A Case Study
AIDS in Baganda Women:
A Case Study
The case study reviewed for this paper involves a study Baganda women, 65 who tested positive for HIV and 65 who tested negative for HIV; the Baganda women lived in Kampala, Uganda (McGrath et al. 153). The authors selected this group in order to examine the cultural and social context of sexual risk behavior because the Baganda are the most populous ethnic group in Kampala, Uganda; also, Uganda “ranks second to the United States in number of AIDS cases in the world” (McGrath et al. 153-154).
Metaphors for AIDS are not mentioned in the study; however, the women are well aware of HIV’s etiology, that it is spread by sexual activity. It seems that many of the women do not know their serostatus, or if they are infected with HIV or not; the authors state that the case study’s “subjects were given the option of knowing their serostatus, [but] few women requested HIV test results” (McGrath et al. 154). Unfortunately, the study does not explain why the women do not know their serostatus and opt not to learn the results when they are offered.
The women are also well aware of how AIDS spreads and “report having only one partner out of fear of AIDS” (McGrath et al. 156). The Uganda AIDS Control Programme tries to encourage people to protect themselves from AIDS by offering messages such as “stick to one partner” or “zerograzing,” where the first message promotes monogamy and the second promotes either having one partner, fewer partners, or even abstinence (McGrath et al. 157). In spite of the fact that the women are well aware that even if they “stick to one partner” that they are still at risk for AIDS because they cannot control their partners’ sexual behavior, none of the women currently used condoms (McGrath et al. 158). Unfortunately, no explanation is offered by the study for why women are not using condoms. Whether it is an economic, social, or combination of these two issues is not discussed. Knowledge about treatment is not discussed either, although it is reasonable to construe that in this population where so few women know their serostatus, do not want to know their serostatus, and many are infected, treatment is considered to be too expensive for women who make an average of less than 3,000 Ugandan shillings a month, or about $4.30 (McGrath et al. 155).
This particular case study does not mention bodily mutilations or alterations that may transmit the disease, although when reading through a different study, it was discovered in a STD clinic in Nairobi, Kenya that there was “a higher prevalence and incidence of HIV among uncircumcised men” (Hunter 67). The study also does not mention patterns of migration.
However, the study extensively describes marriage patterns and sexual risk behavior that helps spread AIDS. For example, “traditional Baganda rules for sexual behavior prohibit sex for women outside of marriage . . . although males may have multiple partners” (McGrath et al. 153). There are several instances in which it is acceptable for women to have sex outside of marriage, the most common of which is economic necessity. The study’s subjects indicated that “if a husband doesn’t provide for his wife, she is justified in having sex with a man who provides money or other items” (McGrath et al. 157). Traditional reasons why a woman could be expected to have sex with men other than her husband include rituals for the birth of twins, funerals, and weddings (McGrath et al. 157). Finally, it is not uncommon for a man to have more than one wife. Of these behaviors for women, the riskiest is having sex for economic reasons.
The Baganda women are well aware of AIDS and some methods of prevention, but economic problems may still lead them to engage in risky activity. Even if they “stick to one partner” they still feel at risk because of their men having multiple partners. Cultural issues are explored, but do not answer why the women are not taking further precautions, such as with condom use, or declining to know their serostatus.
References
Hunter, David J. (Jan. 1993). AIDS in Sun-Saharan Africa: The Epidemiology of Heterosexual Transmission and the Prospects for Prevention. Epidemiology 4(1): 63-72.
McGrath, Janet W., Schumann, Debra A., Pearson-Marks, Jonnie, Rwabukwali, Charles B., Mukasa, Rebecca, Namande, Barbara, Nakayiwa, Sylvia, & Nakyobe Lucy. (Jun. 1992). Cultural Determinants of Sexual Risk Behavior for AIDS Among Baganda Women. Medical Anthropology Quarterly 6(2). 153-161.
