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Sot. Sci. Med.

Vol. 37, No.


Printed in Great Britain

AFRICAN

7, pp. 859-872, 1993

0277-9536193
$6.00+ 0.00
Pergamon Press Ltd

WOMENS CONTROL OVER THEIR


IN AN ERA OF AIDS

SEXUALITY

A STUDY OF THE YORUBA OF NIGERIA


I. 0. ORUBULOYE, JOHN C. CALDWELL~and PAT CALDWELL*
Faculty of the Social Sciences, Ondo State University, Ado-Ekiti, Nigeria and 2Health Transition Centre,
National Centre for Epidemiology and Population Health, Australian National University, Canberra,
A.C.T. 0200, Australia
Abstract-Very limited knowledge is available about African womens control over their sexual relations
with husbands or other stable partners in situations where there is a high risk of STDs and HIV/AIDS.
Such control must be seen as encompassing womens control over their sexuality and reproduction as well
as the broader areas over which they can make decisions. The paper examines other research findings in
sub-Saharan Africa, and then reports a study carried out by survey and anthropological methodologies
among the Yoruba people in Ado-Ekiti, a town in southwestern Nigeria. Because the AIDS epidemic is
still at an early stage in Nigeria and because of the relation of STD infection to HIV-transmission, as
well as the probability that the behaviour developed for limiting STD transmission will subsequently be
employed to limit HIV transmission, the study focused on STDs. Yoruba women have a considerable
ability to re.fuse sexual relations for a limited time, and they are placed at greater risk of STD infection
by their ignorance of whether their partner is infected than by a lack of ability to control the situation
when STDs have been identified. This ability may be more limited in the case of AIDS because of its longer
duration.
Key

words-Africa,
HIV/AIDS, STDs, womens health, womens autonomy, sexual relations, spousal
relations, morbidity, mortality

INTRODUCTION
Because sub-Saharan
Africa has been more affected
by the AIDS epidemic than any other part of the
world, and because heterosexual transmission of the
disease is dominant in this region, probably fivesixths of all the HIV-positive women in the world are
found there. Although the kinds of relationships
which give rise to the disease are still being identified
and quantified, it is almost certain that the greatest
risk to women is provided by their husbands or stable
partners and that the majority of seropositive women
in Africa have been infected by their partners. This
has almost equally certainly long been the case with
sexually transmitted diseases, which are a serious
problem in the region [I, 21.
In these circumstances a major social and health
concern in sub-Saharan Africa must be the extent to
which women can control their sexual activity, either
by refusing sexual relations or insisting on safe sexual
practices, when their partners are infected with STDs
or HIV/AIDS. The emphasis on STDs as well as
HIV/AIDS arises in two ways: firstly, the STD
epidemic has a longer history and womens rights to
refuse sex in high-risk circumstances may well have
evolved with regard to relationships threatened by
STDs; and, secondly, a reduction of STD transmission by the adoption of suitable measures probably reduces the chances of HIV transmission.
The purpose of this paper is to report a 1991
investigation, carried out in a Yoruba area of south-

west Nigeria, of womens ability to control marital


sexual relations when their husbands (or other permanent partners) are infected with STDs, and to
explore the implications for HIV infection. AIDS is
only just beginning to penetrate the district, so the
emphasis is on STDs; this emphasis is of value both
in an effort to learn how to cope with the STD
epidemic, as a matter of urgency in its own right and
as a protection against the potential AIDS epidemic;
and to provide an understanding of a situation so
central to combating the likely AIDS epidemic.
An extraordinary aspect of the important social,
demographic and health question of the extent to
which sub-Saharan African women can control or
modify their sexual relations with their partners,
especially with husbands, is how little it has been
researched. There has been some interest among
family planning researchers, but this has not extended
further than decision-making rights with regard to
reproduction and the adoption of specific types of
contraception. Beyond this, the major interest by
demographers and other social scientists has been the
mandated periods of female sexual abstinence, especially the postpartum one [3-6].
The reasons for the failure to research circumstances where there were real questions of female
choice with regard to their sexuality, and to look at
such health issues as the avoidance of venereal disease, appear in retrospect to have been complex. One
was a deep-seated fear of voyeurism which still has

859

860

I. 0.

ORUBULOYE

some hold on both the health and womens fields as


is shown by the avoidance of sexuality in such recent
books as Women and Health in Africa [7] and Persist ent Inequalities: Women and World Development [8]

except where they deal specifically with AIDS.


Schoepf [9] argues that anthropologists in Africa have
avoided mentioning sexuality because of a desire not
to reinforce stereotypes. With regard to STDs, there
was probably also a feeling that the route to their
control was not one of behavioural change, partly
because that meant an interference with fundamental
human rights and partly because there were biomedical solutions if only they could be applied. These
attitudes have not disappeared from the AIDS
agenda, although the biomedical solution is a question of waiting rather than application.
The fact that no one investigated womens control
over their sexuality, outside the circumstances where
sexual abstinence was mandated, is probably explained by the assumption that they had no such
control. A committee of Yoruba, the people of
southwest Nigeria who form the main focus of this
paper, concluded during the first decade of the twentieth century in a report to the British Government
that The husband has rights to his wifes person but
none to her property [lo]. Caldwell and Caldwell
[l I] claimed, when discussing family planning, that
husbands had more absolute rights over their wives
reproduction than over their sexuality, but, in the
latter regard, they were referring to sexual relations
with other men rather than with the husbands themselves. The AIDS epidemic has made an understanding of the issues involved a matter of urgency, and
attempts have been made to approach them even
employing large-scale data sets [12].
Drawing on East African research in Kampala,
Uganda, Ankrah reported that women spoke of their
vulnerability:
Among these [areas where they lacked any control] were the
lack of decision-making powers in matters of sex, their
susceptibility to infection from husbands to whom traditions
permit multiple partners, the necessity to use sex as an
economic resource [with husbands as well as others], and a
sense of helplessness because of ignorance of ways to change
their social situation [13].

She also quoted the conclusion of the First International Workshop on Women and AIDS in Africa,
held in Zimbabwe, that women have limited power
to negotiate or enforce strategies to reduce their risk
of HIV infection.
Ankrah saw this situation
as
arising from The low status of the African woman
3
... .
The rural woman in particular in Africa may find herself
economically dependent on her husband, but without any
leverage at all, such as independent income. Lacking the
right of ownership, control over, or adequate access to land
and cash, the rural African woman is highly disadvantaged

..
Husbands
who have gone to the towns, often
setting up new households and having multiple sexual

et

liaisons, can still demand their matrimonial sexual


rights whenever they return to the household. This
extreme material powerlessness does not explain relative female sexual disadvantage among the Yoruba or
in much of coastal West Africa, a theme to which we
shall return. First, however, it is necessary to turn to
two interrelated themes touched upon above: the
extent to which female powerlessness with regard to
marital sexuality is merely an aspect of a broader
powerlessness, and the extent to which the situation
varies regionally.
These issues have been increasingly explored with
regard to Eastern and Southern Africa. This is appropriate in terms of the current greatest intensity of the
AIDS epidemic, but this is not the main reason for
the relative neglect of West Africa. The reason for the
greater focus of social theorists on East and Southern
Africa is that in most areas in that region women are
at a relatively greater economic and decision-making
disadvantage to their husbands than is the case in
coastal West Africa, a situation which explains, for
instance, why the debate on Gluckman on fatherright societies was confined to the East and South
and perhaps even why these are the areas most
affected by AIDS [14-161. This does not mean that
the East African debate is irrelevant, but it does mean
that the conclusions have to be treated with care
when focusing on West Africa.
Ssekiboobo [17] summarized the Ugandan research
on wives inability to refuse husbands sex, insist on
safe sex with them or force them to curtail their
extramarital sexual relations as showing that the
women were powerless for the following reasons:
(1) disaster would follow if their husbands cast
them out of marriage, as they would no longer
have access to either land or their children;
(2) in that society, early training and community
attitudes not only teach women (and men) that
wives should defer to their husbands in the area
of sexuality, but make cross-gender discussion
of sexuality very difficult, and negotiation in
this area almost impossible; and
(3) a level of violence by husbands towards wives
is accepted by the community, especially when
wives refuse what men regard as their conjugal
rights.
The fundamental factor is the control of land and
other resources by men, a situation established by the
patrilineal tradition and consolidated by colonial
divorce laws. Obbo [18] reports that most Ugandan
women cannot own land and it is argued that many
would see no point in marriage if it did not provide
access to land or other resources. The complementary
aspect of this provision of resources is that they must
provide their husbands with sexual services in all
circumstances [19]. Compared with those of West
Africa, wives are imprisoned by a society in which
they so finally break ties on marriage with their
families of origin that they are not welcomed back as

African womens control over their sexuality


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 (nor the law) will expect them to
bring their children. Compounding their problems is
the fact that East and Southern African women are
seen primarily as farmers with only very limited
access to urban trading, and even on family farms
there is no clear separation of what they themselves
have produced, for, again unlike West Africa,
families have a unified budget controlled by the
husband. Turshen [20] summarized the situation:
The root of the problem is womens subordination
and the limited opportunities African women have to
gain recognition and independence through productive work.
Further west many of these same factors continue
to operate, although possibly in a somewhat lessened
form. Schoefp [21,22] reports that most wives in
Zaire, in circumstances of gender inequality and
poverty, cannot refuse their husbands sex. If they
leave the marriage or are thrown out of it they lose
access to resources. Those who have reduced their
risk are women with decision-making
autonomy
based on their capacity to support themselves and
their dependants without resorting to sex within or
outside marriage. Turshen [7, p. 2141 cites a Burkina
Faso woman, from the West African Savannah, as
arguing: Peasant women that we are, we will never
fight against our husbands and co-wives: they are too
useful to us. Clearly, however, there has already
been a change in emphasis.
In contrast researchers on West Africa have generally described a situation where wives enjoy more
autonomy. This is the case in individual research
reports [23-271, in collected volumes of studies by
many researchers [28-301 and in works surveying the
research field [15,31, 321. Such autonomy is emphasized in the case of Yoruba women, especially those
(probably the majority) who engage in trade [33,34].
Even here Afonja [35] warns that, although Yoruba
women have considerable autonomy, there is still
substantial gender inequality and modernization is
intensifying it. Elsewhere in West Africa researchers
have described other societies where women are at
least as independent as the Yoruba and where
trading, and in matrilineal societies even separate
spousal residence, is explained as the basis for
womens relative freedom. These points are made
with reference to the Ashanti of Ghana [36]; the Baule
of the Ivory Coast [37], who nevertheless regard
marriage as imposing a constraint because virilocal
residence means the imposition of the views of the
husbands families; and Ivorian women as a whole
[38], of whom two-thirds are recorded as being
economically active outside the home.
Most of these studies maintain that the womens
autonomy rests on their ability to trade either in their
own villages or by migration to larger towns. Yet this,
too, rests on something more fundamental still and

861

that is the nature of the West African family, the


example par excellence of the descent lineage and an
institution which never casts off its members, not even
its daughters. It is this which gives wives a separate
resource base from their husbands. They have the
right to return to their families of origin and to bring
their children. They can, on their return (or even in
the case of intact marriages) demand access to the
land of their families of origin, and, even though this
may result in disputes or ill-feeling, they usually get
it. The concept of lineage is so strong that even in
patrilineal societies such as the Yoruba, where colonial endorsed native law assumed in the case of
divorce that children would normally stay with their
father, most in fact ended up with their mother or her
relatives [25]. Continuing relations with their own
separate potential resource base have allowed West
African women to become traders and control their
earnings, and have meant that marriage, which is
essentially on arrangement between two families, is
posited upon the wife having her own access to some
of her husbands patrilineal land and to the product
of her farming and that of her children (except that
which is needed to feed her husband) which she may
sell. This gives rise to a system of separate budgets for
wives and husbands [39], much favoured by families
of origin in that they allow their children to assist
them financially without spousal interference or even
knowledge.
These observations should not lead too readily to
the conclusion that West African wives have control
over their sexuality within marriage. Most have less
to fear than East and Southern African women if
their marriages break up, and so are in a better
position to engage in brinkmanship in refusing sex to
husbands. But many wish to maintain their marriages
for economic reasons or because of ties of affection.
Furthermore, in a modernizing, urbanizing country,
the return to the family of origin may prove to be
more difficult than in the days of huge rural compounds, especially if the wifes parents are dead.
Furthermore, reproduction, and hence, it is usually
assumed, sexuality, are peculiarly the decisionmaking province of the husband and even of his
relatives. These are matters which have almost entirely escaped research interest in West Africa,
although in Middle Africa the AIDS epidemic, and
especially AIDS action programs with a research
component, have begun to change the situation.
Even less attention has been paid to what actually
happens within a family when sexually transmitted
disease breaks out. There is really nothing recorded
on the older venereal diseases, and little on AIDS.
Ankrah reports that in Kampala, When a woman
falls ill or shows AIDS related symptoms before her
partner does, she is more likely than he to be sent
back to her relatives or to be abandoned [4]. A
major continuing
research program among the
Baganda of Uganda, which began in 1987, reported
that, because of the AIDS epidemic, some women are

I. 0. ORLJBUU)YE et al.

862

limiting the numbers of their extramarital partners,


but none feel that they can in any way modify their
sexual relations with their husbands or insist on the
use of condoms even when they are deeply apprehensive about what might result from the husbands
promiscuous sexual relations with a range of other
women [40]. The respondents were, of course, those
who stayed in marriage, and there may well be some
women who broke up their marriages precisely on
this issue.
RESEARCH

IN ZAIRE

Research on Zaire is reported in some detail here


partly because the society is culturally and geographically closer to West Africa than are East and
Southern Africa and partly because relevant field
work has been done there.
Schoepf and colleagues have described the CONNAISSIDA project carried out from 1987 in the two
largest cities of Zaire, Kinshasa and Lubumbashi
[21,22,414%]. This was essentially an action project
to reduce the transmission of AIDS with an emphasis
on the use of the condom to ensure safe sex and with
much of the focus on non-marital sexual relations.
Nevertheless, it did have a research component, and
some of its attention was paid to the position of
married women. In the general investigation of the
situation of wives, it was reported that Both elite
and working class wives express powerlessness in the
face of what they know, assume, or suspect to be their
husbands multiple partners [41, p. 6341. Statements
from a series of wives made it clear that wives are in
no position to refuse sex to a husband on the grounds
that he might transmit a sexual disease, and are
hardly any better placed to insist-or even suggestthat he should use a condom. The latter suggestion
would be likely to infuriate him on the specific
grounds that he is being accused of infidelity and the
broader grounds that his wife is overseeing his life
outside the home, while the husbands powerful and
intrusive family would feel annoyed and involved
because condom use might well prevent conception.
Schoepf [41, p. 6351 also reported:
The interviews reveal another dimension of differences in
power between spouses. When asked to consider how they
would respond if a spouse were to develop AIDS, men
generally replied that they would divorce their wives.
Women replied that they would feel sad and cease sexual
relations with their husbands. Condoms were not mentioned
by either sex.

The womens refusal of sex would also be highly


likely to lead to divorce and to the loss of access to
the resources which her marriage had provided [22,
pp. 273-2741.
Schoepf and colleagues [44, pp. 1962011 reported
on a workshop held in 1987 with, and at the request
of, a Protestant Mothers Club, a group of 60 women
apparently above average on the socioeconomic scale
and with better than average ability to communicate

with their husbands. More significantly they were


already concerned about AIDS and the problems it
posed for their marriages. The womens views
emerged from discussion groups and role playing.
Among this group of churchwomen, one-third said
that their husbands would not use condoms, refused
to discuss the risks arising from extramarital sexual
relations, and became angry at their wives attempts
to discuss these matters; one-third found that they
were able to talk to their husbands but were quickly
put off with assurances that the latter were taking few
risks; and one-third achieved agreement that their
husbands would use condoms: apparently for extramarital relations only, possibly also as a means of
halting the discussion, and, of course, never verified.
Their full range of workshops reported that the
empowerment of wives was essential but difficult. In
terms of safe sex they reported that it was difficult for
wives even to get the message across that they wished
to be protected by condoms because Condoms are
commonly perceived as offering protection for men
against women [44, p. 1991. Indeed the whole program came up with a forbidding list of fears about
condoms: that they are harmful to women and may
cause sterility; that they will limit conceptions; that
they prevent sperm entering women which is good for
their health and also for the development of healthy
foetuses; that men do not gain sexual satisfaction
when using them; and that wives who use them are
more likely to seek adulterous relationships, and, in
any case, will be suspected of this by their husbands
relatives [41-43].
Many of the questions which we address in this
paper with regard to other sexually transmitted diseases were raised in terms of HIV/AIDS by Irwin and
colleagues in focus group research in a large factory
in Zaire, where discussions were held with 78 male
factory workers and 48 of their wives [45]. The
hypothetical nature of the questions and the focus
group approach almost certainly meant that responses tended to conform with what governments
were saying and researchers believed. This group was
urban and reasonably well educated. Just over half
the men said that, if they found they were HIV
positive, they would not want their wives to know,
but most added that they would take precautions.
This apparently meant the use of condoms, but may
have been inflated by telling the researchers what the
respondents believed they wanted to hear. In contrast, the majority of women said that, if it happened
to them, they would tell their husbands, apparently
partly because men have greater sexual rights over
women than women have over men, but partly also
because they had no other way of getting the money
necessary for treatment. There was very likely also a
politeness response here.
In terms of sexuality, most women said they would
stay with a seropositive husband to care for him but
would refuse to have sex with him or share the same
bed. A minority of informants of each sex believed

African womens control over their sexuality

that they would stay and have sex when condoms


were used, or would separate or divorce, usually
under pressure from relatives to remain healthy and,
above all, to bear healthy children by another man.
A few wives said that it was inevitable that they
would stay and continue sexual relations as before.
Half of all husbands said that separation would
follow the discovery that they were seropositive, most
believing that wives would take the initiative in this.
Most of the rest said that they would stay together
without sex (some adding the qualification until they
were cured), while a few reported that they would
continue to have sex either with condoms or until the
AIDS symptoms developed. When it was the wife
who was found to be seropositive, most said they
would wish to continue to live with their husbands
but without sexual relations, while the rest said that
divorce was inevitable even if it was probable that
their husbands had infected them. This suspicion was
confirmed by the men, a large majority of whom
believed divorce would follow with accusations of
infidelity. Both men and women agreed that their
families would play roles, his family normally being
supportive of him and usually demanding a divorce
(and accusing the wife of being the source of infection), and her family being less likely to be supportive
of her and less likely to demand divorce. The majority
of respondents did not believe that, even if the disease
did strike, condoms would be used in their relationship, even though most knew where to obtain them.
The sequelae of AIDS are much more likely to be
sexual abstinence, with or without separation, than
the use of condoms. Apart from fear of and aversion
to condoms, and the difficulty of discussing their use
in marriage even when HIV/AIDS provides evidence
of relations with other persons, most of the women
did not believe that condoms would succeed in protecting them from infection, although the men were
somewhat more optimistic. All these responses
should be interpreted in the light of the fact that 40%
of the males and 21% of the females believed AIDS
to be curable, and that 12% of each sex had already
used condoms. In the real world what happens is the
outcome of a sequence of events including successive
negotiations between partners and between each of
them and their families. The intrusion of families is
more likely in the case of AIDS which is incurable
and eventually becomes very noticeable than in the
case of gonorrhoea or syphilis where partners may
wish to keep the disease secret.
Thus, speculation on what is likely to happen to
marital relationships and other partnerships as a
result of the infection of either partner was becoming
common, but was supported by little testimony as to
what actually did happen. Wives seemed relatively
defenceless, but most of the evidence came from East
Africa, especially Uganda, or Zaire in Middle Africa.
Womens ability to defend themselves against HIV
infection was likely to have antecedents in their
ability to defend themselves against the older sexually
SSM
37P-c

863

transmitted diseases, but almost nothing was known


on this subject.
In these circumstances, two related programs
planned research on womens control of their sexuality (see Acknowledgements for details of the programs): in southwest Nigeria, in the presence of
STDs, and in southern Ghana, in the presence of
HIV/AIDS. This division was dictated by the higher
levels of the latter disease in Ghana. The Nigerian
study is reported here.
THE EKITI PROJECT

The collaborative OSUA-ANU research program


in the Ekiti District of Ondo State had worked since
1989 in interrelated
areas of health, STDs,
HIV/AIDS and fertility. Ekiti is the northernmost
district of Ondo State, about 150 miles in a direct line,
and 200 miles by road, northeast of Lagos [46,471. It
is also the northeast comer of the area settled by the
Yoruba people. The district headquarters is Ado-Ekiti, an old centre which now has a population of
around 150,000 persons. STDs of various types have
long been common, although most of the population
identify all sexually transmitted disease as gonorrhoea.
The Yoruba number about 20 million people, the
great majority being in southwest Nigeria and the
remainder across the border in Benin. The sociological and anthropological literature on them is rich
[47-511. They are patrilineal and patrilocal, but,
because the descent lineages are so important, wives
continue to receive a great deal of support from their
families of origin and retain rights within those
families. Traditional farming in Ekiti has concentrated on tubers such as yams, cassava (maniac) and
cocoyams (taro), as well as plantains (large non-sweet
cooking bananas), beans (cow peas) and rice.
Although these were subsistence crops, they also
constitute, in uncooked or cooked forms, the backbone of womens marketing, which has now been
supplemented by the goods of the modem world
ranging from carbonated drinks and alcohol to textiles, medicines and insecticides. Yoruba men undertake a substantial share of the farming, helped often
by immigrant labourers from drier parts of Nigeria,
and this frees women for their marketing activities.
In terms of womens control over their sexuality, it
is important to note that the culture has long expected women to shoulder the responsibility for
ensuring that no sexual relations take place, no
matter how importuning husbands or other partners
may be, during menstruation and the postpartum
period, and after becoming a grandmother or reaching menopause. These periods totalled over 60% of
a womans time between menarche and menopause in
a study of Ibadan city as late as 1973 [5]. Although
the main responsibility is on the woman to maintain
these periods, she is helped by the societal consensus
that they are proper and necessary and that ignoring

864

I. 0. ORUBLMWE et al.

the postpartum proscription on sexuality may result


in the death of children; and by the overseeing of the
period and even physical intervention by relatives
[52]. The duration of postpartum sexual abstinence
and the level of fertility among Ondo State Yoruba
was recorded 13 years later by the 1986 Ondo State
Demographic
and Health Survey [53] as very
little below the Ibadan levels, even in urban areas.
However, a 1991 study of Ado-Ekiti recorded total
fertility rates probably around 5 and postpartum
sexual abstinence just under 12 months or similar
to the duration of postpartum amenorrhoea [54, pp.
226-2271. Thus, by the early 1990s wives in Ado-Ekiti
were probably
sexually unavailable
for only
about 40% of their 2&40 age span, but their
duty and right to defend those periods probably
remained as strong as it had been when the periods
were longer.
Yoruba society, like that of most of coastal West
Africa, differs from the descriptions of East Africa
with regard to womens general powerlessness and to
the explanations for limited control of their sexuality.
Yoruba women monopolize trading and have rights
to much of those farm products they help to produce.
They almost always have separate budgets from their
husbands, and largely support themselves and their
children. They can easily obtain divorce and have a
right to return to their families of origin. On the other
hand, many wish to maintain the relationship, and
some have an economic incentive to do so in that they
may have access to more of their husbands family
land.
Yet neither traditional control of mandated abstinence periods, nor a very substantial degree of economic and physical independence, seems to guarantee
them as much control over their sexuality as might be
anticipated. The reasons are the same as those explaining why such relatively independent women lack
much control over their practice of contraception.
The patrilineal (and patriarchal) nature of the society
and the payment of bridewealth, even though now
usually small and little more than symbolic, gives a
husband the right to demand both sex and reproduction [l I]. A woman who refuses sex for any period,
without a very good reason, must anticipate a breakdown in the marriage, and hence must take that into
account when making sexual decisions. It was discovered in Ibadan that the situation was not very different in terms of single girls and young women. Their
boyfriends insisted that a refusal of sex showed the
lack of a real relationship, in a situation where most
girls felt the need of friendship and stable relationships and were very adverse to precipitating a crisis
1551.
Ado-Ekiti was in 1991 a suitable place for this
research. Levels of gonorrhoea in southern Nigeria
had been probably around 10% a decade before [56;
see also 46, p. 711and appeared still to be around that
level in Ekiti. From 1989 the Nigerian Population
Policy ensured that condoms were freely available

and they are now stocked by all family planning


centres and most pharmacies and medical stores [54].
The study was carried out in late 1991 and consisted of a probability sample of 600 women drawn
from Ado-Ekiti and of in-depth interviews with a
subsample of those identified by a battery of questions as having known that their sexual partners were
suffering from a sexually transmitted disease, or
having themselves suffered from such a disease. Our
interest lay both in what rights women had to refuse
or modify sexual relations in the first circumstance
and whether there was a symmetry in the situation of
spouses relative to each other in the two situations.
By marital status, 8% of the women were single, 83%
currently married, 3% divorced or separated, and 5%
were widows. Half of the married women were in
formal polygynous relationships.
Over 99% of the women interviewed knew something about sexually transmitted diseases and how the
infection was passed on. Most were apprehensive and
most felt that their male partners sexual activities left
them exposed to the possibility of infection. However,
most of their knowledge and apprehension was in
relation to gonorrhoea. There was surprisingly little
knowledge of other STDs, although there was a
growing realization that AIDS might be on its way.
Of the total respondents, 49 (8.2%) of the women
reported having had partners whom they knew to
have suffered from sexually transmitted diseases and
48 (8.0%) reported that they had themselves experienced STDs while in some relationship. The similarity
in numbers here strikingly resembles the situation
reported elsewhere with regard to HIV/AIDS. Fewer
women than men have multiple sexual partners, but
the fact is that a higher proportion of them are
infected by permanent partners. However, only a
small number of these cases of parallel infection
report the reactions of spouses to each other when
both were infected during the one episode.
We report first on the attitudes and experience of
all respondents in refusing sex to partners, usually
temporarily; we then specifically examine the experience when one partner or the other had been
identified as suffering from a sexually transmitted
disease.
A WOMANS

RIGHT

TO REFUSE TO HAVE SEX WITH


PARTNER

Certainly Yoruba women have always had the


right to refuse sex with partners on certain occasions.
Indeed, in a range of circumstances it was morally
obligatory. There was pressure of varying degrees on
women to refuse sex before marriage, especially if
they were betrothed; while menstruating;
during
pregnancy, especially in the later months; for up to
three years after childbirth, especially while breastfeeding; after becoming a grandmother; and certainly
after menopause. These were, admittedly, special
(although frequent) occasions, and the proscription

African womens control

did not apply at other times. Nevertheless, the role


that such occasions played, and the authority it gave
to women with regard to sexual relations, mean that
the concept of the female right to refuse a partner
sexual relations is central to the culture, and may,
especially with social change, be transferable to other
circumstances. The Ado-Ekiti evidence is that the
women are really abstaining from sex for the postpartum period even though the conventional period is
shortening, and for much the same periods for successive children. They are still bound by the fear that
sexual activity at an earlier time will, through the
infusion of sperm or just the sexual excitement and
heating, injure the foetus [52, pp. 79-831.
Thus, when the respondents were asked whether a
woman had the right to refuse her partner sex, 94%
of them immediately asserted that she certainly had
this right; and 97% of them stated that it was a
fundamental female or human right or gave examples
of when the right should be exercised.
The respondents were then asked whether they had
ever refused a demand by their partner for sex. Most
assumed that the cessation of postpartum and similar
periods of sexual abstinence was decided by discussion and rarely reached the point of a demand.
Nevertheless, 77% of respondents reported that they
do refuse sex to their partners, and 97% described at
least one occasion as is summarized in Table 1. Most
gave multiple responses and hence it is the distribution of responses which is presented. However,
most took the traditional forbidden times for granted
and concentrated on circumstances where women
could exercise a choice.
Postpartum sexual abstinence is increasingly being
partly replaced by contraception. In these circumstances one might anticipate that a growing number
of women would forbid sex soon after a birth on the
grounds that one or other of them had forgotten the
contraception.

over their sexuality

865

Sections (2) and (3) of Table 1 are somewhat


artificially divided, the division depending on the
respondents reaction to events rather than on the
underlying problems themselves. The punishments,
the fights, the unhappiness, even the tiredness and
many of the occasions when a wife insists that she too
had a choice arose far more often than not from the
husbands outside social life and from his relationships or suspected relationships with other women.
To a large extent they were a product of a polygynous
society where de facto polygyny extends far beyond
the boundaries of formal polygyny. The society has
traditionally insisted that women cannot put their
complaints on these matters into words, and many
still feel they have no alternative to stating that they
feel tired, which is often true enough, partly for
emotional reasons. Many feel that their husbands
have, before the occasion recorded here, shown little
interest in them, evidence of other women and perhaps of their own advancing age.
The interviewers continued to focus on this occasion, and on the husbands reactions. As interpreted by the respondents,
these reactions are
summarized in Table 2. Most of the cannot remember or cannot describe were undoubtedly polite
refusals, and were believed to include an above
average proportion of angry reactions from husbands.
Male partners were, more often than not, angry.
However, rape within marriage is not common. The
society is not domestically violent, and the safety
valve is that most men can turn to other women. This
is also uppermost in the minds of many of the wives
or women friends. Few wives put this into words.
They are not supposed to, as was made clear in a
1974-1975 study of Ibadan [52, pp. 86881. In a 1991
study of Ondo Town only 10% of philandering
husbands seriously reported that their wives knew of
their other relationships [57]. This is the central

Table 1. Reasons given by respondents who had refused their partners sexual relations
CA= 580)
Response
Major category
(1) Forbidden time:

(2) Antagonism:

(3) Not inclined:

Subcategory
Menstruation
Postpartum sexual abstinence
Too soon after birth for sex
without contraception
Punishment for his behaviour
Punishment (or decision not to
have sex) when husband has
taken another wife
Fight
Unhappy (usually with the
husband or the marriage)
Husband drunk
Tired or sick
Too much sex
The wife also has a right of
choice

Percentage
of all
responses
10
10

21%

2
9
4
1

23%

20
2
34

56%
100%

Note: excluding 20 respondents who reported they had never refused.

I. 0.

866
Table 2. Reported

immediate

ORUBULWE et al.

reactions of male partners to the respondents


relations (IV = 5801
Response

Percentage
of all
responses

Major category

Subcategory

Hostile:

Tried to have sex by force


Furious, angry, annoyed
Offended
Silent, would not speak
Pleaded for her to change her mind
Reported this to her parents
Threatened to send her away

Turned

to other women:

Accepted

Cannot

the refusal:

remember,

Turned to other wife


Went out to other women
Did not sexually approach

cannot describe,

3. Responses

1
21
8
5
6
1

42%

1
her again

Understood why she refused


Apologized for improper approach
Accepted situation calmly

5%

4
1
21

32%

no response

pretence of the society and makes large-scale sexual


networking possible. That networking is based on the
fact that the society is in spirit even more polygynous
than it is formally, and it is this that restrains women
from refusing sex to their partners too often. These
fears are brought out clearly in Table 3 where the
responses are set out to the more general question
What happens if a woman refuses sex to her partner?. Here the answers were not only generalized but
more in terms of the longer term reaction and more
often in terms of steps subsequently taken or the
long-term situation.
The divisions in Table 3 are less a categorization of
the personalities and philosophies of husbands than
of the types of offence committed. As we will see,
diagnosed STD infection in male partners tends most
often to fall into the category of being understood by
their partners, especially if it is believed that the cure
will take little time. The large category unhappiness
in the home refers to a degree of breakdown in
marital relations without formal separation or moving out.
Clearly, much refusal or prolonged refusal of sex is
dangerous. Nevertheless, as a woman becomes older,

Table

refusing them sexual

21%
lluV/.

and as the husband acquires more women friends or


wives, both wife and husband may accept her refusal
to continue having sexual relations. Indeed, he, or
both, may desire it. She is still, nevertheless, regarded
as a wife with full honour to that status.
Nevertheless, the chief constraint on wives refusing
sex, except where the society holds them to be in the
moral right in such circumstances as in the menstruation and postpartum periods, is the ease with which
husbands can seek sexual solace elsewhere. Temporary refusal of sex may easily become permanent, or
it may lead to the breakup of the household, or to the
appearance of more wives. We asked wives about the
social and cultural pressure on them to accede to
husbands demands and nearly all said such pressures
were, and, as far as they knew, always had been
nonexistent. Certainly, in traditional rural society, a
wife who refused sex to her husband would face not
only pressure from him but from his relatives and
ultimately her own. But these urban wives do not
appear to face such pressures and most do not
appreciate that they ever existed. The pressure on
these modern urban wives was the need to take the
conjugal consequences into account. The wives are

to the question What happens


partner? (N = 601)

if a woman

refuses sex to her

Percentage
of all
Major category

Subcategory

Negative

Turns to other wives


Looks for other wives
Turns to other women
Leads to separation or divorce
Wife no longer receives any support
Unhappiness
in the home
Husband believes wife has lover

3;
1

61%

Partner
Partner

8
28

36%

Neutral

reactions:

reactions:

No response

usually understands
ignores the situation

3%
100%

African womens control over their sexuality


Table 4. How women learnt that their partners were infected with
an STD

Told by partner
Told by doctor after partner had infected
respondent
Told by co-wife or other partner of partner
after she had been infected by him
Suspected from partners symptoms
No response

34

70

7
3
1

14
6
2

49

100

not even very afraid of violence, again because the


husband has so many other options.
This, then, is the context within which we must
endeavour to understand what happened in those
relationships where STDs struck, and what might
happen as HIV/AIDS spreads.
WOMEN

WHOSE CURRENT PARTNERS


CONTRACTED STDs

HAD

Although most of the 49 women who reported


having had infected partners were married, single
women were significantly more likely to have gone
through this experience. This appears to be explained
by the fact that the single group contained a proportion of young women who put off their marriages
longer than most and had a succession of partners
before marriage. The most significant differential
(both statistically and socially) was that between
women with a single partner and those in polygynous
marriages. Over one-third of the women were currently polygynously married, but this group provided
only one-seventh of the number with partners who
had suffered from STDs. This is further confirmation
of the direct observation that polygynously married
men have fewer outside liaisons than those men with
a single partner [46, p. 701.
Gonorrhoea was identified as the STD by 46 (94%)
of the respondents and syphilis by only 2 (4%).
Clearly other less easily identified STDs are underreported but these figures bring out clearly why most
people draw little distinction between venereal disease
and gonorrhoea.
Most of the population do not easily recognise the
symptoms of STDs. Table 4 shows how the respondents realized that their partners were infected.
One reason that STDs are so dangerous and spread
so widely is that so few people quickly recognize the
symptoms. Women often fail to recognize the disease
in themselves because vaginal infections and discharge are common. They may fail to recognize
symptoms in their husbands because to a very considerable extent they live separate lives with sexual
intimacy only at night, and often know little about
where and when husbands urinate. Ultimately, the
source of knowledge is the health system, both modern and traditional. Men told their wives or other
female partners because doctors had diagnosed the
complaint and insisted that a cure could be effected

867

only by treating both partners. Similarly doctors told


the women themselves or told infected co-wives.
Table 5 presents the respondents sexual reactions
on learning of the infection.
The table brings out clearly the situation described
at greater length by many of the respondents. All the
single women refused sex, and this is a freedom that
everyone understands they have. What is more striking is that most wives were also in a position to do
so. They can exercise this right because of the leverage they possess from the instability of Yoruba
marriages, from the fact that nearly all earn incomes,
and because they and their children will be received
back by their families of origin. They can also exercise
it because they have a traditional duty to refuse sex
at times of impurity or disability such as during
menses or in the postpartum condition and it is easily
accepted by partners and by the community that
STDs can be classified in this way. What is particularly interesting in what may be an early AIDS
epidemic is that 16% of couples employed condoms.
This has proved possible because a similar proportion
of Ado-Ekitis couples are now using condoms for
fertility control [54]. However, the two groups are not
identical, for some women who trust condoms to
achieve fertility control do not have the same faith
with regard to their imperviousness to infection, while
others, who normally find condoms distasteful, will
agree to their use as a protection against infection.
Another question remains lurking in these responses,
which we cannot answer because we did not interview
the male partners. The usual male response to the
postpartum sexual abstinence of wives is to go to
other women. Did these men with identified STDs do
this without revealing their infection or did they too
regard themselves as hors de combat during this
period?
None of the marriages broke up as a result of the
disease. One reason was that all the partners agreed
to treatment, an unsurprising situation in view of the
fact that nearly all knew the exact nature of the
complaint because they had sought medical help for
their physical disorders. In the society as a whole
STDs are frequently taken for treatment to traditional healers, but in these cases where partners
knew of their spouses condition it was often at the
insistence of a modern doctor.
Another reason is that most Yoruba women take
it for granted, often reluctantly, that their partners

Table 5. Womens sexual reactions to the knowledge of their


partners infection
Continued normal unprotected sexual activity
Continued sexual activity but with condoms
-suggested by husband
-insistence of wife
Refused sex until partner underwent treatment
No response

4
4
37
2

8
8
76
4

49

loci

868

I. 0. ORUBUWYE et al.

have other partners. Interestingly, STDs are associated with sexual networking rather than specifically
going to prostitutes, an accusation that has frequently
been made in the West. Only four (8%) of the women
mentioned prostitutes or bar girls as the likely source
of infection, further evidence of a diffused rather than
focused pattern of sexual relations [57]. However, it
is noteworthy that 34 (69%) of the women employed
derogatory phrases (some equivalent to the contemporary English cheating) when referring to the
behaviour that had resulted in infection.
An important question is whether women prefer to
maintain secrecy about these problems of their conjugal relationship or whether they need social and
emotional support. Only one-third of the respondents
discussed the problem with anyone other than their
partner or health personnel. This would appear to
provide solid evidence that most were quite clear
about their right to adopt the courses they did, and
indeed that their husbands usually accepted the situation. Of those who did tell others, half told their
parents, seeking a traditional form of support, half
told their women friends, seeking a more contemporary form of solidarity, and a few felt it their duty to
warn co-wives.

HOW MALE PARTNERS BEHAVE TOWARD


HAVE CONTRACIED STDs

WOMEN WHO

Of the 48 women who knew that they had contracted an STD, almost all gonorrhoea, exactly half
told their partners while the other half did not.
Clearly, disclosure failures on this scale limit the
capacity of partners to take action. Those who told
their partners usually did so because they believed
that their partners were the source of infection and
wished to allocate blame and share responsibility for
doing something about it. In nearly all cases their
doctors had told them that both would have to be
treated. We do not know how many men failed to tell
their female partners, but we believe it was a lower
proportion and evidence that husbands are less afraid
of wives than wives of husbands, at least in these
circumstances, because a polygynous society is much
more likely to condone men having multiple partners.
In these 24 relationships where the women had
revealed the disease, 17 of the male partners refused
any more sexual relations until the woman was cured.
Most of the rest were not so much brave or chivalrous
as convinced that they had the disease themselves and
had brought it into the relationship. Most went for
treatment at the same time as their wives or girlfriends. Of the 24 male partners, only one demanded
a divorce, four more were angry, while another gave
his wife long lectures. Three said or did nothing. But
the rest confined themselves to practical steps, arranging treatment or advising on it. The reactions
among the 17 women who were refused sex until cure
by their partners were in agreement by 11, and
sadness and insecurity in three more cases. Two

women pleaded for continued sexual relations and a


third woman went off to another man. One of the 24
infected women reported feeling ashamed that she
had contracted the disease, more felt angry or uncomfortable, and most just regarded it as one of lifes
vicissitudes. Nevertheless, they did not readily discuss
it: only one-third of them told anyone except those
treating them and their partners, and of these half
informed a relative and half a friend, often seeking
advice about what to do. Of those who told their
partner, only four believed he had told anyone except
healers, and only one of these that he had informed
his own relatives.
There is less difference between the situations according to whether the female or the male is infected
than we had anticipated. No infected husbands lost
their wives and only one infected woman lost her
husband. It is a tolerant society, especially on sexual
matters, and venereal infection is often regarded as
bad luck. Part of the husbands tolerance arises from
the fact that many suspected that they had infected
their wives. We were startled at first to learn that,
while 76% of women had refused sex until treatment
to infected husbands, only 35% of husbands refused
sex to infected wives. It turned out that this was less
a measure of womens liberation or of a lesser fear of
gonorrhoea among men-although
that undoubtedly
is the situation-than
the fact that most men with
infected wives assumed that they were the origin of
the disease and that both were already affected by it.
Similarly only one-third of each sex told others, but
the women did so mostly for support in refusing sex
while the men were mostly complaining about their
wives.

HOW WOMEN BELIEVE THEY WOULD REACT TO


INFECTED MALE PARTNERS

The research now turned back to what the reactions of all the respondents would be to their partners
having a sexually transmitted disease. Their reactions
are shown in Table 6, which should be interpreted in
the sense that the respondents assume that they
themselves are not infected with the disease.
The table certainly shows a future determination
by the respondents to protect themselves from infection. Actual experience, as we have seen, sometimes
proves to be different, although even most of these
women claim they would refuse sex next time. Often
a woman may not realise that her husband has a
sexually transmitted disease or may not be able to
convince him that that is what he is suffering from.
Others may take the risk of infection rather than see
the marriage deteriorate or other wives come into it.
What is most striking is that not even all those
women who had experienced condoms would be
prepared to employ them to continue having sex with
partners who contracted a venereal disease. We explored this reluctance fully with the results set out in
Table 7.

African womens control over their sexuality

869

Table 6. Responses to the question If your husband/boyfriend becomes infected with a venereal
disease, would you refuse to have sex with him? and subsequent questions (N = 601)
PCXentag
of all
responses

Response

Question
(1)

(a)
(b)

Would you refuse to have sex?


Why would you refuse?

(2)

[On being shown a condom]


(a) Do you know what this is?
(b) Have you and your partner ever
used one?
(c) If your partner had a venereal
disease, would you be willing to
have sex with him using a
condom?

(1)
(2)

YES
So as not to become infected

99
99

(3)

YES

82

YES

46

YES

36

The fact that most respondents would not trust


condoms to protect them from infection arises from
a mistrust of these contraceptives. Many believe that
they are too thin to give that type of protection.
Everyone has stories, sometimes second-hand, perhaps apocryphal, of condoms breaking or coming off
when being used. Perhaps some have been stored for
too long, or are of poor quality, or are the wrong size.
There is still some residual fear that condoms
themselves are more dangerous than anything else.
Until recently, there was a widespread belief that
condoms could slip off during use and end up lodged
in the womb, causing injury and death. It is only their
more widespread use that has, at least in urban areas,
countered these fears. There is also a resistance,
largely by Catholics and some members of the syncretic Africanist churches, to any form of contraception.
These findings must be seen against a background
of very recent and quite steep increase in contraceptive use in Ado-Ekiti. This is partly a response to the
economic structural adjustment program (SAP), but
it also owes much to rising educational levels, the

legitimation offered to contraception by the govemments population policy, and the easy availability of
contraception [54].
TO WHAT EXTENT DO URBAN EKITI WOMEN
THEIR OWN BODIES?

CONTROL

The Yoruba women of Ado-Ekiti have certain


advantages in controlling their sexuality. Traditionally they have been expected to play a major role,
supported by their husbands and the husbands relatives, in ensuring that sex does not take place for an
appropriate lengthy period of time after the birth of
each child, during pregnancy, menstruation and at
older ages. There is a very clear concept of the woman
being in charge of these decisions even if, and especially when, her husband shows weakness. This
must, to some extent, flow over into other areas, at
least when there is a moral dimension to the situation.
It is recognized that there is a moral issue when the
husband is drunk, and to some extent, at least in
recent times, when he takes another wife without
consulting the first. In addition, the Yoruba woman

Table 7. Responses to the question Why wouldnt you be prepared to employ a condom and so continue having sex with
a partner who had a venereal disease? directed only to respondents who said they would not employ a condom to allow
sexual relations to continue (N = 216)
Percentage distribution
of responses

Responses
Major category

Subcategory

(1)

Fear of infection

(a)

Not convinced that condoms


will guarantee against infection

(2)

Fear of infection and condoms

(a)

Dont know enough about condoms to


be able to make a decision about whether
they are safe and whether they would
prevent infection

(3)

Aversion to condoms
ii;

(4)

Aversion to all contraceptives


it;

(5)

Aversion to partner

(a)

(b)

Subcategory

Major category

73

73

Condoms are dangerous


Dont like sex with condoms
Abstinence is best
Cure wont take long and abstinence will
suffice for this period
Would no longer feel like sex with him if
he behaved so as to contract a veneral
disease
Having sex with respondent would not be
his main problem. He would have to get
cured and sort himself out

100

100

870

I. 0.

ORUSULOYE

is to a large extent financially independent. She is a


trader or has some other occupation: apart from a
couple of students, only about 1% of the respondents
in this study were solely dependent on their husbands
for income. Admittedly, she normally faces considerable cost in supporting herself and her children, and
her husband normally helps with support costs, but
she can usually walk out and stand alone if necessary.
In addition her family of origin will welcome her
back, and, if necessary, some relative will look after
the children. She can often find another husband
fairly quickly.
On the other hand, the society has high levels of
polygyny and marital instability, with marriage
breakup and remarriage common. Annoyed husbands can easily leave, to stay with their sisters or
parents; or throw the wife out, or take another wife
in. They can also go to other women friends. It is
precisely these considerations that have been the
major factor in forcing down the duration of postpartum sexual abstinence [55, 581. Wives may be reluctant to break up marriages too easily. Furthermore,
tradition has little to say about the wifes reaction to
the husbands gonorrhoea; indeed it usually blamed
her for giving it to him through disorders or imbalances in her menstrual or reproductive systems [59].
Husbands may well take the high moral ground with
regard to their right to sexual relations (some quoting
the Bible), especially when there is some dispute
about exactly what the disorder is and sometimes
when the husband fails to disclose all he knows about
it.
A Yoruba woman can clearly turn down her
husbands advances on a single night. He may even
feel some pride in this demonstration that he is too
virile for her, and hardly knows his own strength. But
there are great risks in continuing to refuse the
husbands advances for any sustained period. Yet
most persons recognize venereal disease as a reason
for refusing sex to partners and the concept certainly
now exists in the society. It may broaden in the
HIV/AIDS era.
One problem awaiting the HIV/AIDS era is the
continuing deep suspicion of the condom as an STD
prophylactic. How much greater is that suspicion
likely to be for HIV. Yet the suspicion of the condom
as an antinatal device is passing rapidly. The same
may yet happen with regard to its prophylactic use.
Much will depend on just how good the condoms are
and whether there are genuine cases of their not
preventing infection (or conception).
The major
difference
between
STDs and
HIV/AIDS is the latters incurability, a situation
which a growing proportion of the population of
Ado-Ekiti now accepts because of the governments
informational campaign [60]. Women have been able
to refuse sex in the case of STDs for the period of
treatment. Indefinite refusal, as most anticipate in the
case of HIV/AIDS, would be likely to result in the
husband driving away the wife (except in the symp-

et al.

tomatic stage where he would probably trade abstinence for care) or becoming threatening or violent, in
which circumstance most wives would leave. A growing trust in condoms would probably mean that a
number of marriages, but probably a minority, where
the husband was seropositive, would remain intact.
Where only the wife is seropositive in most cases she
would probably be driven away.
What is clear from the research is that most
Yoruba women have undisputed control of their
sexuality when their partner suffers from STDs or
AIDS. The refusal of sex may result in the breakup
of a marriage but is unlikely to result in a continuing
marriage dominated by violence or forced sex, or by
pressure from their own relatives for the husband to
be allowed his conjugal rights or for the wife to stay
with him.
It appears probable that in an AIDS epidemic most
Yoruba women with a seropositive husband will
break off the marriage, refuse sex, or agree to it only
with condoms-although
the proportions adopting
these choices cannot be predicted from the STD
research. The exceptions will be those women,
whether seropositive or seronegative, who have convinced themselves that they are probably already
infected or those who do not believe the disease is
incurable.
The situation described here for STDs and implied
for AIDS is probably representative of most of
coastal West Africa. If women know that their husbands (or stable partners) are suffering from STDs or
AIDS they can demand sexual abstinence, safe sex or
leave the marriage. Their ability to refuse sex or
demand safe sex rests on the ease with which they can
leave a marriage. This in turn depends partly on their
access to resources, namely their ability to trade, to
retain their own budget, and, probably, to get access
to farming land from their families of origin. This
access to resources is vital, but not fundamental.
What is fundamental-and
what provides the contrast with East and Southern Africa-is the unique
lineage structure of West Africa with its assumption
that no child of the lineage ever leaves it. Women do
not break with their families of origin when they
marry. It is this which gives them the unchallengable
right to return home from an unsatisfactory marriage and to secure access to land, which allows them
to become independent market women and also to
keep much of the product from their farming and sell
it, to keep and control their own savings, to suffer no
loss of face when they leave a marriage for their
parents or brothers houses, and to weaken any claim
by their ex-husbands or the husbands relatives on the
custody of the children. This is a vast array of
resources which makes their situation very different
from women elsewhere in Africa.
Of course, they may not want to break up the
marriage. The husband may have more resources and
the wife may feel affection for him and a fondness for
the home and family life. She may feel he needs care.

African womens control over their sexuality


In an urbanizing and modernizing society there may
be accommodation difficulties in her relatives taking
her in.
But the major difficulties are of other types and
may be susceptible to outside intervention.
The first difficulty is that most wives with husbands
suffering from STDs do not realize the fact, and this
is also the case with the great majority of women
whose husbands are seropositive. With regard to
STDs there is an urgent need for schools, public
health authorities and doctors to teach the community about STDs. People should be more aware of the
symptoms, the treatment and the need to inspect their
partners more closely. They should also be made to
feel much more guilty about not telling their partners
when they are infected. A similar case can be argued
for much more HIV testing (which is at present only
vestigial) and for much better counselling for infected
persons to inform their partners.
There is need for a much stronger conviction on the
part of wives that they have the right to demand that
their husbands should restrict their sexual activities to
marriage or practise only safe sex outside it, and, in
the event of non-compliance, to react by demanding
abstinence or safe sex within the marriage or breaking
it up. Women need support from the community and
the government in convincing themselves that this is
a right and moral stance. Communities are moving
this way. Women are getting more support from
relatives in refusing sex when the husband is drunk,
and this appears to be transferable to when he has an
STD or AIDS and possibly to when he enjoys a
high-risk sex life.
Acknowledgements-This
research was funded by SAREC
(the Swedish Agency for Research Cooperation with Developing Countries) and was developed from an earlier program funded by the Rockefeller Foundation. Resources
have also been contributed by Ondo State University,
Ado-Ekiti, Nigeria, and the Australian National University,
Canberra. The authors wish to acknowledge the contribution in Nigeria of S. S. Oni, Jacob Oni, Mrs Fadeyibi and
Mary Christopher, in Australia of Ben Amenuvegbe, Pat
Moor, Wendy Cosford and Pat Goodall, and at Northwestern University, Evanston, of Caroline Bledsoe, Denise
Miller, Calvin vander Leeuw and Leighton Peterson. The
Ghana uroiect will be renorted in 1993 in a suecial AIDS
supplement of Health Transition Review : Sexual Networking and HIV/AIDS in West Africa, by John C. Caldwell,
Gigi Santow, I. 0. Orubuloye, John Anarfi and Pat Caldwell.
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