[Social and cultural obstacles to AIDS prevention in developing countries].

Abstract

In countries where the transmission of HIV is predominantly heterosexual, both men and women are equally affected, including a considerable proportion of women of reproductive age. In various African capitals HIV seroprevalence of 30% was ascertained among pregnant women. Many within Christian Churches have considered AIDS as a punishment of God for sinful behavior and promiscuity. In eastern Africa HIV and other sexually transmitted diseases have been characterized as the disease of women because they were blamed for bringing the disease into the home. Among socioeconomic and cultural factors that play a role in the spread of AIDS are underdevelopment, low level of education (especially among women and girls), and a poorly functioning health care system. Some women are forced by the need to survive into prostitution and do not use condoms because of unavailability or the partner's refusal. Also migration by men to cities in search of work, leaving behind their families, leads to promiscuity and the abandonment of social controls and traditional norms. Fertility is of major importance for Africans. A woman who does not get pregnant has to resort to traditional medicine or try another man. Sexuality in Africa is not in the center of their value system, nor is chastity highly valued. In most of Africa cohabitation is much more tolerated than in the Western world. With different partners the risk of STDs and contracting HIV is high. African women have more sexual freedom than women in the West, and extramarital sex is the best way of making money for many married women. In addition, young women frequently have sex with older men who have had many partners. Polygamy for men is accepted socially, so is wife inheritance. Commercial sex is also available, and even college students engage in it for getting money for school.