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Research Urban and Regional Studies Institute PRC

Poverty, gender and psychosocial dimensions of safe-sex behaviour in Sub-Saharan Africa

Principal investigators

George Groenewold, Inge Hutter and Jeroen van Ginneken




Ministry of Foreign Affairs/NIDI

Description of the research

About 70 per cent of the 42 million people infected with HIV live in Sub-Saharan Africa and the main mode of transmission is heterosexual intercourse. Over 80 per cent of all HIV infected women in the world live in this sub-region. Their infection rates are higher than of men and the gap continues to grow. Southern Africa is the world’s worst affected region and all seven countries have HIV prevalence rates between 15 and 35 per cent. Condoms are a cheap and effective means of protection, yet, current condom use rates are very low and rarely exceed 5 per cent.

This study examines effects of contextual, interpersonal and personal characteristics on safe sex behavior in a sizeable sub-group of Zambian women: sexually active women who know about the health benefits of proper condom use but who continue to engage in unsafe sex practices. Analyses of ZDHS 2001/2002 data shows considerable variation in safe sex practices by province, ethnic affiliation, wealth status, women status, age, marital status, education, risk perceptions, access to condoms and perceived self-efficacy in sexual engagements. These characteristics are used to ‘profile’ women with lowest condom use so that they be served with HIV/AIDS programs and channels of communication that take account of their profiling characteristics. The research isexpanded to a comparative study of several African countries.


  • Groenewold, G., R. Horstman and B. de Bruijn (2004), Gender and the role of men in reproductive health: Applications in studies on HIV sexual risk-behaviour in Zambia, safe motherhood in Nepal. NIDI research report for Ministry of Foreign Affairs/DGIS.
  • Groenewold, G., I. Hutter and J. van Ginneken (2004), Poverty, gender and psychosocial dimensions of safe-sex behaviour of Zambian women. Journal article in progress.


  • Research for better health. Symposium on research in international health. 19 May 2004, AMC, Amsterdam.
Last modified:15 November 2012 2.26 p.m.