. "4 SEXUAL BEHAVIOR AND HIV/AIDS." Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences. Washington, DC: The National Academies Press, 1996.
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Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences
Postpartum and Other Abstinence
Postpartum abstinence probably evolved simply as a means of birth spacing, but became ritually sanctioned so that it would be maintained. In Bamako and Bobo-Dioulasso, two cities of the Sahel region, the prevailing belief among women interviewed in 1983 was that women must not have sex while they are breastfeeding because the ingestion of semen will spoil the mother's milk (van de Walle and van de Walle, 1991). As was pointed out earlier, it is common for men to seek other partners during the postpartum period; indeed, many researchers believe postpartum abstinence is a principal prop of high levels of sexual networking, and call for the promotion of condoms to breastfeeding women as a means of eliminating the danger of "dirty milk" (e.g., Hogsborg and Aaby, 1992). Anarfi (1993) suggests that a possibly related dynamic is under way in Ghana: women are limiting their postpartum abstinence in an attempt to keep husbands from seeking other sexual partners. He reports an average of 12.4 months of abstinence in Ghana, where, he says, the taboo period was much longer in the past.12 Half of the women in his sample reported contraceptive use, versus a national average of 13 percent among currently married women (Ghana Statistical Office and IRD/Macro Systems, 1989). However, repeated surveys sometimes contradict the conventional wisdom that postpartum abstinence is everywhere on the wane. In Cameroon, the average length of postpartum abstinence remained at 13.9 months between 1978 and 1991 according to WFS and DHS data, while in Kenya the mean number of months rose from 2.9 in 1977/78 to 5.9 in 1989. The median length of postpartum abstinence measured by the 1993 DHS in Kenya was 3.0 months (Figure 4-1).
Couples may abstain from sex for other reasons, such as during a woman's menstrual period or in times of mourning. Researchers report that in some contexts, the definition of "abstinence" may be flexible, extending to situations that include sleeping with a person only on a single occasion. Such misconceptions, if common, would diminish health educator's recommendation of "abstinence" as a protection against HIV/AIDS.
Standing and Kisekka (1989) report that passing on wives to the brothers or family members of dead husbands remains common in some societies, particularly
No evidence for this claim can be found in the trends from the 1979-1980 WFS, the 1988 DHS, or the 1993 DHS in Ghana. Anarfi's measure is higher than the 1979-1980 WFS mean of 10 months (Central Bureau of Statistics [Ghana], 1983), but lower than the 1988 DHS mean of 14 months (Ghana Statistical Service and IRD/Macro Systems, 1989) and the 1993 DHS mean of 14 months (Ghana Statistical Service and IRD/Macro Systems, 1994).