
often know of other relatives and associates extramarital
affairs. Quite often they initiate and sustain such
relationships.
Identifying partners was more problematic.
Only a small fraction of the men could and willing
to accurately describe their extramarital partner’s
partners and the majority of the men could not be
bordered and would not participate in a sexual network
more complex than the ones they were in. the threat
that the men might break with partners they suspect
of having affairs with other men made those partners
conceal the existence of other men in their lives.
This often happens if a man suddenly discovers that
the woman he was going out with had another partner
or partners. Women are conscious of this and are apprehensive
of the risk that might jeopardize the support they
receive from their extramarital relationships provide
additional vital income for poor families, widows,
divorced or separated women, single girls seeking
support to stay in school or become established careers
and to married women whose husband cannot meet their
financial need and who choose to lead high profile
lives.
The research clearly showed that
it was a difficult task to identify partners’
partners even in a society that pride itself in the
openness of sexual matters. Attempts to do this may
cause severe damage to network of relationships and
impair future social science research. For a more
complete identification, a new form of methodology
will have to be invented. Perhaps it may be possible
to do this in a small community where everybody knows
one another, the type of relationships entered into
by individuals and where the research can successfully
conceal his identify.
OBSTACLES TO BEHAVIORAL
CHANGE IN THE PRESENCE OF AIDS
Earlier research reports on sexual behavior and sexual
network (Orubuloye et al. 1994) led us to believe
that their obstacles to behavioral changes is the
need to investigate an important aspect of the social
and behavioral context of the AIDS epidemic. In an
attempt to fill this gap a resistance, to change in
Sexual behavior Project was undertaken in 1998/99
to test the earlier propositions, ascertain current
situation and determine future trend.
Four research areas were selected
in Southwest Nigeria: Ado-Ekiti, the capital of Ekiti
State; Ibadan the capital of Oyo State; Badagry and
Ojoo two sub-urban areas in Lagos and Ugep a rural
district of cross river- State in Southeast Nigeria
(et al Orubuloye and Oguntimehin, 1999 and Caldwell
et al 1999).
The Ado- Ekiti research interview
all males who frequent the hotels and bars, which
offer commercial sex for a period of three months.
A household sample survey of adult male was conducted
in sexual affairs with more than one partner Ibadan,
Lagos and ugep. The survey yielded a total sample
of 1005 respondents; five more tan the anticipated
size of 1000 males. Questions were asked of the men
the number of their sexual partners over a period
of time attitude towards STDs/AIDS and death and use
condom. The refusal are was only one percent in Ugep,
typical of rural areas, five percent in Ibadan, ten
percent in Ado-Ekiti and 15percent in Lagos a busier
and less tolerant population.
The results were not different from
our previous investigations. Reported number of sexual
partners was high and many men were not ready to disclose
their sexual network of relationships beyond one or
two partners. A larger proportion of men is yet to
see the dangers inherent in their sexual behavior.
There was a general robust attitude
towards death and the majority accepted death as inevitable
and was willing to accommodate its timing. This a
major obstacle to sexual behavior change and may be
will a catalyst for the spread of the epidemic. An
AIDS epidemic is well underway in Nigeria the level
may well reach that of the East and southern African
epidemics. Nigeria has a large population yet a few
have had close contact with AIDS deaths primarily
because the epidemics started late. When it was established
that certain people died of AIDS friendly neighbor
and relatives are not told because of the shame that
may bed brought to the families of the affected people.
Very few Nigerians have been buried with the mourners
knowing for certain that the cause of death was AIDS.
The reality of the epidemic has not yet impacted on
the vast majority of the people, hence the denials
of the existence of the disease.
CONCLUSION
Researching sexuality, sexual behavior and multiple
sexual relationships has raised the central issue
of sensitivity to providing information on matters
that are generally considered to be private. Although,
there is a high level of premarital and extramarital
sexual activity in Nigeria, the practice is not usually
widely discussed and interviewers may be misinformed
or refused information. The knowledge that an investigation
is see king information within a community on multiple
sexual relations can cause excitement and a curiosity
about which person is begin interview. There was understatement
of sexual partners especially by rural females while
urban males tended to overstate theirs. On the contrary
men tended to understate their relations with sex
workers by describing them as friends. Nevertheless,
the evidence on the core data on sexual networks produced
a pattern that is internally consistent t and methodological
that is satisfactory and findings that can be trusted.
The HIV/AIDS epidemic has facilitated research on
sexuality and sexual behavior and earlier conception
that sexuality and sexual behavior cannot be studied
because of the sensitivity and that such investigation
would distort relations with respondents and damage
other inquiries has finally been put to rest.
By I. O. Orubuloye.
Dr. Orubuloye is a professor at Department of Sociology,
University of Ado-Ekiti, Nigeria.
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