Multiple sexual partners migrant labor and the makings for an epidemic: knowledge and beliefs about AIDS among women in highland Lesotho.

Abstract

Field research conducted in 1991-92 among a small segment of the rural population in highland Lesotho yielded valuable findings on the beliefs knowledge and risk factors related to acquired immunodeficiency syndrome (AIDS). Women from 195 randomly selected households from the Mokhotlong district were interviewed as were 13 traditional healers. At the time of the study only one case of AIDS had been acknowledged in the district and there were 44 reported cases nationwide. The Basotho women demonstrated a high degree of knowledge about AIDS: 85.6% of respondents identified sex with multiple partners as the most common means of transmission 49.2% mentioned limiting the number of sexual partners (to two) as the most effective way of preventing infection and 34.4% were aware of the risk of fetal transmission. The most common sources of information about AIDS were informal discussions with friends and relatives (40.5%) and government hospitals (38.5%); 89.7% considered it important that children learn about AIDS prevention only 3.1% had ever used them; this low use level reflected husbands opposition lack of access and misconceptions that condoms remain inside a womans body after intercourse. 28.2% had been infected with a sexually transmitted disease (STD) in the 6 months preceding the interview and 20.5% reported pelvic inflammatory disease in this period. 83.1% perceived sex with multiple partners involving the exchange of money or basic necessities (bonyatsi) to be a common even necessary social phenomenon in this impoverished area where husbands are frequently absent given dependence on migrant labor in Lesotho. 83% of respondents believed the practice of bonyatsi will accelerate in the future as more adolescents become involved and greater numbers of women receive no support from husbands. Unless viable economic opportunities are created for these women the widespread practice of bonyatsi will provide a vehicle for widespread transmission of AIDS virus. Since condom use cannot be achieved without male support educational campaigns aimed at men are necessary. Finally traditional healers who demonstrated a lack of knowledge about AIDS and its causes should receive intensive training.