The social impact of AIDS in Sub-Saharan Africa

Van de Walle, E.

Milbank Quarterly 68(Suppl 1): 10-32

1990


ISSN/ISBN: 0887-378X
PMID: 2381376
Document Number: 355556
Social values, traditions, and norms related to age and sex distribution, morbidity and mortality patterns, urbanization, marriage, sexual practices, and childbearing have largely shaped the AIDS epidemic in many sub-Saharan African countries. While one may only speculate on the extent of HIV infection and its long-term impact on these societies, one can expect changes to occur in these demographic and cultural patterns. Strongly interrelated factors inherent to some of these societies and affecting the observed pattern of HIV infection include the length and acceptability of postpartum female sexual abstinence, the acceptability of pre- and extramarital sexual relations and prostitution, age differences between men and women at 1st marriage, and the degree of urbanization. Some countries traditionally have long periods of postpartum female sexual abstinence, accepted male extramarital relations over the period, and large age differences between spouses. Where such population characteristics exist, especially in cities, the risk of husband-wife HIV transmission may be significant. Moreover, a high probability of contracting and transmitting the virus may only be exacerbated in societies which expect female virginity at marriage, while nonetheless tolerating prostitution. Evidence to this effect may be observed in the differing social conventions and infection rates of Kigali and Kinshasa. The spread of infection in the future will heighten cultural discrepancies between the behavior of peoples in rural and urban areas, and upset the growing social and economic advantage of the city over rural areas. Societies will, however, adapt and develop new long-term behavioral and cultural norms out of necessity will emerge, accompanied by a nonetheless continued urbanization and total population growth.

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