Download FACTORS AFFECTING SEXUAL PRACTICES IN WEST AFRICA

FACTORS AFFECTING SEXUAL
PRACTICES IN WEST AFRICA - A
POSITIVE DEVIANCE APPROACH
STELLA BABALOLA
CLAUDIA VONDRASEK
JANE BROWN
Johns Hopkins University Center For Communication
Programs, Baltimore
Paper presented at the 2001 APHA Annual Conference, October 21-25, 2001,
Atlanta, GA
Credits
The research was conducted for the SFPS project
with funding from the United States Agency for
International Development. The Johns Hopkins
University Center for Communication Program
(JHU/CCP) provided technical assistance for its
implementation.
Dr. Dieneba Ouedraogo was contracted to collect
and analyze the data.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
WHAT IS POSITIVE DEVIANCE?
Normative (objective reality) perspective:
– Behavior that is labeled in a superior manner due
to a non-adherence to the normative structures of
society (Heckert, 1997)
Reactivist (subjective reality) perspective:
– A behavior that is positively evaluated and
sanctioned
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
RATIONALE FOR A POSITIVE
DEVIANCE APPROACH
• In every community, there are people who
while having access to the same resource base
as others yet adopt positive deviant behaviors;
• Studying the positive deviants and
understanding the motivations for their supraconformist behaviors should provide useful
insights into how to promote safe sex
practices.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
SEXUAL BEHAVIOR AMONG YOUTH IN
THE WEST AFRICAN SUB-REGION
Literature review in the study countries reveals
the following:
• First sexual intercourse typically takes place
out of wedlock, especially among urban youth;
•Early sexual experimentation: age at fist sex
varies between 15 and 18 years in most West
African societies;
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
SEXUAL BEHAVIOR… cont.
• Sexual abstinence is not a popular option
among youth;
• Group norms favor multiple sexual partners
and many sexually active youth have more
than one sexual partner. In Burkina Faso, more
than 8 of 10 sexually active youth have had
two or more sexual partners (DHS, 1999);
• Condom use is low;
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
POSITIVE DEVIANT BEHAVIORS
EXAMINED
• Delayed sexual initiation;
• Consistent condom use
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
METHODOLOGY
• Pre-interview screening to identify
“authentic” positive deviants
• In-depth interviews with identified
positive deviants aged 15 - 24 years
• In-depth interviews with parents,
guardians, youth leaders and community
opinion leaders
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
STUDY LOCATIONS
• Burkina Faso:
– Ouagadougou
– Ouahigouya
• Côte d’Ivoire
– Abidjan
– Dabou
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
FINDINGS
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
DELAYED SEXUAL INITIATION
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CHARACTERISTICS OF DELAYED
STARTERS
• Data derived from IDIs with:
– 12 primary sexually abstinent youth and 12 late starters
• Primary sexually abstinent youth: 19 years or more,
yet to become sexually active
• Late starters: first sex at 20 years or more
• Most sexually abstinent youth have a romantic
partner
• All dream of experiencing sexual intercourse one day
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
INTENDED TIMING OF FIRST SEX
SOME INTEND TO ABSTAIN UNTIL
MARRIAGE:
– With the help of God, I will hold on until the
end, even if I have to wait another 5 or 10
years until marriage” Abstinent female, 23
years, Abidjan.
– “Even if I have a boyfriend, I will have no sex
until marriage.” Abstinent female 19 years,
Ouahigouya, Burkina Faso
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
INTENDED TIMING OF FIRST SEX
SOME HAVE A CERTAIN AGE IN MIND. THEY
BELIEVED THAT AT THIS AGE, THEY WOULD
BE READY TO COPE WITH THE
CONSEQUENCES OF PREMARITAL SEX:
– “ At 21 or 22 … because at 22, I should be able to take
care of my responsibilities…in case of problems, I
should be able to take care of myself, provide for
myself.” Abstinent female, 20 years, Dabou, Côte
d’Ivoire.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
INTENDED TIMING OF FIRST SEX
OTHERS ARE WAITING TO FIND A
PARTNER WHO INTENDS WEDLOCK:
– “If I find someone who is ready to go all the
way with me, then I will be willing to have
sex with him. I have been with this man for
2 years but I am yet to give myself to him. I
am not in a hurry” Abstinent female, 20
years, Dabou, Côte d’Ivoire
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CORRELATES OF DELAYED
SEXUAL INITIATION
• COMMITMENT TO THE IDEAL OF
SEXUAL ABSTINENCE;
•SELF-ESTEEM: mixed findings
– generally positive opinions about physical
appearance
– some demonstrate high self-confidence
while others demonstrate low selfconfidence.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CORRELATES OF PRIMARY
SEXUAL ABSTINENCE
• TRADITIONAL VIEWS ABOUT SEX:
– sex generally viewed as a serious act, marking
the passage to adulthood;
– the importance of sexual intercourse goes
beyond the pleasure it provides:
• “the pleasure, yes! But beyond the pleasure, it is if
you are responsible, you should think of making
children as a result” Abstinent male, 19 years,
Ouagadougou.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CORRELATES OF PRIMARY
SEXUAL ABSTINENCE
– sex should not take place except the
persons concerned are ready for
responsibility
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CORRELATES OF PRIMARY
SEXUAL ABSTINENCE
Positive attitudes towards premarital
chastity:
– “it is not good to have sex before marriage but in
these days, you just have to…. Few men can wait
to be regularly married before having sex”
Female late starter, 23 years, Abidjan
– Before marriage, sex is not good…a person
should remain a virgin until marriage”
Abstinent female, 19 years, Ouagadougou
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CORRELATES OF PRIMARY
SEXUAL ABSTINENCE
Traditional views about virginity
– a girl’s virginity perceived to be a gift to
the person she will eventually marry
– virginity is perceived as a sign of respect
for parents and the future husband
– Virginity is perceived as a source of pride
for the girl
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
MOTIVATIONS FOR SEXUAL
ABSTINENCE
• Religiosity:
– fear of God
• “only if the person is converted, if he fears God
and follows the laws and doctrines of the
church…” Late starter, 23 years, Abidjan
– Commitment to the teachings of the religion:
• “In catechism, they taught us that sex is only for
married couple. I grew up with that idea”
Abstinent female, Ouagadougou
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
MOTIVATIONS FOR SEXUAL
ABSTINENCE
• “My behavior is guided by the Word of God. My
relationship with God allows me to remain abstinent
according to His Word.” Abstinent male,
Ouagadougou.
Vicarious experience:
– “Three of my friends in school became pregnant and
tried to abort.. They became the laughing stock of the
school. This made me to lose interest in sexual
relations” Abstinent female, 22 years, Abidjan.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
MOTIVATIONS FOR SEXUAL
ABSTINENCE
• clear and lofty academic and professional ambitions:
– desire for academic success
– desire for financial independence
• “I want to be free, I do not want to depend on anyone, I want to
fly on my own wings.”Female late starter, 23 years, Abidjan
– desire for a high professional status
• “I want to study aeronautics or physics. Sex is not one of my
priorities at this time… I transfer my sexual urges to my
academic work.” Abstinent male, 19 years, Ouagadougou
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
MOTIVATIONS FOR SEXUAL
ABSTINENCE
Perceived negative consequences of premarital
sex
– Perception that a pregnancy or HIV/AIDS could jeopardize
the attainment of life ambitions
Clear strategies for achieving life goals:
– The loftier the ambitions, the more intense the need to avoid
pregnancy, the more the need to preserve life is felt, and the
less importance sex takes.
– Focussing on life goals, sexually abstinent youth endure the
difficulties and relentlessly fight the obstacles in the way.
JOHNS HOPKINS
J
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
MOTIVATIONS FOR SEXUAL
ABSTINENCE
Parental influence
– little communication about sexuality between
parents and children.
– Much of the communication consists in advice
given to the child, especially the female child from
the mother;
– Parental control and the fear of the parents is the
key family factor motivating sexual deviance:
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
MOTIVATIONS FOR SEXUAL
ABSTINENCE
– “Often when there is a film on the TV about girls, the
old man would say: ‘if a daughter of mine becomes
pregnant, she will have to leave the house’ Do you
think that if I became pregnant I would have the
courage to go and tell him” Abstinent female, Abidjan
– “I used to visit this girl, but the father warned me that
he should no longer see me with her daughter.”
Abstinent male, Ouagadougou
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO SEXUAL ABSTINENCE
• Romantic love
– “I met him when I was 20. Initially, I did not
want to have sex with him. I accepted to have sex
with him when I turned 21. I succumbed because
I loved him” Late starter, 23 years, Abidjan, Côte
d’Ivoire
– “Sex is a way of showing love to someone who is
worthy of that expression…” Abstinent female,
19 years, Ouagadougou, Burkina Faso
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO SEXUAL ABSTINENCE
• Family pressure: After a certain age (in
early adulthood) parents tend to encourage
their children to become sexually active:
– “It is with my mother that I have the most
problems…She believes that religion is messing
up my life. She is concerned that I am not like the
others.” Abstinent female, Abidjan.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO SEXUAL ABSTINENCE
– “It was my father that made me to date this man.
He said that all my friends had boyfriends…”
Late starter, Abidjan
In response to the pressure from the parents,
the abstinent youth committed to the ideal of
abstinence may decide to take a boyfriend or
girlfriend without necessarily engaging in
sexual intercourse
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO SEXUAL ABSTINENCE
Peer pressure - sexually abstinent
youth are the object of mockery and
disdain by peers:
– “Often, they say that I am not normal”
– “They make fun of me, they say that I am
strange”
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO SEXUAL ABSTINENCE
Peer pressure can result in negative
behavior change
– “When I was in school, the girls would
come and tell me about their adventures,
what they did the previous night whereas I
did not even have a boyfriend. Finally, I
gave in” Female late starter, 22 years
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO SEXUAL ABSTINENCE
• Economic dependence on romantic
partner:
– “I often wish I had a boyfriend to help me out
financially but wonder if it is possible to have one
who would be willing to help without asking for
sex in return. When I think of this, I refrain myself
‘cause I have no intention of losing my virginity.”
Abstinent female, 19 years, Abidjan
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CONSISTENT CONDOM USE
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CHARACTERISTICS OF
CONSISTENT CONDOM USERS
• Data derived from 12 IDI;
• Consistent condom users are
knowledgeable about the benefits of
condom
•Condom rarely used for the first sexual
intercourse due to lack of knowledge, nonavailability of condom and lack of skills
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CORRELATES OF CONSISTENT
CONDOM USE
HIGH SELF-ETEEM
– Positive perceptions about physical appearance
• “I am handsome, I have a nice physique. They say that I have
the physique of an executive” Consistent user, 21 years,
Abidjan
– High self-confidence
• “There are many things that I do better than my peers”
• “When it comes to ‘toasting’ girls, I may not be the best but I
do hold my own”
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CORRELATES OF CONSISTENT
CONDOM USE
•Liberal views about premarital sex
•Low perceived self-efficacy for sexual
abstinence
•Low tolerance for (or doubts about)
mutual faithfulness
•Limited religious involvement, low
religiosity
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
MOTIVATIONS FOR CONSISTENT
CONDOM USE
• Life preservation:
– “I always use a condom because there are
diseases out there. Seeing people lose weight with
their hair turning yellow… that is not for me. If I
have to die of a disease, certainly not of AIDS.”
Consistent user, 24 years, Ouagadougou
• Pregnancy avoidance
• Vicarious experience
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
• Subtle parental influence:
– “I had a classmate who put a girl in the family way.
His father stopped paying his school fees, so he had
to stop schooling. Since I am afraid of my own father,
I cannot afford to take chances.” Consistent condom
user, 21 years, Abidjan.
•Life ambitions and the perceived negative
effects of pregnancy and HIV/AIDS on the
achievement of life goals
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO CONSISTENT CONDOM
USE
• Unwarranted trust in the partner
that comes with length of the
relationship:
– “I stopped using the condom with him
because after going out with him for six
months, I felt I could trust him.” Lapsed
consistent user, 22 years, Abidjan
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO CONSISTENT CONDOM
USE
• Economic dependence on partner
leading to reduced power in
relationships;
• Peer pressure:
– “..they say that you cannot eat a banana
with the skin…” Consistent user, 17 years,
Abidjan
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO CONSISTENT CONDOM
USE
• Pressure from the partner:
– “Some of my girlfriends have told me: ‘if
you insist on using a condom, that means
you go not trust me, do you think I am
fooling around?’. My response is to ask
them to show me the results of their HIV
test or the absolute proof that they are not
fooling around.”
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
THREATS TO CONSISTENT CONDOM
USE
• Non-availability of condom:
– “One night, I was seeing off a friend and met
a girlfriend of mine. It was the only
opportunity I would have had to make love
with her. But because it was late at night all
the shops were closed and I had no condom
on me. It was very hard….” Consistent user,
20 years, Abidjan.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CONCLUSIONS
• There are many youth who deviate
positively from unhealthy group norms
concerning sexuality; Using the positive
deviants to promote safe sex practices
should be a viable programmatic
approach
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CONCLUSIONS
• The choice of a positive deviant
lifestyle is influenced by family and
contextual factors upon which the actor
has little or no influence. However, the
choice also depends on some
psychosocial ideational factors that are
subject to volitional control on the part
of the positive deviant, including:
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs
CONCLUSIONS
•
•
•
•
•
•
Self-confidence
lofty life ambitions;
perceptions about sex;
risk perceptions;
perceived self-efficacy;
perceived severity of HIV/AIDS
• Programs should design appropriate
strategies based on these ideational factors.
JOHNS HOPKINS
U
N
I
V
E
R
S
I
T
Y
Center for Communication Programs