Widow cleansing and inheritance among the Luo in Kenya: the need for additional women-centred HIV prevention options
| Autor: | Jamilah Taylor, Christina Wong, Lennah Oluoch, Lilian Ouma, Brian Perry, Amy Corneli, Jacob Onyango, Kawango Agot, Caroline Otieno |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty widow inheritance FEM-PrEP Adolescent Widow inheritance HIV prevention Culture Population HIV Infections Context (language use) complex mixtures law.invention Interviews as Topic Young Adult Condom law Ethnicity medicine Humans Luo education Qualitative Research condom Health Services Needs and Demand education.field_of_study Traditional medicine business.industry widow cleansing Public Health Environmental and Occupational Health Widowhood social sciences Focus Groups Kenya Focus group humanities Women's Health Services Sexual intercourse Sexual abstinence Infectious Diseases Family medicine behavior and behavior mechanisms population characteristics Marital status Female business Research Article |
| Zdroj: | Journal of the International AIDS Society |
| ISSN: | 1758-2652 |
| Popis: | Introduction The customs of widow cleansing and widow inheritance are practiced in several communities throughout sub-Saharan Africa. In the Nyanza Province of Kenya, according to tradition, Luo widows are expected to engage in sexual intercourse with a “cleanser,” without the use of a condom, in order to remove the impurity ascribed to her after her husband's death. Luo couples, including widows, are also expected to engage in sex preceding specific agricultural activities, building homes, funerals, weddings, and other significant cultural and social events. Widows who are inherited for the purpose of fulfilling cultural obligation have a higher prevalence of HIV than those who remain un-inherited or are inherited for the purpose of companionship. Methods As part of a larger descriptive qualitative study to inform study procedures for FEM-PrEP, an HIV prevention pre-exposure prophylaxis clinical trial, we conducted 15 semi-structured interviews (SSIs) with widows, 15 SSIs with inheritors, and four focus group discussions with widows in the Bondo and Rarieda districts in Nyanza Province to explore the HIV risk context within widow cleansing and inheritance practices. Thematic qualitative analysis was used to analyze the data. Results The majority of widows reported in the demographic questionnaire being inherited, and most widows in the SSIs described participating in the cleansing ritual. We identified two main themes related to HIV prevention within the context of widow cleansing and inheritance: 1) widows must balance limiting their risk for HIV infection with meeting cultural expectations and ensuring that their livelihood needs are met, and 2) sexual abstinence undermines cultural expectations in widowhood while the use of condoms is deemed inappropriate in fulfilling culturally prescribed sexual rituals, and is often beyond the widow's ability to negotiate. Conclusions Women-controlled HIV prevention methods such as antiretroviral-based oral pre-exposure prophylaxis, vaginal gels, and vaginal rings are needed for HIV-negative widows who engage in sexual rituals related to widowhood. |
| Databáze: | OpenAIRE |
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