AEGiS-14IAC: Sexual violence, pressure and HIV in rural Mwanza, Tanzania.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Sexual violence, pressure and HIV in rural Mwanza, Tanzania.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrE1282)

Plummer ML, Wight D, Wamoyi J, Mshana G, Ross D, Salamba Z
NIMR/AMREF/LSHTM, Mwanza, Tanzania

BACKGROUND: There is a need to collect accurate data on unwanted sex in a rural African context, to better understand how it may contribute to HIV transmission.

METHODS: The paper draws on data from: a self-completion questionnaire with 6,077 primary school adolescents; 72 in-depth interviews with HIV+, pregnant or randomly selected primary school adolescents; 6 series of 3-4 focus group discussions (FGD) with same-sex groups in their late teens or early 20s; and participant observation (PO) carried out by young researchers in 7 villages (total 110 person-weeks).

RESULTS: FGD and PO were the most useful methods, identifying 3 categories. (a) Publicly acknowledged 'rape' is limited to violent sexual assaults which become subject to quasi-judicial responses such as a fine or beating, because the victim is not believed to have encouraged it. (b) More prevalent appears to be sexual violence that is not publicly defined as "rape". If a woman took a gift from a man prior to an assault, she is likely to be blamed for it. Also, she may not report it if an authority or a friend acted as an intermediary facilitating the assault. (c) In some instances, violence does not occur but the woman only has sex due to pressure from relatives, the threat of violence, or the threat of being shamed because of previously having accepted a gift from the man. Qualitative researchers estimate that a quarter of young women have been pressured into sex after accepting a gift, and half have been pressured into it by intermediaries. Any statistical link between unwanted sex and HIV may relate to a lack of vaginal lubrication caused by female arousal, and/or the degree of violence, as these are likely to contribute to abrasions. Condom use is rare even in consensual sex, so a lack of condom use per se is not likely to contribute to higher HIV transmission.

CONCLUSIONS: Force is used in some sexual encounters, and non-violent pressure is even commoner. Both may contribute to HIV transmission.

Keywords: AEGIS, Tanzania, HIV Infections, Violence, Pressure, Rape, HIV Seropositivity, Sex Offenses, Aggression, Domestic Violence, Interviews, Human, Female, Male, Adolescence, Pregnancy

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