treatment of discharge and itching, while 13 percent had used traditional drying agents exclusively for tightening the vagina. The study found that a significantly higher proportion of HIV-infected than uninfected women had used intravaginal agents for treatment purposes, but no difference was found in HIV status among women who used these agents for tightening (Dallabetta et al., 1995). In Lusaka, Zambia, 50 percent of women attending an STD clinic reported having ever engaged in dry sex behavior (Sandala et al., 1995). A variety of practices was reported, including drinking an elixir or "porridge" before having sex. There was no evidence of a strong relationship between these practices and HIV infection (Sandala et al., 1995).

Oral/Anal Sex

Conventional wisdom holds that oral and anal sex are uncommon among most sub-Saharan African groups. However, this belief may reflect the fact that studies rarely investigate levels of nonvaginal sex. IRESCO (1992), studying sexual practices among commercial sex workers and their clients in Cameroon, found that 26 percent of commercial sex workers and 28 percent of their clients reported experience with anal intercourse, while over one-third of men and one-quarter of women in the group reported having experienced oral sex. In focus group studies in Uganda, some heterosexuals said they engaged in anal sex while women were menstruating (Standing and Kisekka, 1989). In a study of 329 women attending an STD clinic in Lusaka, Zambia, 8 percent of women reported ever engaging in anal intercourse (Sandala et al., 1995).

Homosexuality

Although very little sound research appears to have been done on homosexuality in sub-Saharan Africa, its existence is overwhelmingly denied in academic publications. This claim may result because "homosexuality" as a lifelong sexual identity is rare or unknown, rather than because men never have sex with men.

Ahmed and Kheir (1992) report homosexual behavior to be common though clandestine in northern Sudan. The authors express a concern that a recent government crackdown on female commercial sex workers may increase the incidence of homosexual sex, thus perhaps increasing the spread of HIV. Male-with-male sex featured prominently in focus group discussions among the Hausa in Nigeria (Kisekka, no date). Other studies give evidence of homosexual behavior among the Kikuyu in Kenya, the Hausa in Nigeria, and mine-workers in South Africa (Standing and Kisekka, 1989). According to D. Moodie et al. (1988, quoted in Standing and Kisekka, 1989), the mine-workers most likely to have boys acting as "mine-wives," that is, performing domestic and sexual services for them, were Mozambican migrants who also had the highest HIV prevalence.



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