Social cultural factors in HIV/AIDS transmission among women in Rwanda .
par Jean paul NTEZIRYAYO
Kigali Institute of Education - Bachelors degree of Sciences 2009
To all my family
I would like to thank GOD for having kept me alive up to day and managed to accomplish my studies and this research work for my education in Kigali institute of education.
I thank the entire staff of Kigese clinic, for their kind and moral support rendered to me during my research; Mrs MUGABEKAZI Emma should be appreciated most for her help.
I am deeply indebted to give special thanks to my supervisor Mister WERE Edmond for his commitment and advice expressed to me during this research work.
I deeply thank all my family especially my parents, NAMUGIZE Faustin, MUKAMARARA Euphrasie for their moral and materials support extended to me during the whole academic struggle at Kigali Institute of Education.
I can not finish without expressing my special thanks to my girlfriend UWIMANA Lilianne, for her moral contributions and affection. And I thank all my friends in general especially; NSENGIMANA Donatien, NAHIMANA Didier, BUCYANA fidèle, MVUNABANDI Mathias and my brothers for their moral and materials support.
I really acknowledge you very much for the assistance you rendered to me during my studies.
TABLE OF CONTENTS
TABLE OF CONTENTS iii
LIST OF TABLES vi
LIST OF GRAPHS vii
LIST OF ABREVIATIONS viii
CHAPTER I: GENERAL INTRODUCTION 1
I.1. BACKGROUND OF THE PROBLEM 1
I.2 STATEMENT OF THE PROBLEM. 4
I.3 OBJECTIVES OF THE STUDY 5
I.4 RESEARCH QUETIONS 5
I.5 SIGNIFICANCE OF THE STUDY 5
I.6 LIMITATION OF THE STUDY 6
CHAPTER II: LITERATURE REVIEW 7
II.1 INTRODUCTION 7
II.1.1 THE POSITION OF WOMEN IN SOCIETY 8
II.1.2 WHAT MAKES WOMEN VULNERABLE TO HIV/AIDS 9
II.1.3 WOMEN VULNERABLE FOR MANY REASONS 10
II.2 SOCIAL CULTURAL FACTORS IN HIV TRANSMISSION 11
II.2.1. INTRODUTION 11
II.2.2 MARRIAGE 12
II.2.3 POLYGAMY 12
II.2.4 EARLY MARRIAGE 13
II.2.5 MULTIPLE SEXUAL PARTNERS 14
II.2.6 HARMFUL CULTURAL AND TRADITIONAL PRACTICES 14
II.2.7 GENDER BASED VIOLENCE 15
II.2.8 STIGMA AND TABOOS 16
II.2.9 RELIGION 16
II.2.10 POVERTY 17
II.2.11 LACK OF ACCESS TO PRODUCTIVE RESOURCES OR INCOME 18
II.2.12 LACK OF EDUCATION AND TRAINING 19
CHAPTERIII: METHODOLOGY 21
III.1. INTRODUCTION 21
III.1.1 QUALITATIVE METHOD 21
III.1.2 SOURCE OF DATA 21
III.1.2.1 PRIMARY DATA 21
III.1.2.2 SECONDARY DATA 21
III.1.3 LOCATION OF THE STUDY 22
III.1.4 STUDY POPULATION 22
III.1.5 POPULATION AND SAMPLE 22
III.2 TECHNIQUES OF DATA COLLECTION 22
III.2.1 Interviews 22
III.2.2 Questionnaire 23
III.3 DATA PROCESSING AND INTERPRETATION 23
III.4 LIMITATION OF THE RESEARCH 24
III.5 SUMMARY 24
CHAPTERIV: DATA ANALYSIS AND INTERPRETETION 25
IV.2.1 Age of respondents 25
IV.2.2 Qualification of respondent 26
IV.2.3 Socio-cultural factors that influence HIV transmission among women. 26
4.3 SUMMARY 33
CHAPTERV: GENERAL CONCLUSION 34
V.1 GENERAL CONCLUSION 34
V.2 RECOMMENDATIONS 35
V.3 SUGGESTION FOR FURTHER RESEARCH 36
LIST OF TABLES
Table1: The age of respondents 25
Table2: qualification of respondent 26
Table3. The social and cultural practices that influence HIV/AIDS transmission. 27
LIST OF GRAPHS
Fig.1 Percentage of women infected with HIV/AIDS in 5years 20
Fig. 2. Number of women infected with HIV 29
Fig.3 Percentage of men and women in Rugarika Sector 30
LIST OF ABREVIATIONS
HIV: Human Immune deficiency Virus
AIDS: Acquired Immune Deficiency Syndrome UNAIDS: United Nations programme on AIDS TRAC: Treatment and Research on AIDS Center. P3: Primary 3
P6: Primary 6
S3: Senior 3
S6: Senior 6
This study examines the social cultural factors that influence HIV/AIDS transmission among women in RWANDA and especially in RUGALIKA sector. Some of those social cultural factors we can say marriage, polygamy, early marriage, poverty, religious beliefs, lack of access to productive resources and lack of education and training.
The objectives of the study were to identify the social cultural factors which influence in HIV transmission among women and the constraint of HIV/AIDS among women and to find out how those constraint can be overcome and also to identify the measures that could be take for more prevent the spread of HIV infection to the women and to the all people in general.
The research contains 5chapters which are: 1st chapter: general conclusion; 2nd chapter: literature review; 3rd chapter: research methodology; 4th chapter: data analysis and interpretation and the 5th chapter is general conclusion and recommendation.
This research was conducted in RUGALIKA sector which has about 2990 women aged between 21-35 years old and thus a sample of 290 women was selected in different region of RUGALIKA sector.
After the interpretation of the findings; the most vulnerable group is the women aged between 31-35 years; the vulnerability is due to different factors but most of them we have: poverty issues, polygamy, lack of access to productive resources, lack of education and training, religious beliefs and we cannot forget the physiological factors.
After the genocide of 1994, Rwanda has known many orphans; and in RUGALIKA sector young women and girls are often to be sexual exploited in order to survive.
CHAPTER I: GENERAL INTRODUCTION I.1. BACKGROUND OF THE PROBLEM
All cultures create a division of labor based on gender; gender and sexuality determine the extent to be vulnerable to HIV and the ability to access available prevention, treatment, care and other services.1 It is gender which encompasses all duties, rights and behaviors a culture considers appropriate for male and females, in social invention gender gives us a sense of personal identity as male or female.
Social cultural norms build notions of masculinity and feminity which in turn create unequal power relations between men and women. The social cultural factors in traditional beliefs and practices in the African society play a great role in determining the position of women and girl in society. Masculinity requires men to be more dominating, knowledgeable and experienced in life. This assumption puts many young men at risk of HIV infection as such cultural norms prevent them from seeking information or admitting their lack of knowledge about sex or methods of protection. The Rwandan culture allows a man to be a head of family where each proposition and rules to be followed are elaborated by him; the culture trained the girls to be good mothers, and housewives and were educated to be submissive, polite, and obedient and to respect all the man in general.
Many cultures in Africa allowed the girls to be married at age of 16 with a man who has wives even if he has over 4 wives. The polygamy in Rwanda is known for a longtime ago until today and the early marriage for a girl at 16 or less than sixteen years old caused the girl to be forced into having sexual intercourse with their husband usually much older than she can increase the young girls' vulnerability to HIV.
1 . www.icaso.org
Depending on the culture norms, the social structure shows that a man takes a primary responsibility and dominates in their households which encourage multiple sexual partners for men even he is married, while women tend to be faithfully2.
The female genital cutting which was mostly practicable in Rwanda heightened the risk of HIV transmission. As the culture tends women to be faithfully and polite sometimes they have sexual intercourse without negotiating with the partner (husband) at what time and in which manner to do it, even if a woman is sick, she must respect the norms of culture that caused the violence against woman and girls ,including rape, female genital mutilation, early and forced marriage, violence related to commercial sexual exploitation, including trafficking and other forms of sexual violence can increase the vulnerability to HIV/AIDS. The man is more likely to refuse to use condom, they used to beat the women when they refuse to sleep with them (to have sex with them).Depending on social cultural norms, many men think that it is a wife's duty to have a sex with her husband; because that is the main reason they come together. Violence at home is also directly and indirectly associated with men's increased vulnerability to HIV. In our days violence or the fear of violence is also considered to be a barrier to women seeking HIV testing and for those who seek testing it acts as a barrier to disclosure of their HIV status to their partners3. HIV/AIDS in developing countries including Rwanda is endemic and seriously needs to be reverted. The third demographic and health survey conducted in 2005 indicates that in Rwanda 3% of the people lives with HIV. The data shows that women are particularly vulnerable to HIV infection. Rwanda detected the first case of HIV on its territory more than two decades ago4.
2 Gender, sexuality, rights and HIV P.11
3 Gender, sexuality, rights and HIV P.11
4 Anne-Emmanuelle calves in 1998
HIV/AIDS prevalence in Rwanda is at 3%, women and girl are the most vulnerable due to different cultures and background and many social cultural factors like;
+ Early marriage and pregnancies.
+ Multiple sexual.
+ Harmful culture and traditional practices. + Violence against women.
+ Stigma and Taboos.
+ Lack of access to productive resources.
These are the some of the factors that influence the transmission of HIV to the women and we will talk more about those social cultural factors in the next chapters. .Many girls and women are vulnerable to HIV for many reasons. Like many girls whose genital tract is still not fully mature, they become infected with HIV during unprotected vaginal intercourse; in all over the world the domestic violence reduces women's control over their exposure to HIV; obviously women are in poor position to question about the extramarital encounters, negotiate condom use or refuse to have sex which caused them to be infected with HIV5. Polygamy is much known as a factor which influences the transmission of HIV. A female genital cutting increases the HIV infection among girls and women6. Depending on Rwandan culture norms it is a taboo to talk especially about sex and sexual activities, and that acts as a barrier to seeking knowledge of HIV prevention and providing the treatment care. Religion is known as one factor among many others which influence HIV infection. Many religions beliefs condemn premarital sex, contraception including condom use and homosexuality.
6 Gender, sexuality, rights and HIV
In fact the sexuality and gender stereotypes constructed by religion can inhibit prevention efforts and increase vulnerability to HIV infection. Rwanda as a developing country, we can mention poverty as the main factor of HIV infection; poverty increases susceptibility to contracting HIV through several channels, including increased migration to urban areas, limited access to education and information related to HIV prevention. As a developing country, lack of education is much known for many people in Rwanda and great number is for the women so the women's access to education and vocation training, and the sexuality division of labor that puts women in lower status jobs, increases women's vulnerability to HIV. Women are vulnerable to HIV, sometimes it is social pressure to acquiesce to elders, and sometimes it is a combination of factors, as may be the case with older «sugar daddies» who offer schoolgirls gift or money for school fees in return for sex. But if the cultural norms have remained relatively stable through time, the same can not be for social and economic circumstances7.
The social cultural norms and cultural practices are the main factors which can influence the transmission of HIV/AIDS among women. Those factors are different and very common depending on religion, human attitudes and the cultural values. The cultural norms allows the men to have sex any time they wish ,what is different for the women, and according to the situation regarding the women in cultural norms, they have no right to negotiate the time to have sex with their partner(husband).The position of women in society, lack of access to education and training, poverty are considered as the main factors that influences the transmission of HIV/AIDS among women. Occasional sexual activity and multiple sexual partners both increase the risk of contracting HIV/AIDS. This study offers an incomparable window on the internal dynamic of social cultural factors that affects women's lives.
I.3 OBJECTIVES OF THE STUDY
The main objective of the study is:
> To identify social cultural factors which facilitate HIV infection in women?
> To find out measures which may be taken to overcome the constraints of HIV/AIDS among women?