Postpartum abstinence and risk of HIV among young mothers in the Kassena-Nankana district of Northern Ghana

Abstract

This study explored the role and shaping of postpartum abstinence on young mothers' sexual conduct and vulnerability to HIV infection in a rural setting of Northern Ghana. Young mothers in their mid-twenties to early-thirties and men married to young mothers were purposively selected for repeated semi-structured interviews. The interviews were tape-recorded, transcribed and Nvivo software was used to organize and manage the data for analysis. In this setting, postpartum abstinence was perceived as a risk period for STIs due to increased male infidelity during this period. Yet, women's urge to take action to mitigate the risk of STIs is compromised by childbearing obligations. More assertive women, however, employ crafty and nifty protective strategies including the masturbation of their male partner when they perceive themselves at risk. We conclude that the advent of HIV and AIDS, coupled with improved access to sexual and reproductive health information and modern contraception, has eroded the logic of observance of postpartum abstinence in the Kassena-Nankana District of Northern Ghana. Efforts should be made to facilitate easy access to modern contraceptives and HIV protection by rural women.

Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb

“…The promotion of child health through birth spacing is the main reason for observing abstinence in Tanzania [9,28], Ghana [10], Ivory Coast [11,19], and Nigeria [20]. In the present study however, abstinence was observed mainly to avoid kubemenda .…”

“…The practice of postpartum abstinence is closely linked to child spacing in Tanzania [9], Ghana [10], and the Ivory Coast [11,12], with additional connections to lactation and child health in Ghana [10], the Ivory Coast [11], and Malawi [13]. In Tanzania, the 2010 demographic and health survey [14] found the median length of postpartum abstinence to be 3.8 months, with 19% of participants in the survey still abstaining at 12–13 months postpartum.…”

“…Qualitative interviews in the same area reveal that both women [17] and men [18] express concerns over the resumption of sex during the breastfeeding period, with a belief this may negatively affect the health of the baby. In Ghana [10], Ivory Coast [19], and Nigeria [20], there is an increased risk of the spread of HIV and other sexually transmitted infections (STIs) during the breastfeeding period, as men are reported to engage in extramarital sex while their women partners observe abstinence. Such risks and concerns over the possible health implications are also voiced by Tanzanian first-time mothers [17] and fathers [18].…”

Review of contributions from HDSSs to research in sexual and reproductive health in low‐ and middle‐income countries

“…Generally, most individuals continued to feel that they were not at risk of HIV, but two studies (Achan et al . , ) found that young womens’ childbearing obligations make protective sex less feasible for them; more assertive women insist their husbands use condoms, or employ protective strategies such as masturbation of their partner when they perceive themselves at risk.…”

Performing Drug Safety Research During Pregnancy and Lactation: Biomedical HIV Prevention Research as a Template

“…[27][28][29] In some cultures, rates of sexual concurrency for men may increase during the postpartum period, increasing lactating women's risk of HIV exposure and acquisition. 30,31 Acute maternal infection during lactation also increases risk for transmission to the infant. [32][33][34] The increased risk of HIV acquisition during pregnancy and the increased transmission risk to the infant with new infection during pregnancy and lactation compel the identification of safe and effective HIV prevention strategies for these populations.…”