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  • Title: Sexual behaviour, perceptions of infertility and family planning in sub-Saharan Africa.
    Author: O'reilly KR.
    Journal: Afr J Sex Transmi Dis; 1986 Oct; 2(2):47-9, 80. PubMed ID: 12281127.
    Abstract:
    Sexually transmitted diseases (STD) are a particular problem in the developing world. Sexual behavior and rapid societal changes appear to be contributing to the high prevalence. Infertility, a consequence of STD, is seen as one of the most devastating things that could happen to an African woman. Behavioral risk factors for STD include age at 1st intercourse, number of sexual partners and use of contraception. The 1st two indicate length of exposure and amount of exposure respectively. Along with the prevalence of STD in the community, these factors allow an estimate of the population at risk for STD. Demographic risk factors from developed countries may not be applicable to developing countries. Data on sexual behavior in Africa is poor. Great intercultural variation exists. Age at 1st intercourse is earlier in Africa than America, with over 1/3 of African women reporting sexual activity by age 14, and 90% by age 17. Premarital sexual activity is high. Prostitution is widespread in African cities, and has been related to lack of expectations for marital fidelity, premarital celibacy and the infrequency of romantic love. Prostitutes play an important role in STD transmission. Current population growth in Africa has skewed the population towards the young, there has been rural to urban migration, and there are skewed sex ratios with many more men in cities: all of these factors predispose to STD. The high prevalence of untreated STD, resulting in increased infertility acts paradoxically to increase rather than decrease the fertility in Africa. Infertility is devastating for an African woman, resulting in divorce and diminished social status that often leads to prostitution. The fear of infertilty results in refusal of contraception and early childbearing to demonstrate fertiltiy.
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