BBC News - Wednesday, 19 November, 2003

Many women in particular are risking contracting the virus, as some practices involve artificial drying of the vagina.

The reasons behind the practices are varied - some are to do with tribal beliefs, while others are simply efforts to please men during sex.

British worker Nikki Ezire - who had spent much time in Zimbabwe, Zambia and West Africa - told the BBC's Africa Live programme that she had met many African women who used douches of tree bark to dry themselves.

"It occurred to me that if you're drying out your vagina then it's more likely to split, and the risks of transmission are greater," she said.

Ugandan doctor Nelson Musoba said a number of sexual practices that may be conducive to the spread of Aids were common throughout Africa.

He said the non-penetrative practice of Katavali - established in the West of Uganda but now common throughout the country - often caused a condom to split - if one was even worn.

"... It is likely to lead to breakage of the condom, and bruising, and transmission of the HIV virus," the doctor said.

Even "official" advice can be misleading.

Nikki Ezire said she had seen an article in a Ghanaian woman's magazine advising a girl struggling to satisfy her fianc e, to give herself a douche with the antibacterial disinfectant Dettol.

Bebe, an HIV positive woman from Zimbabwe, told the programme she had seen girls using tomato leaves to dry themselves.

Wife inheritance

However, sexual practices are not the only traditions that may be causing the rapid spread of the virus in sub-Saharan Africa.

Wife inheritance, for example, is also thought to be playing a role - where the widow of a man is encouraged to marry her brother-in-law.

The tradition, widespread throughout many parts of Africa, was established to ensure a woman would not become poverty-stricken if her husband died.

But the cause of death for many men is now Aids. If the woman carries the virus, she will often pass it on to her new husband.

One contributor to Africa Live said she knew one woman who had married and remarried four brothers in the space of two years.

Meanwhile tribal beliefs have also caused Aids deaths to be dismissed as evil spirits or juju.

But Dr Musoba warned that changes throughout Africa would not be as likely in the near future.

"The same issue of wife inheritance is still occurring here, despite the high levels of awareness of ways of transmission of HIV that we have experienced in this country," he said.

"We still see people who, despite knowing the consequences, continue to practice wife inheritance."

He stressed that people's behaviour usually took a very long time to change.

"Behavioural change is linked to many factors - to environmental issues, to economic status.

"Situations of sickness and insecurity, cultural practices - all those compound and make people engage in risky behaviour."
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