HIV in Uganda

"Cultural Attitudes and Rumors Are Lasting Obstacles to Safe Sex"

http://www.nytimes.com/2010/05/10/world/africa/10aidscondom.html?fta=y

Because a man buys a wife from her father for cows or cash, he “owns” her. If she refuses sex or insists on a condom, he may beat her or throw her out of the house.

Also, condoms thwart pregnancy, and “I prove my manhood by having children,” said Mr. Bitti, a father of 14. “That is how a girl proves she is a woman. In Africa, you cannot tell anyone to stop having children. They will even think, ‘I would rather have AIDS and leave my children when I die. At least I will have produced my three.’ ”

Prostitutes, too, have disincentives. They typically get $5 for sex, but $10 to $20 more for sex without a condom. (Though it did not come up in Bwindi, prostitutes elsewhere in Africa have complained that some clients secretly bite holes in condoms because they believe flesh must make contact for the sex to be real.)

Young women from all but the wealthiest families are under constant pressure to trade sex for high school tuition, for grades, for food for their siblings, even for bus fare.

“People say: ‘Oh, I don’t worry. Sleep with me and we will all have H.I.V. together.’ ”