Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T10:43:22.941Z Has data issue: false hasContentIssue false
  • English
  • Français

POVERTY, SEXUAL EXPERIENCE AND HIV VULNERABILITY RISKS: EVIDENCE FROM ADDIS ABABA, ETHIOPIA

Published online by Cambridge University Press:  17 May 2012

ASSEFA TOLERA SORI
ASSEFA TOLERA SORI
Affiliation:
College of Social Sciences, Addis Ababa University, Ethiopia
Get access Rights & Permissions [Opens in a new window]

Summary

This study explores the relationship between poverty and vulnerability to HIV infection in Ethiopia using primary (quantitative and qualitative) and secondary data from two sub-cities of Addis Ababa. The data show that sexual experience is influenced by diverse factors such as age, gender, economic status and education level. Household economic status and migration explain the nature of sexual experience and level of vulnerability to HIV infection. Poor uneducated women in poor neighbourhoods are more likely to engage in risky sexual encounters despite awareness about the risk of HIV infection as they operate in an environment that provides the ‘path of least resistance’ (Lindegger & Wood, 1995, p. 7). This article argues that poverty provides a situation where early sexual initiation, ‘transactional sex’ and an inability to negotiate for safer sex are associated with low income, lack of education and increased vulnerability to HIV infection. This vulnerability is simultaneously contested and accepted as a commitment to even sacrifice one's life for the sake of one's loved ones. As a modest contribution to the ‘structural violence’ approach, which emphasizes social inequalities based on gender, class, ethnicity and race and inequalities in terms of exposure to risk and access to health care (Massé, 2007), this article challenges the ‘African promiscuity’ discourse, which ‘does not permit policymakers to think beyond sex’ (Stillwaggon, 2006, p. 156), and encourages researchers and policymakers to ask the right questions to understand the complexity of HIV/AIDS and seek solutions to the pandemic.

Type
Research Article
Information
Journal of Biosocial Science , Volume 44 , Issue 6 , November 2012 , pp. 677 - 701
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aina, T. (1988) The myth of Africa promiscuity. In Sabatier, R. et al. (eds) Blaming Others: Prejudice, Race and Worldwide AIDS. The Panos Institute, London, Paris, Washington.Google Scholar
Allen, T. (2005) AIDS and evidence: interrogating some Ugandan myths. Journal of Biosocial Science 38, 7–28.Google Scholar
Cohen, D. (2001) Joint epidemics: poverty and AIDS in sub-Saharan Africa. Harvard International Review 23(3). URL: http://hir.harvard.edu/articles/920/3/Google Scholar
Congressional Caucus for Women's Issues (1992) Violence against Women. URL: www.mith2.umd.edu/WomensStudies/GenderIssues/Violence+Women/caucus-reportGoogle Scholar
Drimie, S. (2001) The Impact of HIV/AIDS on Rural Households and Land Issues in Southern and Eastern Africa. URL: http://www.fao.org/wairdocs/ad696e/ad696e04.htmGoogle Scholar
Epstein, H. (2002) The hidden cause of AIDS. New York Review 9th May, pp. 43–49.Google Scholar
Farmer, P. (1992) AIDS and Accusation: Haiti and the Geography of Blame. University of California Press, Berkeley.Google Scholar
Farmer, P. (1995) Culture, poverty, and the dynamics of HIV transmission in rural Haiti. In Brummelhuis, H. T. & Herdt, G. (eds) Culture and Sexual Risk: Anthropological Perspectives on AIDS. Gordon and Breach, Newark, NJ, pp. 3–28.Google Scholar
Farmer, P. (1997) On suffering and structural violence: a view from below. In Kleinman, A. et al. (eds) Social Suffering. University of California Press, Berkeley, pp. 261–284.Google Scholar
Farmer, P. (1999) Infection and Inequalities: The Modern Plagues. University of California Press, Berkeley.Google Scholar
Farmer, P. (2003) AIDS: a biosocial problem with solutions. Anthropology News 44(6), 7.Google Scholar
Farmer, P. (2004) An anthropology of structural violence. Current Anthropology 45(3), 305–325.CrossRefGoogle Scholar
Farmer, P. (2005) Pathologies of Power: Health, Human Rights, and the New War on the Poor. University of California Press, Berkeley and Los Angeles.Google Scholar
Farmer, P. E., Connors, M. & Simmons, J. (eds) (1996) Women, Poverty, and AIDS: Sex, Drugs, and Structural Violence. Common Courage Press, Monroe, Maine.Google Scholar
Farmer, P. & Kleinman, A. (1994) AIDS as human suffering. In Podolefsky, A. & Brown, P. J. (eds) Applying Cultural Anthropology: An Introductory Reader. Mayfield Publishing Company, Mountain View, CA.Google Scholar
Farmer, P., Léandre, F., Mukherjee, J. S., Claude, M. S., Nevil, P. et al. (2001) Community-based approaches to HIV treatment in resource-poor settings. Lancet 358, 404–409.CrossRefGoogle ScholarPubMed
Federal HIV/AIDS Prevention and Control Office (FHAPCO) (2008) Report on Progress towards Implementation of the UN Declaration of Commitment on HIV/AIDS. FHAPCO, Addis Ababa, Ethiopia.Google Scholar
FMoH/HAPCO (2006) AIDS in Ethiopia. 6th Report, September 2006. FMoH/HAPCO.Google Scholar
Franklin, S. (2004) HIV/AIDS, Health and Vulnerability. SEI Briefing Note. Stockholm Environment Institute, Oxford.Google Scholar
Gessessew, A. & Mesfin, M. (2004) Rape and related health problems in Adigrat Zonal Hospital, Tigray Region, Ethiopia. Ethiopian Journal of Health Development 18(3), 140–144.Google Scholar
Hunter, S. D. (2003) Who Cares? AIDS in Africa. Palgrave Macmillan, New York.Google Scholar
Jakab, E. A. M. (2000) Louis Pasteur: Hunting Killer Germs. McGraw-Hill, London.Google Scholar
Kalipeni, E., Oppong, J. & Zerai, A. (2007) Introduction: HIV/AIDS, gender, agency and empowerment issues in Africa. Social Science & Medicine 64, 1015–1018.Google Scholar
Kimaryo, S. S., Okpaku, J. O., Githunk-Shongwe, A. & Feeney, J. (eds) (2004) Turning a Crisis into an Opportunity: Strategies for Scaling Up the National Response to the HIV/AIDS Pandemic in Lesotho. Third Press Publishers, New Rochelle, New York, USA.Google Scholar
Leclerc-Madlala, S. (1997) Infect one, infect all: Zulu youth response to AIDS epidemic in South Africa. Medical Anthropology 17, 363–380.CrossRefGoogle ScholarPubMed
Lester, F. T., Ayehunie, S. & Zewdie, D. (1988) Acquired immunodeficiency syndrome: seven cases in an Addis Ababa Hospital, Ethiopian Medical Journal 26(3), 139–145.Google Scholar
Lindegger, G. & Wood, G. (1995) The AIDS crisis: review of psychological issues and implications, with special reference to the South African situation. South African Journal of Psychology 25(1), 1–11.CrossRefGoogle Scholar
MacKinnon, C. (1989) Toward a Feminist Theory of the State. Harvard University Press, Cambridge, MA, and London.Google Scholar
Masanjala, W. (2007) The Poverty–HIV/AIDS nexus in Africa: a livelihood approach. Social Science & Medicine 64, 1032–1041.Google Scholar
Massé, R. (2007) Between structural violence and idioms of distress: the case of social suffering in the French Caribbean. Anthropology in Action 14(3), 6–17.CrossRefGoogle Scholar
Molla, M., Ismail, S., Kumie, A. & Kebede, F. (2002) Sexual violence among female street adolescents in Addis Ababa. Ethiopian Journal of Health Development 16(2), 119–128.CrossRefGoogle Scholar
Murphy, B. (2004) The Political Economy of AIDS. URL: http://www.redflagsweekly.com/features/2004_feb17_1.htmlGoogle Scholar
Negassa, H., Khodakevich, L., Kefenie, H. et al. (1990) Surveillance of AIDS cases in Ethiopia. Ethiopian Journal of Health Development 4(2), 107–113.Google Scholar
Nguyen, V-K. & Peschard, K. (2003) Anthropology, inequality, and disease: a review. Annual Review of Anthropology 32, 447–474.CrossRefGoogle Scholar
Parker, R. (2001) Sexuality, culture, and power in HIV/AIDS research. Annual Review of Anthropology 30, 163–179.CrossRefGoogle Scholar
Parker, R. G., Easton, D. & Klein, C. (2000) Structural barriers and facilitators in HIV prevention: a review of international research. AIDS 14 (Supplement 1), S22–32.CrossRefGoogle ScholarPubMed
Phatlane, S. N. (2003) Poverty and HIV/AIDS in Apartheid South Africa. Social Identities 9(1), 73–91.CrossRefGoogle Scholar
Pokroy, J. (1999) Police sensitivity to rape survivors: police perceptions. BA Thesis, University of the Witwatersrand, Johannesburg, South Africa.Google Scholar
Poku, N. K. (2002) Poverty, debt and Africa's HIV/AIDS crisis. International Affairs 78(3), 531–546.CrossRefGoogle Scholar
Rodrigo, C. & Rajapakse, S. (2010) Review: HIV, poverty and women. International Health 2, 9–16.CrossRefGoogle ScholarPubMed
Root-Bernstein, R. (1993) Rethinking AIDS: The Tragic Cost of Premature Consensus. McMillan/Free Press, New York.Google Scholar
Rosaldo, M. & Lamphere, L. (eds) (1974) Women, Culture, and Society. Stanford University Press, Stanford.Google Scholar
Salazar, X. et al. (2005) Vulnerability and sexual risks: Vagos and vaguitas in a low income town of Peru. Culture, Health and Sexuality 7(4), 375–387.Google Scholar
Schepper-Hughes, N. (1996) Small wars and invisible genocide. Social Science & Medicine 43(5), 889–900.Google Scholar
Schoepf, B. (1991) Ethical, methodological and political issues of AIDS research in central Africa. Social Science & Medicine 33, 749–763.Google Scholar
Schoepf, B. (1992) Sex, gender and society. In Dyson, T. (ed.) Sexual Behaviour and Networking: Anthropological and Socio-cultural Studies on the Transmission of HIV. Derouax-Ordina, Liége, pp. 353–375.Google Scholar
Sen, A. (1999) Development as Freedom. Oxford University Press, Oxford.Google Scholar
Singer, M. (ed.) (1998) The Political Economy of AIDS. Baywood, Amityville, NY.Google Scholar
Singer, M., Flores, C., Davidson, L., Burke, G., Castillo, Z. et al. (1990) SIDA: the economic, social and cultural context of AIDS among Latinos. Medical Anthropology Quarterly 4(1), 72–114.Google Scholar
Stillwaggon, E. (2006) AIDS and the Ecology of Poverty. Oxford University Press, Oxford and New York.Google Scholar
Subramanian, S. V. (2002) The macroeconomic determinant of health. Annual Review of Public Health 23, 287–302.Google Scholar
Tekola, B. (2005) Poverty and the Social Context of Sex Work in Addis Ababa: An Anthropological Perspective. FSS Special Monograph Series No. 2. Forum for Social Studies, Addis Ababa.Google Scholar
Tilson, D. & Larsen, U. (2000) Divorce in Ethiopia: the impact of early marriage and childlessness. Journal of Biosocial Science 32, 355–372.Google Scholar
Treichler, P. A. (1999) How to Have Theory an Epidemic: Cultural Chronicles of AIDS. Duke University Press. Durham, NC/London.Google Scholar
UNDP (2002) Conceptual Shifts for Sound Planning: Towards an Integrated Approach to HIV/AIDS and Poverty. Concept Paper. UNDP Regional Project on HIV and Development.Google Scholar
UNAIDS (2010) Global Report on the Global AIDS Epidemic. UNAIDS.Google Scholar
UNAIDS/WHO (2005) AIDS Epidemic Update. December 2005. UNAIDS and WHO.Google Scholar
UNAIDS/WHO (2008) AIDS Epidemic Update. December 2008. UNAIDS and WHO.Google Scholar
Wagstaff, A. (2002) Poverty and health sector inequalities. Bulletin of the World Health Organization 80(2), 97–105.Google ScholarPubMed
Ward, M. (1993) Different disease: HIV/AIDS and health care for women in poverty. Culture, Medicine and Psychiatry 17(4), 413–430.Google Scholar
Whiteside, A. (1992) AIDS and Development. Editorial. AIDS Analysis Africa 8(2).Google Scholar
WHO (1995) The World Health Report 1995 – Bridging the Gaps. URL: http://www.who.int/whr/1995/en/whr95_en.pdfGoogle Scholar
Van Donk, M. (2002) HIV/AIDS and Urban Poverty in South Africa. South African Cities Network. URL: http://www.sacities.net/knowledge/research/publications.Google Scholar