Cultural practices and HIV/AIDS: a case study of sexual cleansing in Rachuonyo District

Abstract

The HIV pandemic remains a major health challenge globally. The epidemiology of AIDS is now well understood; although the role of traditional cultural practices in its spread is not well understood. This study sought to investigate the role of sexual cleansing in HIV AIDS transmission. The ritual of sexual cleansing (chodo kode), the subject of this investigation is a prelude to wife inheritance or levirate marriage. This is a common practice within the study population. The widow has a duty to find a cleanser and if she is unable to get a one, her sons or relatives will make sure that they find one for her. The specific objectives of the study were: (a) to determine the perceptions of widows, clan leaders and cleansers on sexual cleansing, (b) to document the details of sexual cleansing and its cultural significance, (c) to understand why the practice still persists and d) to determine the role of sexual cleansing in the spread of HIV/AIDS This was a descriptive qualitative study using purposive and snowball sampling. The data were collected using in-depth interviews and focus group discussions. The target populations were widows, cleansers and clan elders, living in Rachuonyo district of Western Kenya. Triangulation was done for qualitative data to take care of test and assure validity and confidence; content analysis and coding of the data were done to unveil, explore and unravel the symbolic meanings of this cultural practice, its significance, the perceptions of the community and the role that it plays in the spread of HIV AIDS. The end results are a detailed check of the sex cleansing ritual and explanations of its underlying symbolic significance. From the analyzed data it is clear that the ritual of sex cleansing for the widows still goes on and it is not a new practice. The ritual involves the act of having sexual intercourse between a widow and a commercial cleanser (Jakowiny) - who will be paid, or a brother-in -law (shemeji/ jater) who may not need or expect payment. In regard to HIV/AIDS, most respondents said that the prevalence of AIDS could not stop them from practicing the ritual. They argued that it was better to stop what they could than what seemed impossible. There is no cure for HIV IAIDS, while there is a cure for Kode. An intervention program is necessary. The widows should be educated to realize that the sex that the she has during cleansing is no different from the other normal sex. Both types of sex are capable of transmitting HIV. More emphasis should be put on symbolic cleansing. Another aspect that should be looked into seriously is the expansion of VCT services and promotion of condoms use in the rural areas. Research on interventions would be helpful to determine the best approach to effecting change of deeply held cultural practices and rituals