Safety of early marriage in Sub-Saharan Africa is a faulty presumption

Shelley Clark

Though many parents in Sub-Saharan Africa believe early marriage will shield their adolescent daughters from the HIV/AIDS epidemic there, Shelley Clark, Assistant Professor in the Harris Graduate School of Public Policy Studies, has done research that suggests the opposite may be true.

Clark is a demographer whose interests include the causes and consequences of gender inequality in South Asia and reproductive health policy in Sub-Saharan Africa. Before joining the Harris faculty, Clark worked at the Population Council on a project focused on transitions to adulthood for young girls in South Africa, where as many as 25 to 35 percent of all adolescents are infected with HIV.

Her recent research has found that in the countries of Sub-Saharan Africa, where 30 to 40 percent of girls between 15 and 19 years old are married, the presumed safety of marriage is illusory. Parents, policymakers and researchers often assert their strong belief that marriage offered the best protection against contracting a sexually transmitted disease. “Parents told us they really wanted their daughters to marry early to protect them from HIV,” Clark explained. “Public and private policymakers actively encouraged virginity before marriage and promoted marriage as the best option to avoid disease. Most researchers saw premarital sex as the problem and marriage as the solution.” Her research has asked whether it is true that marriage really offers this dramatic benefit.

She has found that married adolescent girls face higher risks of HIV-infection than sexually active unmarried girls their own age. She finds three reasons for this. First, marriage effectively means the end of condom use, Clark said, both because of the desire to become pregnant and because condoms are taken as a sign of distrust. Second, sexual frequency rises dramatically with marriage. And third, married girls at a given age have husbands who are older and more sexually experienced–and therefore more likely to be infected–than boyfriends of single girls. For all of these reasons, Clark explained, “girls fare far worse after marriage than before.”

The age gap compounds those risk factors. “These girls typically marry a man five to 10 years older than themselves, and an older partner is more likely to be infected,” Clark said. “He will have had more sexual partners, including prior wives, since many of these marriages are polygamous.” Husbands often are older, in part, because of a required, traditional “bride price,” which is a fairly large sum of goods or money given to the families of their brides. Men often must save for the bride price over a long period of time.

Clark also showed that given the low transmission rate of HIV, the risk posed by frequent, unprotected intercourse, which is far more prevalent among married girls, is a more critical determinant in the likelihood of infection than is the number of sexual partners one has had. This helps to account for the unexpected finding that even single girls with multiple partners are at less risk than their married counterparts.

She believes the surprising conclusion about the risk to married girls raises important policy questions. “What do we tell these young girls to do? The usual messages, which include prevention by abstinence, the use of condoms or a reduction in the number of sexual partners, are not applicable to married girls,” Clark said.

According to Clark, the first step is to convince policy leaders and parents that encouraging early marriages as a means of protection against HIV is not the right approach. In Sub-Saharan Africa, where sexually transmitted diseases are pandemic, there are no easy answers, and entrenched attitudes about marriage and sex are very hard to change.

Clark wonders how much delaying marriage, decreasing the age difference between husband and wife, or changing behavior between spouses would help. “Unfortunately, many individuals in these countries appear to be fatalistic about contracting HIV,” she said. “We need to develop policies that will raise awareness and change prevailing beliefs in a way that will genuinely address the problem.”