HIV / AIDS among Kenyan Youth

HIV / AIDS among Kenyan Youth

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In 2001, Sub-Saharan Africa recorded the highest number of
deaths from HIV/AIDS, with 29.4 million people living with
AIDS; 10 million young people and 3 million children. Among
these, 12.2 million were women and 10.1 million men. In 2002,
3.5 million new infections were reported. From this backdrop,
Kenyans were interviewed on their perceptions of sex and
condom use within heterosexual relationships revealing that
denial and silence played a major role in the escalation of the
pandemic while gender differences, culture and power were
perceived as negatively impacting negotiation of sex and
condom use within Kenyan communities.
Kagutui ka mucie gatihakagwo ageni.
(The secrets of one’s home are not to be revealed to strangers)
- Gikuyu proverb
AIDS was a disease that shines in hush and thrives on secrecy. It was
prospering because people were choosing not to talk about it. It was
this realization that provoked me to go wider, beyond my personal
circle, beyond the people I worked with. The quieter we keep it the
more people it will affect and stigmatize, especially while people
believe that AIDS affects some people and not others (Kaleeba 29).
This article is based on semi structured interviews with four Kenyan men
and women on how they perceive, and negotiate sex and condom use
within heterosexual relationships. It focuses on gender, culture and
power, and how these dynamics are projected, if at all, in participants’
negotiation of sexual relationships within the Kenyan community. The
purpose of the study is to understand the relationship between gender,
power and HIV/AIDS prevention.
Sub-Saharan Africa has recently recorded the highest incidences of
death from HIV/AIDS with a total of 29.4 million people living with the
disease. Among these, ten million are young people aged fifteen to
twenty four while three million are children under the age of fifteen. In
the year 2002, 3.5 million new infections were reported (UNAIDS 2).
One reason for this seemingly recent rise in the number of infections
is the result of years of denial and silence about the existence of
HIV/AIDS. Recent statistics indicate that Botswana’s adult prevalence
Sex, HIV/AIDS and Silence
45
rate for example, has peaked to 38.8 %, Lesotho 31%, Swaziland 33.4%
and Zimbabwe 33.7%. In total, Africa experiences 6,000 AIDS related
deaths per day and Kenya, 18 deaths per hour (UNAIDS 3).
Researchers, educators and governments now suggest the need [for]
culturally sensitive knowledge of sexual beliefs and practices as a way
forward to understanding and evaluating patterns of HIV/AIDS
transmission in different communities, in view of designing effective
intervention programs (Lansky 3).
This paper focuses on a study of culture and HIV/AIDS, and what
effects gender differences and power might be having on HIV/AIDS

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prevention initiatives in a Sub-Saharan African country. Gender
differences in HIV/AIDS programs are important considerations to make
because disaggregated statistics show that 12.2 million women in Sub-
Saharan Africa compared to 10.1 million men aged fifteen to forty nine
are infected. The effect of HIV/AIDS on women’s lives has also resulted
in the drastic decline of agricultural production in which 80% of rural
women in the region are occupied, leading to the acceleration of rural
poverty and continued economic dependency (UNAIDS 3).
Gender inequality and violence, are defined by Mbote as "any act [
…] that results in, or is likely to result in physical, sexual or
psychological harm or suffering to women, including threats of such acts,
coercion or arbitrary deprivation of liberty whether […] in public or
private life” (1). These factors are also crucial in determining women’s
reproductive health concerns. However, little has actually been
documented on these “owing to lack of ‘proof’ and low reporting of
cases” (1). As a result, male aggression continues to undermine women’s
sense of subjectivity and power thus violating women’s right to freedom
of expression and autonomous decision making. In this work, gender
power relations are seen as inhibiting HIV/AIDS prevention efforts and
in particular condom use. A number of myths about femininity and
masculinity are cited. The myth, for example, those women should
preserve sexual ‘purity’ and ‘innocence’ may limit their knowledge and
ability to own and negotiation male condom use (Leclerc- Madlala: 2).
Literature points to cultural beliefs surrounding sex and AIDS,
carried on through silence, taboos, fear, religion, morals, and ethical
beliefs as playing a significant role in HIV/AIDS prevention program
failure. For example, pre-marital and extra-marital sex is prohibited for
women in most cultures. How ever there are different standards set for
men as is illustrated by the Nigerian Safiyatu Huseini Tugur Tudu case,
in which the Islamic law, Sharia, an extension of Islam, in a male
dominated society, ordered the execution of this alleged adulterous
woman, without trial, while, at the same time, requiring at least four
witnesses to testify against the man involved, before any punishment
could be meted against him. (3) Another example is in some Southern
African cultures, where men are said to prefer “dry” sex, which
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according to the researcher exposes women to greater risk to HIV/AIDS
infection and has therefore been termed mass femicide (Ifeyinwa 3).
Cultural expectations also pressure men to maintain power through
unsafe sexual practices, and discourage women from safe sex
negotiation, by framing such negotiation as a challenge to male power.
This is especially true for married women. According to the Ugandan
author Kaleeba, “Once a woman is married to a man she has to have sex
with him when he wants it. The only way a woman can remain married
and in the same house is if she has sex when he wants it and the way he
wants it. She can’t negotiate for safer sex” (61).
When interviewed, on the themes of sex, HIV/AIDS, gender, power,
and culture, four single and married heterosexual Kenyan men and
women living in the Mid Atlantic region of the United States of America,
shared the following experiences. One college student, Maria Achieng,
(pseudonyms) brought up in Nairobi by Catholic parents and teachers,
like many Kenyan youth had perceptions of sex and HIV/AIDS molded
around taboos and limited choices. She and Wambui Mwangi,
(pseudonym) another respondent from central Kenya had little sex
education in high school, a little too late for some of their classmates
who were already sexually active at the time. The content of the sex
education received was not very helpful either as only morality and
abstinence were taught and any questions left everyone in an
uncomfortable silence. The language was abstract and shrouded in
mysteries of expressions about “diseases being out there” and “being
careful about boys.”
Perceptions on sex education and information
Wambui’s memories of high school sex education are still vivid, her
Kenyan male Social Ethics teacher; a shy middle aged man “struggled to
find the right words to describe the reproductive functions of the human
body.” Her only hope was to share whatever information she and her
friends came across even though “sometimes peers would provide
misleading information.” However, Achieng feels lucky here in the West
because the internet is available, unlike back home in Kenya.
Sometimes Wambui would wish that the church would offer some
sex education, but nobody ever said anything. Her mother did not say
much, but at least her mother told her what she could do when she got
her periods and basically forbid her from being seen with boys (Wambui
2). However, Wambui did not understand the reason for her mother’s
concerns and a sense of rebellion grew in her. She enjoyed boys’
company and did not believe they could harm her. She felt that her
mother and Auntie, whom she lived with in the town, where she attended
school, were over protective; however, it was her Aunt who actually
provided Wambui with more information than her mother had. Although
Sex, HIV/AIDS and Silence
47
her Aunt did not mention contraceptives to her, at least she informed her
that being close to boys could lead to getting pregnant and having to drop
out of school. She tried to be a responsible young woman and thought the
only way to do that was to abstain from sex. Wambui therefore, did not
think she needed to know a lot about sex, all she needed to do was to
keep off sex. She felt that her peers had little information but were more
eager to try things out; she believed they were the wrong kind of friends
and tried not to associate much with them. In her words she had nothing
important to learn from them; her peers did not know more than she did.
Gitau Mwega (pseudonym), a Gikuyu male college graduate,
disclosed that he never tried to seek formal information about sex and
didn’t think that everything his peers said was accurate. He found most
of what he needed to know in popular literature and magazines, music
and media, even though access to these, and discussion of their content
with older people was restricted. According to Wambui however, access
to information is worse in the rural areas where traditional culture is still
very much intact. In the cities, women are beginning to come out and
claim their rights even in marriage. She observes that women are silent
about their rights often because of their concern for another person’s
feelings and fear of being denied marital privileges. Wambui’s view is
that a lot of times women are unable to initiate discussion about sex for
these same reasons.
Although she had no Kenyan boyfriend as such, she had many
Kenyan male friends and had seen couples, many of them very close
relatives, who could not communicate about sexual matters. She believes
that power, fear and superiority, may be to blame for this lack of ease in
communication. She agrees that communication is very important today,
and traditional barriers must be lifted in order to make way for easy
discussion of sex related matters.
Perceptions on Gender, Power and Coercion
On gender and power, Achieng believes that unequal power exists in
Kenyan heterosexual relationships. For example, women are required to
be submissive to one husband, who is also the head of the family. On the
other hand, even though she believes that this is how things should be,
she wonders why society allows men to have more than one sexual
partner and why women themselves often help to perpetuate this culture.
According to Achieng therefore, men are just taking advantage of the
situation by taking all the power to make decisions that favor themselves.
Women feel that it is the men who should make decisions so they leave
the power to them. “We also have to change the culture, the world is
changing, and women are also taking up careers, we cannot hold on to
the old culture.”
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48
Although Achieng found the term coercion difficult to comprehend,
she has read a lot about abusive relationships and even had a neighbor
who was terribly abused by her husband. Wife beating she says is
especially common in her home area. A woman she once knew was
being beaten by her husband, but the family defended the man and
insisted that the woman stays in the abusive marriage. Leaving her
husband would humiliate the entire clan. The woman herself felt helpless
because she had no property of her own and depended on the man.
Finally the abused woman left her husband and started a small business.
“According to her ethnic group, if a woman left her marriage, her
sons would be denied inheritance of their father’s land. Now she has
nothing; her business did not grow, and the man still has the resources,
which makes him still more powerful. She might even return to him.”
Also, when a woman has no voice she cannot know or question what the
man does and that way she may be sexually abused and end up with
sexually transmitted infection. However, if a woman is educated things
might change she might have a little more say even if not totally. Men
also should be educated, and women should have economic resources.
Education gives power.
Muga Ochieng (pseudonym) states that psychological violence,
which he refers to as mental coercion, occurs very often in Kenyan
heterosexual relationships. He states that mental coercion occurs when
one is forced to do something against his/her will. Here the fear of
consequences prevents the victim from resisting or taking action against
the perpetrator. He observes that coercion is a barrier to communication.
Most women who experience mental violence become subservient for
fear of losing economic security. He has seen his own women relatives
who because of psychological coercion have suffered physical injury,
fear and poor quality of relationship, separation, divorce, and single
parenthood.
Perceptions on Sex and HIV/AIDS
Achieng visualizes AIDS as this very frightening disease that is
transmitted through sex and the exchange of bodily fluids and is wiping
out populations. Shocked and very much aware of the effects that this
deadly virus is having on Kenyans, she feels that people should be doing
all they can to stop the epidemic, and yet Kenyans are not showing any
progress at all in this direction.
Her worry is that even though Kenyans see people dying among
them everyday, they do not disclose the cause of death, and, therefore,
AIDS becomes more of a problem that cannot be solved. Her own
neighbor, who for a long time had been condemned as lazy for not
economically progressive, suddenly came alive one day, got a job and
married a wife and had a child. That same year he was diagnosed with
Sex, HIV/AIDS and Silence
49
the disease and died leaving behind a helpless widow and child. An aunt
of Achieng’s was also diagnosed with the disease; Achieng fears that her
aunt may be dead by now.
From the deaths that Achieng has witnessed, she is more convinced
that the disease can be caught by anyone, regardless of social status, class
or sexual behavior. Some of the people she had seen die were not really
promiscuous people, yet Kenyans somehow believe that only prostitutes
can die of the disease. AIDS is therefore seen as a shameful disease “that
we Kenyans cannot say our own relatives have died from.” Achieng feels
that in order to change the situation, we need more effective HIV/AIDS
education programs, with emphasis on condom use and negotiation. It is
important therefore to state the facts regarding how the disease is spread,
for example that any body can get the disease and that AIDS is a disease
one can get from just one sexual act.
With a slight smile Achieng recalls that her friends back home see
the male condom as a funny gadget. It is culturally unfamiliar to many
Kenyans especially in the rural areas, but now, surprisingly, at least in
Nairobi, we find condoms in the supermarket. However, even though
condoms are now more available, men and women, especially, have to
think twice about buying them because of the cost and moral issues
involved. Often women may want to buy a condom in the evening as
they leave work for home, but they are then caught up in deciding
whether to spend the little money they have on food or a condom, both
are now equally important. “In Kenyan hospitals, which I thank God I
have never had to visit, I do not know whether they have them
[condoms] for free but they should.”
Achieng suggests that getting people to use a condom in the first
place is difficult. Before an unmarried couple decides to use a condom,
they should take time to know each other, and it is always difficult for a
young woman to convince a young man that she loves him when she is
asking him to use a condom. Love and trust go together Achieng
suggests.
Even though these thoughts are important for youths who intend to
get married, Achieng has seen statistics being manipulated to confuse the
public about the amount of protection that the male condom provides
against sexually transmitted diseases including HIV/AIDS. She would
rather see people use condoms than take a 100% risk of contracting the
disease. Achieng would not put herself in the awkward position of
having to purchase a condom, but she believes that it should be used with
every sexual act. She would rather dictate that the other party brings his
own condom. But as the age at which youth are starting to have sex goes
down, the issue of societal disapproval and purchase of a condom
becomes a serious matter. For men it may be becoming a little easier but
for women it is still hard to purchase and keep condoms in their
possession.
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50
Furthermore, access to male condoms is constrained by a number of
factors including unavailability, stigma, religion, and cost. Poverty, to
Wambui, is the basis for lack of progress in any HIV/AIDS projects in
Kenya, be they educational, medical, including the distribution of
condoms. Wambui cringes at that nothing is being done about the
situation, having taken care of an infected cousin who was in the last
phase of the disease, she is really frightened that everybody might be
affected.
Another factor affecting prevention Wambui notes is the society
supported male promiscuity, and polygamy. These practices are putting
more women at risk of contracting HIV/AIDS. Wambui claims that
“women are supposed to be there for their husbands, yet men do not care
how women feel…men are supposed to be the providers.”
Gitau, on the other hand believes that although there is a strong
relationship between coercion and HIV/AIDS, an even stronger link
exists between the disease and alcohol abuse especially among the youth.
To him the male condom is useful to a certain extent, but, like Wambui,
he blames the lack of condom use to scarcity of information, education,
and shyness. His advice is that couples wishing to engage in sexual
relationships go for HIV/AIDS testing. He believes that condoms will
offer limited protection, but the most certain way of preventing
contraction of the disease is abstinence. However, many youths will bend
to peer pressure and then try to keep their sexual activities a secret.
Achieng moreover knows that secrecy does not go very far. A
neighbor of hers, she remembers was abused in the privacy of her
bedroom and kept everything to herself, but through whispers and gossip
the neighbors came to learn of her problems, this affected the entire
household, family and neighborhood; eventually the so called private
matter became public. Achieng explains that public discussions about
sex are traditionally unheard of in her Luo community.
Another factor that constrains condom use in Kenya according to
Ochieng, is the belief that man’s traditional role is that of child bearer.
Achieng, on the other hand, states that very often men are unwilling to
admit that they have extra marital affairs and are ashamed of initiating
condom use within marriage. Yet, in most cases women do not control
condom use, it is men who have the power to do so, this puts women in a
disadvantaged position with little control over their reproductive health.
The debate as to whether condom use is morally right or wrong still
prevails in Kenya, as it does in other communities around the world with
Muslims and Catholics teaching against condom use. Ochieng believes
that this debate is irrelevant in a country like Kenya where casual sexual
activity often results from excessive alcohol consumption. He states that
everything should be done to promote condom use in the country.
Sex, HIV/AIDS and Silence
51
The Way Forward
The respondents in this study felt that condoms should be made more
accessible, and women friendly. Kenyans should try to overcome cultural
taboos surrounding condom use. In order to lessen the secrecy and
silence surrounding sex and HIV/AIDS, this way, success in family
planning and HIV/AIDS and STD prevention programs can be realized.
The need for change in sexual behavior was seen as a priority if
Kenyans were to attain eradicate HIV/AIDS. It was observed by all the
participants that although HIV/AIDS awareness in Kenya was reported
to be high, this did not automatically translate into behavior change. The
inclusion of women and first hand experience of people living with
AIDS in all HIV/AIDS campaigns is necessary.
Asked why Kenyans did not change their sexual behavior, some
respondents cited lack of concern. Achieng and Gitau felt that Kenyans
do not believe that AIDS can happen to anyone including themselves.
Gitau states that some Kenyans have generally lost hope in life and no
longer care; they believe that if they do not die of AIDS they will soon
die of a road accident or another calamity. Achieng’s view is that
Kenyans are basically deceived by physical appearance while physical
symptoms might not be visible in every HIV positive individual.
Ochieng suggests that stepping out of one’s culture helps a person to
identify their own shortcomings. He gives the example of his own
experience and how his migration to the United States influenced his
perceptions about sex. In order to effectively change, a people need to
realize that their culture is not innate but rather learned behavior and that
there is a possibility of relearning and therefore changing behavior (Hall
44).
Finally as Gitau suggests, gender equality should be viewed as
central in HIV/AIDS eradication. Although women’s lives in Kenya are
improving, there is a need to reduce their economic dependence on male
partners, which often results in gender imbalance and power differences
which eventually can lead to gender based violence. This research points
to the conclusion that education should play the major role in HIV/AIDS
prevention.
Each of the four participants in this research stated that sex education
and HIV education should be distinct and widespread. This education
should begin early in life, preferably with children of at most ten years of
age adopted into the country’s education system, providing accurate and
uniform information across cultures and ethnic groups. Participants also
suggested that the education should be culturally sensitive but bold
enough to capture the details of HIV/AIDS as a disease and how it can be
prevented.
Because Kenyan schools have experienced serious cases of
institutional sexual and power abuse in the last ten years, for example the
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52
1991 case of indiscipline and violence at St. Kizito mixed secondary
school in Meru where nineteen schoolgirls were killed and over seventy
gang-raped by their male classmates (Steeves 1), respondents believed
that it is high time Kenyans brought the issues of gender based violence
to schools. All Kenyan people must unite and work jointly towards this
goal. National and international governments and non-governmental
organizations should take part. The Kenya Alliance for the Advancement
of Children program that sponsored and developed a curriculum to
educate students on non violent behavior, and recommended the
involvement of religious, political and community leaders, parents,
relatives and guardians in such programs, as a means of legitimizing the
programs . This would help to bridge the communication, cultural and
generational barriers that exist in Kenya which are hindrances to
HIV/AIDS prevention work today.

WORKS CITED
Hall, Edward T. Beyond Culture. London: Anchor, 1976.
Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health
Organization (WHO). AIDS Epidemic Update December 2001. Geneva
Switzerland 2001: Albin O. Kuhn Library, Baltimore, Maryland. 5 May
2003 .

Kaleeba, Noerine, Ray Sunanda, and Brigid Willmore. We Miss You All: Aids
in the Family. Harare: UNICEF 1992.

Lansky, Amy, et al. “A Method for Classification of HIV Exposure Category for
Women without HIV Risk Information” Division of HIV/AIDS Prevention
Surveillance and Epidemiology National Center for HIV, STD and TB
prevention. Recommendations and Reports. 11 May 2001: Albin O. Kuhn

Library, Baltimore, Maryland. 7 May 2003
.
Leclerc-Madlala, Suzanne. “Silence, Aids and Sexual Culture in Africa.” Aids
Bulletin School of Anthropology and Psychology, University of Natal,
September 2000: Albin O. Kuhn Library, Baltimore, Maryland. 5 March
2002 .

Mbote, Patricia Kameri. “Violence Against Women in Kenya: An Analysis of
Law, Policy and Institutions” IELRC Working Paper 2000-1.

Steeves, Leslie H. Gender Violence and the Press: The St. Kizito Story. (African
Series No. 67) Ohio University Center for International Studies: 1998
Umerah-Udezulu, Ifeyinwa. “Resensitizing African Health Care and Policy Practitioners:
The Gendered Nature of Aids Epidemic in Africa.” Jenda: A Journal of Culture And
African Women Studies 2001: Albin O. Kuhn Library, Baltimore, Maryland. 8
March 2002
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