Women’s Perceptions of an Encroaching HIV/AIDS Epidemic: In-Depth Interviews and Focus Groups with Women from rural Senegal

Rebecca Perry, Population Reference Bureau

Objective Over the past century, the slowly advancing Sahara desert has gravely affected the population of Senegal’s northeastern region (the Fouta). One major outcome of the Fouta’s desertification is an elevation in its HIV/AIDS prevalence rates. Moreover, this raised HIV/AIDS rate has received limited research attention; only one study has been published to date that begins to analyze the HIV/AIDS situation in this unique region of Senegal and no studies exist that focus on women’s role in this possible epidemic. Therefore, many questions remain-- perceptions of HIV/AIDS, HIV/AIDS risk behaviors, and for women in particular, their perceived risk of infection in a community of increased male emigration and infidelity among these male partners. This pilot study was designed to reveal the perceptions of, the reactions to and the behavior changes related to HIV/AIDS among Fouta women in one of the region’s capitals, Matam. Using qualitative techniques of in-depth interviews and focus groups with Fouta women, this study presents original data to enhance the overall understanding of HIV/AIDS in this region as well as provide a foundation for future demographic investigations on this distinctive area in Senegal. Background context Senegal has consistently had low HIV/AIDS seroprevalence and incidence rates. According to UNAIDS, Senegal has kept its HIV/AIDS incidence below 1 percent (0.5%) of the population. The country’s success at preventing HIV/AIDS, though not fully understood, has been attributed to early interventions, government dedication and innovative prevention tactics such as the legalization of registered prostitutes. Moreover, throughout the epidemic, Senegal has maintained steady rates of HIV/AIDS while its neighboring West African countries face incidence rates among their adult population (15-49) three times as high (3%) and with signs that the epidemic will only be getting worse. Yet, Senegal’s success might not last-- a possible epidemic is beginning to grow among the migrant population that might alter its low HIV/AIDS rates. Figures published in 2000 showed the majority of AIDS cases (62%) in the Fouta to be among individuals who traveled out of the country for a year or more. Furthermore, the only published HIV/AIDS investigation on this region indicates expatriation as a statistically significant risk for contracting HIV/AIDS. Once known for their great farming and herding capabilities, Fouta men are now faced with the need to look for work in other countries because the Sahara desert has encroached on their livelihood. These Fouta men typically look for work in countries such as South Africa, Cote d’Ivoire, areas that happen to have high HIV/AIDS rates. Staying as long as twenty years, Fouta men often turn to girlfriends and even prostitutes. When these men return to Senegal, they often bring HIV/AIDS. As an increasing number of Fouta men return from work outside of Senegal, their HIV/AIDS status might slowly squander Senegal’s low rates. Data The paper presents data from 5 focus group discussions and 20 in-depth, semi-structured personal interviews with Fouta women in Matam, a capital city in northeastern Senegal. Focus groups were conducted among women from previously established women’s clubs in Matam. In the extremely hierarchical society of the Fouta, these clubs provide women with a means to generate income irrelevant of their class. The study's used women’s clubs to prevent hierarchy from playing a major role in the dynamics between women during focus group discussions. Personal interviews were conducted with a random sample of twenty women’s club members. Both of these qualitative methods were performed in Fulani, the dominant language in the Fouta, with the help of a native Fulani speaker. The focus groups were designed to reveal general perceptions of, reactions to and behavior changes related to HIV/AIDS among Fouta women. In an effort to draw out more specificity and detail, the personal interview questions built on the themes presented during focus group discussions. The final stage of this study includes the analysis and categorization of qualitative data using thematic coding techniques. From an initial overview of the qualitative data, the expected findings are as follows: · The majority of Fouta women know about HIV/AIDS and were able to present accurate methods of HIV/AIDS transmission. · Most Fouta women can provide examples of risky behaviors that leads to HIV/AIDS infection. Among the most commonly mentioned is women’s tendency to have sex with husbands who were once migrant workers. In addition, women discussed exchanging sex for money or other necessities while their husbands were working in other countries. · Though the population of women interviewed had a high awareness of HIV/AIDS, and was fairly knowledgeable about HIV/AIDS transmission and risk behaviors, these women never perceived themselves at risk of contracting or having HIV/AIDS. · Furthermore, HIV/AIDSs association with “vagabondage sexuel,” promiscuity, and death, has made the disease a taboo subject to discuss with others. Many women felt unable to discuss their HIV/AIDS risks or even reveal their sero-positive status to friends or sexual partners. · HIV/AIDS protection through abstinence and condom use was restricted to the younger generation; older women were unable to suggest HIV/AIDS protection mechanisms with their sexual partners for fear of being accused of promiscuity and infidelity. These themes will be combined with current demographic literature in an effort to triangulate the themes drawn from the qualitative studies and provide a broader context. Conclusion Accurate personal risk perception, condom use, and comfort in discussing HIV/AIDS are problematic for Fouta women. Future HIV/AIDS awareness projects in Matam should focus on strengthening these three areas in an effort to prevent and protect against HIV/AIDS.