Polygynists and Their Wives in Sub-Saharan Africa: An Analysis of Five Demographic and Health Surveys

Differential polygyny in Ghana, Kenya, Senegal, Uganda, and Zambia is investigated using individual-level Demographic and Health Surveys data. As well as contrasting polygynists' first wives with women in monogamous unions, the analysis distinguishes higher-order wives from first wives. This permits study of the determinants of the prevalence and intensity of polygyny respectively. Polygyny and other aspects of marriage interlock in very similar ways in all five countries. Individuals' experience of polygyny tends to reflect their luck in the marriage market rather than their socio-economic characteristics. While polygyny is less prevalent in urban areas, other socio-economic factors are important only in Kenya and Zambia, the two countries where less than 25 per cent of married women are in polygynous unions. The prevalence and intensity of polygyny are negatively associated. Thus, any drop in the prevalence of polygyny in Africa may be accompanied by a rise in the number of wives per polygynist.     

Polygyny and African couple research

Fertility and family planning research has recently begun to focus on couples, rather than solely on women. High levels of polygyny in sub-Saharan Africa create two interesting problems for couple analyses. First, some men match with multiple wives in a given sample. Hence observations of a dependent variable that are a function of the responses from a polygynous man are not statistically independent. To correct for this, we propose that researchers use the method of generalized estimating equations. The second problem occurs when survey questions do not properly account for men having multiple partners. Variables constructed from such questions may contain error. Until better data are available, we propose that researchers randomly select a wife for each polygynous man to reduce the effects of this error. We illustrate these ideas by studying the determinants of couples having innovative family planning behaviors and attitudes in Niger.     

Polygyny and the rate of population growth

Summary The roots, motives and feasibility of practising polygyny in societies with a balanced sex structure and the effect of polygyny on the rate of population growth are considered. High demand for labour combined with limited supply over the last several centuries, had been conducive to the evolution of a polygynous nuptiality pattern. The unprecedentedly high rates of population growth during the last several decades combined with progressive economic development have led to a change in the role of the labour factor and consequently diminished its impact upon polygyny. Polygyny is feasible because of a sex-age differential at first marriage, which enables younger cohorts of women to enter the marriage market, and thus results in a very early age at first marriage and universal incidence of marriage among women. A very young pattern of nuptiality inevitably evolves under polygyny, which tends to raise the rate of population growth. No significant variation in fertility between polygynous and monogamous women was found but substantial gaps in standards of living, child mortality, and educational attainment were noted for polygynous households. The findings imply that during the transition from polygyny to monogamy family size will tend to diminish, although initially fertility may not decline concurrently with changing socio-economic status. The most important effects on the rate of population growth thus result from the increase in age at first marriage and declining proportions of ever married women.     

Polygyny and Fertility among the Shipibo of the Peruvian Amazon

This report describes a study of the fertility experience of an Amazon Indian tribe that has shown evidence of having the highest documented fertility of any human group. The Shipibo, who live in the upper Peruvian Amazon, are experiencing rapid cultural change, including a decline in the prevalence of polygyny. This study tests the specific hypotheses that polygyny limits individual female and community fertility through the mechanism of post partum sexual abstinence and longer birth intervals. Total population counts in eight villages and reproductive histories of all females age 13+ show that mean birth interval lengths of polygynous women are four months longer than those of monogamous women. Fertility of polygynous women was lower, with 1.3 fewer term-births per reproductive span than that of monogamous women. The community general fertility rate is negatively associated with the proportion of polygynous birth intervals in the community. In this study, cultural change is strongly associated with higher fertility.     

Polygynous Contexts,Family Structure,and Infant Mortality in Sub-Saharan Africa

Contextual characteristics influence infant mortality above and beyond family-level factors. The widespread practice of polygyny is one feature of many sub-Saharan African contexts that may be relevant to understanding patterns of infant mortality. Building on evidence that the prevalence of polygyny reflects broader economic, social, and cultural features and that it has implications for how families engage in the practice, we investigate whether and how the prevalence of polygyny (1) spills over to elevate infant mortality for all families, and (2) conditions the survival disadvantage for children living in polygynous families (i.e., compared with monogamous families). We use data from Demographic and Health Surveys to estimate multilevel hazard models that identify associations between infant mortality and region-level prevalence of polygyny for 236,336 children in 260 subnational regions across 29 sub-Saharan African countries. We find little evidence that the prevalence of polygyny influences mortality for infants in nonpolygynous households net of region-level socioeconomic factors and gender inequality. However, the prevalence of polygyny significantly amplifies the survival disadvantage for infants in polygynous families. Our findings demonstrate that considering the broader marital context reveals important insights into the relationship between family structure and child well-being.     

Polygyny and child survival in Nigeria: Age-dependent effects

Mortality risks under age five are estimated using data from the 1990 Nigerian Demographic and Health Survey for children in monogamous and polygynous families. Integrating existing theories on polygyny’s relationship with infant and child mortality and some demographic concepts, the study shows that polygyny has different effects on infant and child mortality at different ages. The results indicate that polygyny does not have a significant effect on neonatal mortality (age less than one month). In contrast to the results of previous research, polygyny is significantly associated with lower child mortality during the post-neonatal period (1–11 months), but not during childhood (12–59 months). The study found socio-economic factors to be important confounders of the relationship between polygyny and mortality during the neonatal and post-neonatal periods. The protective effect of polygyny during the post-neonatal period suggests the need to further investigate circumstances that may favour post-neonatal child survival in polygynous families including availability of childcare.     

The Polygyny–Fertility Hypothesis: A Re-evaluation

Previous studies of the relationship between polygynous marriages and fertility have produced mixed results, although on balance evidence suggests that fertility levels are lower in polygynous than in monogamous marriages. It is argued that the inconsistent results stem from the aggregation of fertility data among all wives in polygynous unions, and that major differences are due to variations in fertility by wife-order and number of wives in polygynous unions. Data for 2534 polygynists with 7378 marriages are analysed and contrasted with fertility data from once married women, using information covering population of Utah during the nineteenth century. Our data indicate significant variations in fertility levels by wife-order; these fertility differences are largely due to variations in length of exposure to the risk of conception and birth intervals.     

Polygyny and reproductive behavior in sub-saharan Africa: A contextual analysis

In this paper I examine the effect of polygyny on aggregate reproductive behavior. I argue that within countries there exist different polygyny regimes, each exhibiting a unique reproductive pattern. Using the 1988/1989 Kenya Demographic and Health Survey (KDHS1) data, I identify three distinct regimes: low-polygyny, mid polygyny, and high-polygyny regimes. The results of the bivariate and multivariate analyses reveal strong differences in reproductive preferences and behaviors across polygyny regimes. High-polygyny regimes, for instance, maintain a value orientation that favors and encourages high reproductive performance. The force of this pronatalism operates equally for men and women; but whereas men in this regime attain their reproductive goals by marrying multiple wives, women attain theirs by maximizing their reproductive capabilities. This maximization occurs through early initiation of sexual/reproductive activity, universal marriage and minimal interruption of marriage, nonuse of contraception within a union, and a positive attitude toward high fertility.     

Examining Sexual Orientation Disparities in Unmet Medical Needs Among Men and Women

Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen’s health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexual minorities. The results show that sexual minority women are more likely to report unmet medical needs than heterosexual women, but no differences are found between sexual minority and heterosexual men. Moreover, we find a reversal in the gender disparity between heterosexual and sexual minority populations: heterosexual women are less likely to report unmet medical needs than heterosexual men, whereas sexual minority women are more likely to report unmet medical needs compared to sexual minority men. Finally, this work advances Andersen’s model by articulating the importance of including social psychological factors for reducing disparities in unmet medical needs by sexual orientation for women.     

Non-Heterosexuality,Relationships, and Young Women’s Contraceptive Behavior

Non-heterosexual young women have a higher rate of unintended pregnancy than their heterosexual peers, but their fertility behaviors are understudied. We use longitudinal data from the Relationship Dynamics and Social Life study to investigate mechanisms contributing to non-heterosexual women’s higher pregnancy risk. These data include weekly reports of relationships, sex, and contraceptive use over 30 months. We compare the relationships and fertility behaviors of three groups: exclusively heterosexual (consistent heterosexual behavior, identity, and attraction); mostly heterosexual (heterosexual identity with same-sex behavior and/or same-sex attraction); and LGBTQ (any non-heterosexual identity). We find that mostly heterosexual and LGBTQ women behave differently from exclusively heterosexual women in ways likely to elevate their risk of unintended pregnancy: more distinct partners during the study period, more sexual intercourse with men, less frequent contraceptive use, less use of a dual method (condom plus hormonal method), and more gaps in contraceptive coverage. Mostly heterosexual women resemble LGBTQ women in their contraceptive behavior but have significantly more intercourse with men, which may increase their pregnancy risk relative to both LGBTQ and exclusively heterosexual women. We conclude by considering implications for LGBTQ health and the measurement of sexual minority populations.     

Family, fertility, and sex ratios in the British Caribbean

Abstract This paper re-evaluates the currently held view that unstable forms of conjugal unions depress fertility in the British Caribbean. It is shown that previous investigators overlooked the important variable of persistent male shortages at the mating ages caused by heavy male emigration. Fertility trends are observed and the conclusion reached that male emigration (independent variable) has not adversely affected fertility because the 'informal' polygynous character of the mating system acts as an intermediate variable mitigating the effect of the independent variable on fertility. Given these male shortages it is argued that a trend toward greater stability in conjugal relations would not, as previously assumed, result in higher fertility because permanent female celibacy and the average age of first entry into sexual unions for females would rise. Finally, the paper concludes by commenting on a recent discussion concerning the causal relationship between male shortages and the persistence of marital instability in the British Caribbean. The position is taken that both of these conditions are caused by social and economic factors which are not likely to change in the near future.     

Same-sex domestic partnerships and lower-risk behaviors for STDs, including HIV infection

To determine the association between domestic partnership status and risk behaviors for sexually transmitted diseases, including HIV infection, we analyzed data from a population-based interviewer-administered telephone survey of 2,881 gay men in San Francisco, Los Angeles, New York and Chicago conducted in November 1996 to February 1998. Men in domestic partnerships had a statistically significantly lower prevalence of multiple partnerships, "one-night stands," and unprotected anal intercourse with a non-primary partner than either men with steady partners not identified as domestic partners or men without a steady partner. These findings were independent of age. Men in domestic partnerships had decreased risk behaviors for sexually transmitted diseases, including HIV infection, suggesting but not proving, that conferring legal status to same-sex unions might decrease sexual risk behavior.     

HIV Risk Among Men Who Have Sex with Men Only (MSMO) and Men Who Have Sex with Men and Women (MSMW) in Baltimore

Men who have sex with men and women (MSMW) are at high risk for HIV. However, the majority of research on populations of men who have sex with men (MSM) combines MSMW and men who have sex with men only (MSMO) samples, which limits our understanding of HIV risk behaviors and factors associated with HIV risk among MSMW populations. We used the BESURE-MSM2, a venue-based cross-sectional study of HIV risk behaviors among MSM in Baltimore, MD, to examine HIV risk among MSMW. MSMW were less likely to report unprotected receptive anal intercourse than MSMO (6.8% vs. 19.6%, p = .0024). Among MSMW, 43.0% reported unprotected sex with a woman in the past year, but only 19.4% reported unprotected sex with both men and women, representing only 5.0% of the total MSM sample. In multivariate analyses, we found that among MSMW having unprotected sex with women in the past year, disclosing same sex behavior and having a main female partner were associated with unprotected anal intercourse with male partners. HIV prevention programs for MSMW are needed that address the complex partnerships of MSMW and the social contextual factors within which relationships and behaviors are embedded.     

Exploring First Sexual Intercourse,Sexual Orientation,and Sexual Health in Men

In this study the characteristics of the sexual debut of men who have sex with men (MSM) and men who have sex with women (MSW) age 35 or younger (N = 1,201) were compared with one another. We investigated whether these characteristics were associated with sexual health and behavior, and to what extent. Compared to MSW, MSM tended to be older when they had their first sexual intercourse; their first sex partner was older, they felt less ready, and they experienced more pain. We also found that they reported a higher number of lifetime sexual partners and less condom use compared to MSW. Similarities were also ascertained, such as the fact that individuals from both groups do not differ significantly regarding how they experienced their first sexual intercourse emotionally. Many differences between these groups should not always be seen as problematic, whereas others still indicate a need for targeted interventions.     

Gender comparisons of injection drug use practices in shooting galleries

Previous research studies and anecdotal evidence portray shooting galleries as locales that place injection drug users at great risk for HIV infection, drug use and violence. Collectively, these studies highlight the need to intervene with injectors who frequent shooting galleries. However, few researchers have studied an often-forgotten risk group – women injecting drug users who frequent shooting galleries – and compared their risk behaviors to their male counterparts. To address this gap in the research literature and to evaluate the functionality of the shooting gallery as a setting for HIV prevention, we collected data on risk practices from 201 injectors (101 men and 100 women) who were recruited from eight shooting galleries in Miami, Florida. Results indicate that, compared with men, women injectors engaged in a similar variety and frequency of injection risk behaviors and had more shooting companions. While only minor gender differences were apparent, relatively few injectors – male or female – adhered to current recommendations for needle hygiene practices. Needle hygiene practices existed equally among injectors of both sexes, however very few adhered to current recommendations. Furthermore, contrary to common images of shooting galleries, use of other drugs was infrequently reported, episodes of violence or victimization were uncommon, and sexual contact almost never occurred. Operators of shooting galleries, both men and women, indicated their willingness to participate in HIV prevention efforts. Implications of these findings for HIV intervention indicate that (1) there is a great need to intervene with both men and women IDUs who frequent shooting galleries and that (2) shooting galleries can be an optimal setting for HIV prevention.     

Are young people in the Philippines taking chances with HIV / AIDS?

The numbers of AIDS cases and HIV infections detected in the Philippines have risen slowly but steadily since the first AIDS case in the country was diagnosed in 1984. By the end of 1995, 234 AIDS cases and 470 HIV infections had been reported to the country's Department of Health. However, given the limited extent to which people have been tested for HIV infection, there are most likely many more cases than reported. The HIV/AIDS epidemic is spreading within the Filipino population. The country's substantial commercial sex trade, reports suggesting that many unmarried young men have sexual intercourse with girlfriends and acquaintances, and IV drug use among a small number of young people are factors which contribute to the potential for a serious HIV/AIDS epidemic in the Philippines. Findings from the 1994 national Young Adult Fertility and Sexuality Study, a household survey covering 10,879 men and women aged 15-24 years in 959 different communities, are presented. Almost all respondents had heard of AIDS, but there was some degree of ignorance and misinformation on the modes of HIV transmission. 13% of all single men reported having had only one sex partner, 10% reported two or more partners, and 3% reported five or more. 98% of sexually active men had heard of condoms, 58% knew that condom use can protect against HIV infection, 23% reported ever having used one, and 4% reported using a condom during the most recent act of sexual intercourse.     

Imagined comrades and imaginary protections: identity, community and sexual risk among men who have sex with men in China

This paper describes the recent development of identity and community among gay men in China. It focuses both on the ways emerging forms of gay identity relate to larger ideological and discursive shifts within society, and on the ways these new forms of identity and community affect situated social interaction among gay men themselves. In particular, it addresses the question of how these emerging forms of gay identity and gay community affect the ways gay men in China understand the threat of HIV and make concrete decisions about sexual risk and safety. Among the chief tactics used by gay men in China to forge identity and community involves appropriating and adapting elements from dominant discourses of the Party-State and the mass media. This strategy has opened up spaces within which gay men can claim "cultural citizenship" in a society in which they have been heretofore marginalized. At the same time, this strategy also implicated in the formation of attitudes and social practices that potentially increase the vunerability of Chinese gay men to HIV infection.     

Polygyny as social and biological differentiation among Toposa agro-pastoralists of Southern Sudan

A demographic survey of eight Toposa villages in Southern Sudan was undertaken to delineate patterns of infant and childhood mortality. Among these predominantly egalitarian agro-pastoralists few standard socio-economic variables useful in the detection of demographic differentials were found. Instead, polygyny was used as a measure of social differentiation, hypothesizing that social differentiation induces demographic differences between polygynous and monogamous marriages. Analysis indicated social differentiation through gerontocracy, while significant differences in mortality and fertility levels were found berween monogamous and polygynous marriages, with the latter featuring higher fertility and mortality levels. Underlying rationale for these differences were sought through consideration of social and biological factors.     

HIV diffusion patterns and mobility: Gender differences among drug users

Researchers have recently expanded the scope of study of transmission patterns of AIDS to incorporate spatial and geographical questions. United States diffusion patterns of this disease appear to indicate that it may emanate from urban area epicenters to areas of low and moderate prevalence. The travel patterns of injecting drug users (IDUs) and the extent to which they engage in high risk drug and sexual activities was examined as an explanation of diffusion of the HIV virus from one community to another. The study population of 49,621 was comprised of subjects recruited from approximately 60 sites nationwide from 1988–1991. While the data are limited in some ways, they partially support a diffusion explanation of HIV transmission for males and females. The analysis demonstrates that low prevalence cities were significantly more likely to have been the destinations of both men and women who engaged in high risk drug and sexual activities. In addition, HIV seropositive drug users who engaged in high risk drug and sexual behaviors in destination cities were more likely than seronegatives to travel to high or low seroprevalence areas than to moderate prevalence areas. The findings suggest a need for effective HIV prevention educational messages about the risks of traveling and participating in high risk activities.     

Methods Used and Topics Addressed in Quantitative Health Research on Gay,Bisexual and Other Men Who Have Sex With Men: A Systematic Review of the Literature

Research on sexual minority men (gay, bisexual, and other men who have sex with men) was examined with regard to the measures of sexual orientation used, the methods of research, and the main health outcomes under study. A systematic review of English-language quantitative studies was conducted focused on the health of sexual minority men published in 2010 (n = 250). The results provide a snapshot of the literature and revealed that research on sexual minority men overwhelmingly focused on HIV, STIs, and sexual health for which sexual orientation was most commonly defined behaviorally. For topics of mental health or body/fitness outcomes, sexual orientation was most commonly defined by identity. Most study samples were venue-based, and only 8.8% of published papers drew data from population-based samples. The findings suggest that there exists a need for research on sexual minority men’s health beyond STIs and HIV that will examine mental and physical health outcomes beyond sexual risk, uses probability-based samples, and addresses intersectional concerns related to race/ethnicity and age.