Sex, sexuality, and the meaning of AIDS in Addis Ababa, Ethiopia.

Abstract

Recently, Ethiopia has joined the list of the most severely HIV affected countries in the world, with an estimated three million people infected with HIV/AIDS. In Ethiopia's capital city, Addis Ababa, 17 percent of the entire adult population is believed to be HIV positive. Prevalence rates and the unmistakable presence of AIDS at every level of society notwithstanding, limited effort has been put forth to understand the sexual behavioral factors driving the epidemic, and to link issues of sex and sexuality to HIV. This dissertation examines young Ethiopian men's and women's sexual attitudes, sexual behavior, and their perceptions of HIV risk within the broader context of their social relationships and within the framework of their lives in Addis Ababa, Ethiopia. It is an exploratory study examining a number of issues relating to premarital social and sexual relationships, mate selection, marriage, and sexual risk. The focus of this research is on never married men, aged 19--29, and women, aged 15--24. I have undertaken this study of young people's sexuality and HIV risk perception through a combination of quantitative survey (N = 439) and qualitative focus group discussions (N = 11) in three communities within a single district in Addis Ababa. The results suggest that there is conflict between normative values and the reality of sexual behaviors; that is, while young Ethiopians' attitudes toward sexual matters are conservative, the behavioral reality is that young people are increasingly having premarital sex. I posit that understanding what individuals, families, and society has defined as appropriate sexual conduct for men and women helps us understand the context within which personal choices and behavioral decisions are made---including young people's ability and willingness to take sexual risks and protect themselves against AIDS. This study also provides evidence that while a significant proportion of young men and women engage in risky sexual activities, HIV risk perception is low and that the factors associated with risk perception may be different for men and women.