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Wednesday, May 28, 2014

Modern Marriage, Men’s Extramarital Sex, and HIV Risk in Southeastern Nigeria Daniel Jordan Smith, PhD, MPH

For women in Nigeria, as in many settings, simply being married can contribute to the risk of contracting HIV. I studied men’s extramarital sexual behavior in the context of modern marriage in southeastern Nigeria. The results indicate that the social organization of infidelity is shaped by economic inequality, aspirations for modern lifestyles, gender disparities, and contradictory moralities. It is men’s anxieties and ambivalence about masculinity, sexual morality, and social reputation in the context of seeking modern lifestyles—rather than immoral sexual behavior and traditional culture—that exacerbate the risks of HIV/AIDS.
Data from around the world, including Nigeria, suggest that married women’s greatest risk of contracting HIV is through sexual intercourse with their husbands.1 The implication is that men are acquiring HIV outside of marriage and infecting their wives. At first glance, modern marriage in Nigeria would seem to offer women greater autonomy and equality and perhaps protection from HIV. The growing prevalence of monogamy, declining fertility, a trend toward neolocal residence (establishing marital residence independent of kin) and nuclear household organization, women’s increasing education and participation in the formal workforce as more people migrate to cities, and the rise of love as an important rationale in the selection of a spouse all suggest the possibility of growing gender equality in marriage. But the findings presented in this study show that gender inequality persists in powerful ways, manifested perhaps most obviously—and certainly most dangerously with regard to the risk of HIV infection—in a pronounced double standard for extramarital sexuality. In contemporary Nigeria, married men are much more likely than married women to engage in extramarital sex, and it is more acceptable for them to do so.2
The prevalence of men’s participation in extramarital sex and the fact that women’s sexuality is, ironically, the target of popular discourse about sexual immorality attest to the persistence of gender inequality.3 Modern marriage in Nigeria, despite its appearance of greater equality, places many women in positions in which they cannot easily confront their husbands about infidelity or protect themselves from possible HIV infection. The findings presented here, however, go further than simply attributing the marital transmission of HIV to men’s behavior. Men’s extramarital sexual practices are situated in economic, social, and moral contexts. The social organization of extramarital sexuality is shaped by aspirations for modern amenities and middle-class consumption, the influence of urban fashions, and changing expectations of sexuality. My findings show that these goals and values are themselves shaped by economic inequality, gender disparities, and powerful and contradictory moralities. I argue against notions of African traditions, promiscuous women, and pervasive immorality as the causes of Nigeria’s and Africa’s AIDS epidemic.
The data demonstrate that married men’s risky sexual behavior and their wives’ inability to protect themselves can be understood and explained without resorting to the common fallacy of blaming the victims. It is people’s anxieties about sexual morality in the context of seeking modern lifestyles—rather than immoral sexual behavior somehow associated with traditional culture—that exacerbate risks produced by poverty and inequality. The focus here on how men navigate modernity, morality, and masculinity as they engage in extramarital relationships highlights the importance of intervening directly with men to address women’s risk of contracting HIV. Public health interventions focusing on men in Nigeria and similar settings where men’s extramarital sex is common and gender inequality is marked are urgently needed.
Nigeria is the most populous country in Africa, with more than 130 million people. With the current adult HIV seroprevalence estimated at 5%, some 3.5 million people are infected.4 Worst-case scenarios suggest that in the next decade infection rates could escalate to 20%, producing more than 10 million new cases.5 More moderate forecasts, such as the Nigerian government’s estimates, acknowledge that by 2015, some 8 million Nigerians will have died from AIDS-related causes.6 With the country’s testing and antiretroviral therapy programs still reaching only a fraction of the target population, effective prevention efforts remain a crucial strategy. But perhaps not surprisingly, in a context in which both popular and political discourse on the disease continue to emphasize sexual immorality as a primary risk factor, little appetite exists for focusing on the risks of marital transmission. Even as—and largely because—marriage remains the single most important social duty and marker of adulthood in Nigeria, both policymakers and ordinary citizens remain resistant to the idea that marriage must be understood as a risk factor for HIV infection.

STUDY SETTING AND RESEARCH DESIGN

The study was undertaken in 2 communities in Igbo-speaking southeastern Nigeria, where I have worked and conducted research since 1989. The project areas included the semirural community of Ubakala in Abia State and the city of Owerri in Imo State. Ubakala is made up of 11 villages and has a total resident population of approximately 24 000 people. Most households rely economically on a combination of farming, trading, employment, and remittances from migrants. The community is about 6 miles from the town of Umuahia, and everyday life is increasingly affected by the close proximity of an urban center. Further, the vast majority of adults in Ubakala have lived a year or more in one of Nigeria’s many cities, and at any given time, more than half the people who consider Ubakala their home are living outside the community, mostly in Nigeria’s far-flung cities and towns. With very few exceptions, the entire population of Ubakala is Christian, and most people are regular participants in the activities of 1 of the many churches present in the area. A majority of men and women younger than 50 years have completed at least primary school and are literate, and nearly all parents aspire to have their children attend secondary school and a university. Despite significant changes over the past several decades that have placed strains on traditional systems of social organization, ties of kinship and community remain powerful among both Ubakala residents and their migrant brethren.
Owerri is the capital of Imo State and has a population of approximately 350 000 people. Many of the city’s residents work as civil servants for the state government, but there are also large commercial and service sectors. The bulk of the population is made up of migrants from rural areas, most of whom retain close ties to their places of origin. As in Ubakala and in the entire southeastern region, Christianity is nearly ubiquitous. In addition, Owerri is the home of 4 colleges and universities and has a student population of close to 100 000. Partly because of the presence of colleges and universities, which concentrate a large population of educated young women, married men’s favored partners for extramarital affairs, the city has a reputation throughout southern Nigeria as a hub for extramarital sexual relationships. Owerri was selected as a second site to explore rural–urban differences in perceptions and practices in modern marriage and in men’s extramarital sexual behavior and because of its supposed status as a breeding ground for infidelity.
I spent June to December 2004 in Nigeria, living in a household in Ubakala that included a married woman, several children, and a migrant husband, and in a household in Owerri with a young newlywed couple. Four local research assistants were hired to assist with marital case-study interviews in both sites. Two female research assistants conducted the marital case study interviews with women in Ubakala; I conducted the interviews with men. In Owerri, male and female assistants conducted the marital case study interviews with men and women, respectively. I conducted participant observation in both settings and was responsible for key informant interviews in each venue. Table 1 [triangle] provides a summary of key participant observation venues and activities. Key informants included community leaders, religious leaders, government and nongovernment medical and public health officials, commercial sex workers, and people living with HIV/AIDS. Popular cultural and archival materials related to marriage, sexuality, and Nigeria’s HIV epidemic were also collected.
TABLE 1
Participant Observation Settings: Southeastern Nigeria, June–December 2004
Marital case studies were conducted with 20 couples, 14 residing in Ubakala and 6 residing in Owerri. The couples were selected opportunistically with the objective of sampling marriages of different generations and duration, couples with a range of socioeconomic and educational profiles, and marriages in both rural and urban settings. People in Owerri and Ubakala were better off economically than were residents of some other regions of Nigeria. Although the sample in the marital case studies is skewed to what might be described as an aspiring middle class (most couples were not actually middle class), because of rising education levels and increasing urban exposure that are common in southeastern Nigeria, most Igbo people share characteristics and aspirations evident in the sample. For individual couples, men were almost always older than their wives (typically by 5–10 years) and tended to have higher incomes. However, educational disparities between husbands and wives, although skewed in favor of men, were relatively small, reflecting both the overall increase in access to education and people’s preference to marry partners of similar accomplishment. A breakdown of the marital case study sample is provided in Table 2 [triangle].
TABLE 2
Sample Characteristics of the Couples (N = 20) in the Marital Case Study Sample: Southeastern Nigeria, June–December 2004
Interviews were conducted in 3 parts, generally in 3 sessions, each approximately 1 to 1.5 hours in duration. Husbands and wives were interviewed separately. All respondents agreed to participation after being presented with protocols for informed consent approved by institutional review boards in both the United States and Nigeria. The first interview concentrated primarily on pre-marital experiences, courtship, and the early stages of marriage. The second interview examined in greater depth the overall experience of marriage, including issues such as marital communication, decisionmaking, child rearing, resolution of disputes, relations with family, and changes in the marital relationship over time. The final interview focused on marital sexuality, extramarital sexual relationships, and understandings and experiences regarding HIV/AIDS. All interviews were tape recorded and transcribed, and the interviews were coded using ATLAS.ti (ATLAS.ti GmbH, Berlin, Germany) ethnographic software.

MODERN MARRIAGE IN SOUTHEASTERN NIGERIA

Scholars of West African society have long recognized the pronounced social importance of marriage and fertility in the region.7 Over the past several decades, African societies changed dramatically, and with these changes the institution of marriage was also transformed. Modern marriages were becoming increasingly common in urban centers in West Africa more than 50 years ago, and in some places these changes have even earlier roots.8 In Igbo-speaking southeastern Nigeria, urban elites have practiced what might be called modern marriage since the 1950s, but only in the past 2 or 3 decades have new forms of marriage become common among ordinary people, including in rural areas.9
Perhaps the most concise way to contrast modern Igbo marriages with the past is to note that young couples see their marriages as a life project in which they as a couple are the primary actors, whereas their parents’ marriages were more obviously embedded in the structures of the extended family. The differences are most pronounced in narratives about courtship, in the way husbands and wives describe how they resolve marital quarrels and in the way they make decisions about and contribute to their children’s education. In each of these arenas, people in more modern marriages tend to emphasize the primacy of the individual couple, often in conscious opposition to the constraints imposed by ties to kinship and community. Table 3 [triangle] summarizes the predominant characteristics of modern marriage in southeastern Nigeria.
TABLE 3
Characteristics of Modern Marriage in Southeastern Nigeria: 2004
It is important not to exaggerate these trends. Even in the most modern marriages, ties to kin and community remain strong, and marriage and child rearing continue to be strongly embedded in the values and social networks of the extended-family system. Indeed, the continued importance of ties to family and community and ongoing concerns about the collective expectations of wider social networks permeate people’s stories of modern courtship, the resolution of marital disputes, and decisions about child rearing. The choice of a spouse based on love is, in almost all cases, still subjected to the advice and consent of families. The fact that modern marriage in southeastern Nigeria remains a resolutely social endeavor creates contradictions for younger couples, who must navigate not only their individual relationships but also the outward representation of their marriages to kin and community. Most couples seek to portray their marriages to themselves and to others as being modern but also moral, and this is crucial to explaining the dynamics of men’s extramarital sexual relationships, married women’s responses to men’s infidelity, and the risk of HIV infection in marriage.

GENDER AND THE SOCIAL ORGANIZATION OF EXTRAMARITAL SEX

The prevalence of married men’s participation in extramarital sex in Nigeria is well documented.10 However, conventional scholarly understandings and explanations for the phenomenon are not persuasive. Because they tend to reproduce common stereotypes, they often ignore the diversity and complexity of these relationships and overlook men’s ambivalence that sometimes accompanies this behavior. As in many societies, people in southeastern Nigeria commonly attribute men’s more frequent participation in extramarital sexual relationships to some sort of innate male predisposition, and this perspective is well represented in the literature.11 Some men and women interviewed in the marital case studies articulated this view. In response to a question about why married men seek extramarital lovers, a 54-year-old civil engineer in Owerri repeated a pidgin English phrase heard frequently among Nigerian men: “Man no be wood. It’s something men need, especially African men. You know we have a polygamous culture. This practice of marrying only one wife is the influence of Christianity. But men still have that desire for more than one woman.” Only a piece of wood, he implies, lacks an outward-looking sexual appetite.
Although it is important to note that many Nigerian men and women share a conception of men’s sexual desire that includes a notion that men naturally need or want multiple sexual partners, not everyone sees it this way. Further, explaining men’s extramarital sexual behavior in these terms is insufficient because sexual desires do not emerge or operate in a social and cultural vacuum. Rather, interviewing men about their extramarital relationships, listening to men’s conversations among themselves pertaining to these relationships, and observing men interacting with their extramarital partners in various public or semi-public settings revealed several patterns in the social organization of extramarital sex. Three sociological factors are particularly important for explaining the opportunity structures that facilitate men’s participation in extramarital sexual relationships: work-related migration, socioeconomic status, and involvement in predominately male peer groups that encourage or reward extramarital sexual relations. Table 4 [triangle] summarizes the explanations of how each of these factors functions.
TABLE 4
Primary Factors Influencing Men’s Extramarital Sexual Behavior: Southeastern Nigeria, June–December 2004

Mobility and Migration

Of the 20 men interviewed in the marital case studies, 14 reported having extramarital sex at some point during their marriages, and of the 6 who said they had not engaged in extramarital sex, 4 had been married less than 5 years. Approximately half of all the cases of extramarital relationships described in the interviews occurred in situations in which work-related mobility was a factor.12 In contemporary southeastern Nigeria, both short-term and long-term absences caused by work-related mobility and migration are exceedingly common. For men and women who work for the government, by far Nigeria’s largest formal employer, frequent transfers often separate families. Further, the country’s insecure economy and the prevalence of participation by Igbo people in commercial activities of every scale require frequent mobility and migration, often resulting in periods of spousal separation.
Men whose work takes them away from their wives and families are more likely to have extramarital relationships, and they frequently attribute their behavior to the opportunities and hardships produced by these absences. A 47-year-old civil servant whose postings frequently took him away from his family explained a relatively long-term relationship with a woman in 1 of the places he was transferred: “I stayed a long time without my wife. But eventually this woman befriended me. She was a widow and a very nice woman. She cooked for me and provided companionship. Later, I was transferred back home, and it was over. It was like that.” Although men’s representations of hardship as a justification for extramarital sex contradict the realities of male privilege in Nigeria’s gender-unequal social order, they nevertheless reflect many Nigerians’ sense that work-related migration creates not only opportunities but also pressures to become involved in extramarital relationships.
Further, extramarital relationships in the context of economically driven migration can be more easily hidden from wives, family, and neighbors. Every man in the sample who admitted to having extramarital sex expressed the importance of keeping such relationships secret not only from his wife but also from his extended family and local community. Men’s motivations for keeping extramarital relationships hidden included not only a desire to maintain peace and uphold the appearance of fidelity for their wives but also a clear concern over their own social reputation. The civil servant who described his away-from-home relationship with a widow also said, “I am a matured man with responsibilities in my community—in the church, in various associations. I hold offices in these organizations. I can’t be seen to be running here and there chasing after women. My own son is almost a man now. How can I advise him if I am known for doing this and that?” To the degree that male infidelity is socially acceptable, it is even more strongly expected that outside affairs should not threaten a marriage, and this mandates discretion. Many men were ambivalent about their extramarital sexual behavior, but in most cases they viewed it as acceptable, given an appropriate degree of prudence so as not to disgrace their spouses, themselves, and their families.

Masculinity and Socioeconomic Status

For the vast majority of male interviewees, issues of socioeconomic status, specifically the intersection of economic and gender inequality, featured in accounts of their extramarital relationships. Most often, a man’s relationship to his female lover included an expectation that the man provide certain kinds of economic support. Men frequently view extramarital relationships as arenas for the expression of economic and masculine status. Indeed, it is necessary to understand the intertwining of masculinity and wealth, and gender and economics more generally, to make sense of the most common forms of extramarital sexual relationships in southeastern Nigeria.
In popular discourse, the most common form of economically driven extramarital relationships is said to be so-called “sugar daddy” relationships, wherein married men of means engage in sexual relationships with much younger women with the expectation that the men will provide various forms of economic support in exchange for sex. Although many Nigerians, including many of the participants in these relationships, view sugar daddy relationships in fairly stark economic terms—exemplified by a common expression among secondary school girls and university women that there is “no romance without finance”—a closer look at these relationships suggests that they are much more complicated than portrayed in the stereotypical image of rich men exchanging money for sex with impoverished young women.13 Young women frequently have motives other than the alleviation of poverty. Indeed, typical female participants in these sugar daddy relationships are not the truly poor but rather young women who are in urban secondary schools or universities and who seek and represent a kind of modern femininity. They are frequently relatively educated, they are almost always highly fashionable, and although their motivations for having a sugar daddy may be largely economic, they are usually looking for more than money to feed themselves.
For married men, the pretty, urban, educated young women who are the most desirable girlfriends provide not only sex but also the opportunity, or at least the fantasy, of having more exciting, stylish, and modern sex than what they have with their wives. At a sports club in Owerri where I spent many evenings during fieldwork and where men frequently discussed their extramarital experiences, a 52-year-old businessman described a recent encounter with a young university student to the delight of his mates: “Sometimes you think you are going to teach these girls something, but, hey, this girl was teaching me.” Married men who have younger girl-friends assert a brand of masculinity wherein sexual prowess, economic capability, and modern sensibility are intertwined.

Male Peer Groups

Masculinity is created and expressed both in men’s relationships to women and in their relationships with other men.14 In male-dominated social settings such as social clubs, sports clubs, sections of the marketplace, and particular bars and eateries, Igbo men commonly talk about their girlfriends and sometimes show them off. Male peer groups are a significant factor in many men’s motivations for and behaviors in extramarital relationships.
Although it is not uncommon to hear men boast about their sexual exploits to their peers—frequently alluding to styles and practices that are considered simultaneously wild and modern, another strand of discourse emerges when men explain their motivations. Many men reported that they enjoyed the feeling of taking care of another woman, of being able to provide her with material and social comforts and luxuries. In a candid discussion over beers with several men about men’s motives for extramarital lovers, a 46-year-old man known among his peers as One Man Show for his penchant for keeping multiple young women, explained, “It’s not only about the sex. I like to buy them things, take them to nice places, give them good meals, and make them feel they are being taken care of. I like the feeling of satisfaction that comes from taking care of women, providing for them.” Masculinity proved by provisioning a girlfriend parallels the way men talk about taking care of their wives and families. It foregrounds the connections between masculinity and money and between gender and economics more generally.
It is clear that men with money have easier access to and, it seems, more frequent extramarital sex. But poorer men engage in extramarital sex as well, and their relationships with female partners also typically include some form of transaction, whether it is paying a sex worker or giving gifts to a girlfriend, albeit at a lower financial level than that of more elite men. Although there is no doubt that the desire to forge and present a modern masculine identity combines issues of economics and gender, not all men’s extramarital relationships can be easily explained in these terms. Nearly all men noted the importance of keeping affairs secret from their wives, but in the marital case-study interviews, many men emphasized discretion much more broadly. They hide their extramarital relationships not only from their wives but from virtually everyone. In such cases it is not easy to attribute men’s motives to their desire to appear masculine and economically potent to their fellow men, although men’s more private relationships may still be internalized expressions of masculinity and status.
Some men had occasional extramarital sexual liaisons that appeared to be about little more than sex. In a few cases men seemed genuinely unhappy in their marriages, and in rare instances men fell in love with their extramarital partners. But by and large, men tended to see their extramarital relationships as independent of the quality of their marriages, and in their minds, extramarital relationships posed no threat to a marriage so long as they were kept secret from wives and so long as men did not waste so many resources on girlfriends that they neglected their obligations to their wives and families.

SEX, SECRECY, AND THE RISK OF HIV

Unraveling the issue of secrecy in relation to men’s extramarital sex is crucial for understanding some of the contradictory dynamics that contribute directly to the ways that men’s extramarital sexual relationships translate into married women’s risk of contracting HIV from their husbands. On the one hand, nearly all men want to keep their extramarital relationships secret from their wives, although on rare occasions a man in a troubled marital relationship in which there is no longer much pretense of harmony will openly flaunt his infidelity. On the other hand, for a significant proportion of men—in this sample about half of all men who admitted having extramarital sex—it is apparent that there would be much less benefit to having extramarital affairs without the opportunity to display masculine sexual and economic prowess to peers. But even among men who like to show off their girlfriends to their male peers, there is a general tendency to try to hide these relationships not only from their wives but also from their extended families and their communities, especially in the village setting. In part, this is a means of protecting their wives and children from harmful gossip, but it is also a means to protect their own reputations. In their church congregations, their village associations, and their extended families, men live up to very different expectations than in some of their more urban-influenced peer groups.
The correlation between concerns about social reputation and secrecy regarding extramarital sex also strongly influences the approach of most women to their husbands’ infidelity. In effect, women have multiple reasons to remain silent about suspicions or evidence of their husbands’ extramarital affairs. In more modern marriages, in which couples conceive of their marriage as their own choice, romantic love is frequently an important reason for marrying, and the conjugal unit is viewed as the primary locus of family decisionmaking, women risk undermining whatever leverage they have, because their influence is directly tied to the presumption of an intimate and trusting relationship, by openly confronting infidelity. Further, in modern marriages, women are less willing to call on their kin and in-laws for support in such cases, not only because these marriages are more independent from extended families but also because of the ideology that in such marriages a man’s happiness (and thus his proclivity to seek outside women) is directly related to the capacity of his wife to please him.
What this means for many Igbo wives is that they risk not only losing their husbands’ support if they confront his cheating but also possibly bearing the blame in the eyes of their community (including their female peers) for allowing (or even pushing) their husbands to stray. Most women in the marital interviews were more comfortable talking about other people’s experiences with husbands’ infidelity than about their own, but many women described a common dilemma. A 38-year-old married mother of 4 living in Ubakala said, “In this our society, when a man cheats on his wife, it is often the wife who will be blamed. People will say it is because she did not feed him well, she refused him in bed, or she is quarrelsome. And it is often our fellow women who are most likely to blame the wife.” As a result, although almost all women acknowledged that many men cheat, very few would say openly that they think their own husbands cheat.15

CONDOMS AND PERCEPTIONS OF SEXUAL MORALITY

For women whose husbands cheat, protecting themselves through condom use is difficult, if not impossible. Further, they cannot expect that their husbands will have used condoms in their extramarital relationships. Before public awareness about HIV was widespread in Nigeria, many factors contributed to relatively low use of condoms. Levels of awareness, availability, and affordability remain issues for the poorest and least-educated segments of the population. The impediments to condom use are heightened by popular misperceptions about HIV/AIDS. Even among people who know about condoms, widely circulating rumors suggest they are sometimes ineffective and potentially threatening to health. Further, a common perception exists that condoms symbolize impersonal or promiscuous sex.16 Together, such factors inhibit condom use in many premarital and extramarital relationships, despite the fact that usually neither party wants a pregnancy. In addition, in many extramarital relationships, economic, gender, and generational inequalities make it difficult for women to negotiate condom use with their typically older and wealthier male partners.17 Ironically, the HIV epidemic has further complicated possibilities for condom use because, in a context in which the risk of HIV is popularly associated with sexual immorality, suggesting a condom is tantamount to asserting that one’s partner is risky and hence guilty of sexual impropriety.
For women who suspect their husbands of infidelity, suggesting condom use for marital sex poses multiple problems. Asking for a condom may imply she does not want to become pregnant, which itself can create tension because reproduction is so highly valued. Perhaps worse, her request may be interpreted as indicating that she suspects not only that her husband is cheating but that the type of extramarital sex he is having is risky and, by implication, debauched. What is more, the meaning of her request may be inverted by her spouse and turned against her with an accusation that it is she who is being unfaithful. Responding to a question about whether his wife had ever asked him to use a condom, a 34-year-old father of 3 exclaimed, “How can she? Is she crazy? A woman asking her husband to use a condom is putting herself in the position of a whore. What does she need a condom with her man for, unless she is flirting around outside the married house?” All of these possibilities have become more highly charged in the era of HIV/AIDS, when sexual immorality is associated with a deadly disease.
The ultimate irony is that for women in the most modern marriages, in which the conjugal relationship is primary and romantic love is often an explicit foundation of the relationship, confronting a man about infidelity or insisting on condom use may be even more difficult. In such marriages, a woman challenging her husband’s extramarital behavior or asking for a condom may be undermining the very basis for the marriage and threatening whatever leverage she has with her husband by implying that the relationship itself has been broken. In southeastern Nigeria, where it remains socially imperative to be married, women cannot easily confront, challenge, or control their husbands’ extramarital sexual behavior. The secrets and silences that result from these relationship dynamics can exacerbate married women’s risk of HIV infection.