Sexuality, migration and AIDS in Ghana

Sexual behaviour in Ghana characterizes a society in transition. Although cultural restrictions against sexuality are no longer strictly enforced, the very nature of the social organization puts a brake on some excesses. Migration removes people from these restrictions into a situation where sexual fulfilment is enhanced. This paper explores the risk factors associated with migration. Results of a large survey across Ghana indicate widespread sexual networking. There is, however, an apparent decline in the number of sexual partners in recent periods which may be related to the AIDS campaign. Yet migration acts to increase the extent of sexual networking. While many migrants have regular sexual partners, there are a substantial number of encounters with casual partners. The circular nature of migration and the maintenance of links with home through frequent visits puts people at risk at both ends of the migratory movement. This risk is increased with international migration, associated with higher than average numbers of sexual partners. An appropriate policy for the control of the spread of AIDS in Ghana, therefore, would be one which combines educational programs with strategies for removing the factors which compel young people to migrate

The conditions and care of AIDS victims in Ghana: AIDS sufferers and their relations

So far substantial effort has been devoted to the basic research necessary for AIDS prevention and rightly too. What to do with the AIDS patients, the ultimate victims of the human immunodeficiency virus (HIV), until very recently, had remained almost exclusively the concern of health workers. Sufferers continue to be 'guinea pigs' in the hands of scientific and medical researchers in their frantic efforts to find a cure for the disease. But the long incubation period of the disease means that, even if all HIV transmission were to halt immediately, the number of AIDS cases would continue to grow during the next decade at an average rate of ten per cent a year (Panos Dossier 1992). That aside, the number of AIDS related deaths in some places has already reached alarming proportions, and the impact on families is already manifesting itself in many ways: increasing numbers of orphans, broken families, collapsing family enterprises, loss of family income, growing number of childheaded households, etc. (see Barnett and Blaikie 1992). In economically depressed countries the strain on limited resources has begun to show as inadequate personnel and facilities have to be syphoned off to take care of AIDS patients. The message is quite clear: it is time to look at the other end of the continuum - the AIDS sufferers. It has, thus, become important now to expand discussion of AIDS to include its more general social consequences. In the early years of the epidemic in Africa, Jonathan Mann, the first co-ordinator of WHO's worldwide AIDS program, commented in an interview on German television that African societies had some advantages over Western industrial countries in that AIDS patients would not be isolated, and that their families would look after them. Thus in Africa, the condition of the AIDS sufferer will be better appreciated if it is looked at within the framework of the family

Street youth in Accra city: sexual networking in a high-risk environment and its implication for the spread of HIV/AIDS

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Postpartum sexual abstinence in the era of AIDS in Ghana: prospects for change

Postpartum sexual abstinence for females has been identified as one of the socio-cultural factors with the potential for creating conditions for the sexual spread of HIV in areas where it is practised. In general, women are expected to abstain from sex after childbirth in order to ensure the survival of the mother and child. Men are not similarly expected to abstain and that has been used to rationalize polygyny. With changes in socio-economic conditions making it more difficult now than before to maintain two or more wives, particularly in urban areas, some men will abstain like their wives for fear of HIV infection; but such men may press their wives to resume sex early. Some women, on the other hand, may give in to the demands of their husbands by reducing the prescribed duration of postpartum abstinence. If this happens without the use of effective modern contraception, fertility may be affected. Some may also enter short or long-term relationships outside marriage, hoping that they will be safe from sexually transmitted infection. Using data from the Ghana segment of the Social Dimensions of AIDS Infection Survey, the study examines the responses of women who reported postpartum sexual abstinence and that of their partners. Both men and women reported abstaining, but some women were aware that their partners did not abstain as they did. Some of the women knew the sexual partners of their partners. Mostly it was men who made the first move to resume sex. For any behavioural change to occur, attitudes towards socially-constructed practices such as postpartum sexual abstinence will need to be changed by intensive education of both men and women and also through community support

Experimental research on sexual networking in some selected areas of Ghana

Despite increasing evidence that West Africa is at a critical stage in its experience of the AIDS pandemic, there is a lack of specific information about the sexual behaviour of people in the society. To provide such information, 360 individuals were surveyed. Results indicate that the nature of sexual contacts within Ghanaian society has the potential to promote the spread of STDs and AIDS. Polygyny, central in Ghanaian socio-cultural organization, underlies the male tendency to seek multiple sexual partners. Early widowhood, the general instability of marriage and the high level of remarriage, also suggest that there is a high level of sexual networking within the society. Although Ghanaian society accepts sexual networking, and some people are even casual about the AIDS scare, it appears that people are changing their sexual habits in response to the campaign on AIDS, which seems to have succeeded in instilling fear

Livelihood and the risk of HIV/AIDS infection in Ghana: the case of female itinerant traders

Itinerant trading is the second major economic activity for women who constitute an important chain in the distribution of goods in West Africa. Historically they have played important roles in the political economy of Ghana. With the outbreak of AIDS these women, some of whom move far away from home sometimes for days or even weeks, stand the risk of being infected with HIV through their activities. Using a combination of methods including a survey, focus-group discussions and conversations with key informants, we examine how the trade is organized, the characteristics of the traders, and the risk factors that are likely to predispose them to contracting the AIDS virus. Itinerant women traders appear highly vulnerable, as women and as highly mobile people. This state of affairs, occasioned by the extremely difficult conditions in which the women work, is exploited for the sexual gratification of the men with whom they come into contact. The attempt to reduce the spread of AIDs through education has to target itinerant women traders at the points of transaction

African families and AIDS : context, reactions and potential interventions

This paper reviews publications and research reports on how sub-Saharan African families have been affected by, and reacted to, the AIDS epidemic. The nature of the African family and its variation across the regions is shown to be basic to both an understanding of how the epidemic spread and of its impact. The volume of good social science research undertaken until now on the disease in Africa is shown to be extremely small relative to the need

African families and AIDS : context, reactions and potential interventions

This paper reviews publications and research reports on how sub-Saharan African families have been affected by, and reacted to, the AIDS epidemic. The nature of the African family and its variation across the regions is shown to be basic to both an understanding of how the epidemic spread and of its impact. The volume of good social science research undertaken until now on the disease in Africa is shown to be extremely small relative to the need

To Change or Not to Change: Obstacles and Resistance to Sexual Behavioural Change among the Youth in Ghana in the Era of AIDS

Ghana has one of the highest levels of reported cases of HIV/AIDS in the West African sub-region. The majority of infected persons are in their twenties. Young people are particularly vulnerable to STD/HIV infection for a number of reasons. They are confronted with complex and interlinked bio-social, economic and political structures and community factors. Although they are aware of STD/HIV, they do not practice safe sex or do not use condom consistently. They are more reluctant than older ones to seek treatment for STDs partly because of the attitudes of the older people, the health care providers and the general society to adolescent sexuality or may not be able to afford services. The paper is based on data collected from in- and out-of-school youth at the national and regional levels on their perceptions and reactions to the epidemic. Field work was done in five out of ten regions in Ghana using both qualitative and quantitative instruments. The issues covered included their current attitudes and behaviours related to HIV/AIDS, their reaction to the need for change and their perceived constraints/barriers to behaviour change. HIV/AIDS education messages have not taken the specific concerns of the young people into consideration. Most out-of-school youth are cut off from the mainstream educational and health care facilities. Young people are receptive to AIDS-related messages when they are made part of the planning and implementation of programmes. Attempts at initiating behavioural change in the youth must take into consideration all the complex factors. The source of, and the agents for change, must be seen to be credible and the effort must be reinforced and sustained. The problem may be of barriers than just resistance/refusal of change on the part of the youth. (Institute of African Studies Research Review: 2003 19(1): 27-46