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Additional articles in this series.
Harare, Zimbabwe and Nigeri Village, KenyaSipewe Mhakeni used herbs from the Mugugudhu tree. After grinding the stem and leaf, she would mix just a pinch of the sand-colored powder with water, wrap it in a bit of nylon stocking, and insert it into her vagina for 10 to 15 minutes. The herbs swell the soft tissues of the vagina, make it hot, and dry it out. That made sex "very painful," says Mhakeni. But, she adds, "Our African husbands enjoy sex with a dry vagina."
Many women concur that dry sex, as this practice is called, hurts. Yet it is common throughout southern Africa, where the AIDS epidemic is worse than anywhere in the world. Researchers conducting a study in Zimbabwe, where Mhakeni lives, had trouble finding a control group of women who did not engage in some form of the practice. Some women dry out their vaginas with mutendo wegudosoil with baboon urinethat they obtain from traditional healers, while others use detergents, salt, cotton, or shredded newspaper. Research shows that dry sex causes vaginal lacerations and suppresses the vagina's natural bacteria, both of which increase the likelihood of HIV infection. And some AIDS workers believe the extra friction makes condoms tear more easily.
Dry sex is not the only way African women subordinate their sexual safety to men's pleasure. In a few cultures, a woman's vagina is kept tight by sewing it almost shut. But in most African societies, the methods are subtler: Girls are socialized to yield sexual decision-making to men. Prisca Mhlolo is in charge of counseling at The Centre, a large organization for HIV-positive Zimbabweans. "You're not even allowed to say, 'Can we have sex?' " she notes. "So it's very hard to bring up condoms."
Mhlolo speaks from both professional and personal experience. She is HIV-positive, infected by her late husband. As AIDS eroded his immune system, he suffered from herpes, which broke into open sores on his penis. Mhlolo suggested condoms, "but he said, 'Now that I'm sick you have gotten yourself a boyfriend.' It was very hard."
Many people balk at discussing the sexual practices of particular cultures because the issue is too sensitiveand, in Africa, too racially charged. Whites have caricatured African sexuality for centuries, casting black men as sexual beasts, and some whites still whisper that this is why HIV is running rampant among Africans. But such stereotypes miss the point, which is not the libido itself but the culture in which it finds expression. HIV spread through the American gay community because having anal sex with many partners was common, and the virus infiltrated the Thai army because soldiers routinely patronized prostitutes. In Bombay, where AIDS has exploded, slum lords demand payment in sex. I.V. drug use aside, male sexual privilege is what drives the epidemic.
Studies from many different cultures show that men average more partners than women do and have more sex outside marriage. Because a man ejaculates into a woman, men are more likely to transmit the virus, whereas women are more likely to contract HIV without passing it on. So far, males have outnumbered females in HIV cases, partly because having more partners means more chances to encounter the virus. But new figures show that in sub-Saharan Africa, 55 percent of all infected adults are women.
Of course, Africa contains thousands of cultures, some of which have strict sexual codes. But common to many sub-Saharan societies are the gender roles epitomized by dry sex: Women are unable to negotiate sex, and so must risk infection to please the man. In fact, there are very few female checks and balances on male behavior. This stark inequality "is part of our culture," Mhlolo says, "and our culture is part of why HIV is spreading."
Africa today is far removed from its traditional, tightly knit communities that didconstrain men, mostly to their wives. Africa is also very different from the West, where women exercise a relatively large degree of power. Many parts of contemporary Africa are suspended in a limbo that combines the worst of both worlds, and HIV has exploited this. For example, men retain the mindset of polygamy, but now have many partners through commercial sex or "sugar daddy" relationships that lack the social cohesion of traditional marriages.
But AIDS is forcing African culture to changeand because the virus in Africa is spread mainly through heterosexual sex, the epidemic's largest social transformation may well be in the relations between women and men. Women could emerge from the epidemic with more power, and there is a strong push to make that happen. But there is also a backlash, a call to reimpose restrictions on women in the name of strengthening traditional African cultures and curtailing AIDS.
The battles are being fought not only over sexual practices, but also over larger economic and social forces that subordinate women and facilitate the spread of HIV. The World Bank reports that illiteracy rates among women south of the Sahara are almost 50 percent higher than among men. Many African girls cannot attend school because they are assigned time-consuming chores such as fetching water and firewood. Indeed, African women work longer than menand harder. Studies from Ghana and Tanzania show that rural women transport four times as much as men, often carrying the loads on their head, and other studies show that women do up to 90 percent of hoeing and weeding. Yet they make far less money than men and rarely own property. In Cameroon, for example, fewer than 10 percent of all land certificates belong to women.