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African Journal of Reproductive Health
Women's Health and Action Research Centre
ISSN: 1118-4841
Vol. 12, Num. 3, 2008, pp. 173-184

African Journal of Reproductive Health, Vol. 12, No. 3, Dec, 2008, pp. 173-184

Original Research Article

Gender Dynamics and Sexual Norms among Youth in Mali in the Context of HIV/AIDS Prevention

Catherine Boileau1,Bilkis Vissandjee2,Vinh-Kim Nguyen3,Sélim Rashed4,Mohamed Sylla5, and Maria Victoria Zunzunegui6

1HIV/AIDS fellow, Institute for Health and Social Policy, McGill University, Montreal, Canada E-mail:;
Associate Professor, School of Nursing and School of Public Health, University of Montreal, Canada;
Associate Professor, medical anthropologist, Department of Social and Preventive Medicine, University of Montreal, Canada;
Associate Professor, Department of Social and Preventive Medicine, University of Montreal, Canada;
West Africa Project to Combat AIDS and STIs (WAPCAS); 6Professor, Department of Social and Preventive Medicine, University of Montreal, Canada
*Correspondence: Catherine Boileau, PhD, Institute for Health and Social Policy - McGill University, 1130 Pine Avenue West, Montréal, Québec, Canada H3A 1A3, Tel: (514) 398-6824 Fax: (514) 398-8980 E-mail:

Code Number: rh08046


Socially constructed ideas of gender norms and values attached to sexuality need to be considered when aiming to build the young people’s capacity to adopt HIV preventive behaviours. We conducted ten focus groups and sixteen individual interviews to explore sexual norms among youth in Bamako. Premarital sex, multiple partnering, condom use and transactional sex were discussed. The findings suggest that young people’s sexual norms are shaped by kin or authoritative elders as well as by external influences coming from Western culture. Sexual norms are differentially constructed by men and women and are in contradiction with those of older generations. Views on premarital sex, condom use and transactional sex generated controversy among men and women, as well as among more sexually conservative or progressive youth. However, there was general rejection of multiple partnerships. Empowering youth to pursue open debates on sexuality may be an avenue for HIV/AIDS prevention in Mali.


Dynamique de genre et normes sexuelles parmi les jeunes au Mali dans le contexte de prévention de VIH/SIDA A considérer est les idées de genre qui sont construits socialement et les valeurs attachées à la sexualité lorsqu’on vise à construire la capacité des jeunes gens pour leur faire adopter des comportements préventifs contre le VIH. Nous avons centré sur dix groupes et seize interviews individualisées pour explorer les normes sexuelles parmi les jeunes à Bamako. Le sexe avant le mariage, les partenaires multiples, l’utilisation des préservatifs et le sexe transactionnel ont été discutés. Les résultats suggèrent que les normes sexuelles des jeunes gens ont été façonnées par des parents/familles et des aînés autoritaires ainsi que par des influences externes venant de la culture occidentale. Les normes sexuelles sont par action différentielle construites par les hommes et les femmes et sont contradictoires à ceux des générations précédentes. Les perspectives sur la relation sexuelle avant le mariage, l’utilisation des préservatifs et le sexe transactionnel ont généré de controverse parmi les hommes et les femmes ainsi que parmi la jeunesse sexuellement conservatrice et progressive. Cependant, ils ont tous rejeté en général les partenaires multiples. Autoriser la jeunesse de poursuivre des débats publics sur la sexualité pourra être une possibilité de la prévention du VIH/SIDA au Mali.

KEY WORDS: Gender roles, sexual behaviour, parental norms, HIV/AIDS, young people, Sub-Saharan Africa


The HIV/AIDS crisis in sub-Saharan Africa has contributed to the introduction of the concepts of sexual health and sexual rights into the political discourse and has spurred sexual reform efforts, which have expanded throughout the continent over the past few decades. With the recognition that HIV is primarily transmitted through sexual intercourse, government, NGOs, multilateral aid agencies and activist networks have worked swiftly to implement multiple strategies to change behaviours and promote safer sex. The presence of HIV prevention programs has created a space for a new construction of gender roles and sexual norms 1.

In Mali, as in other Muslim counties in West Africa, transition to adulthood was traditionally thought to occur at puberty; time at which young women were set to be married. Marriages were often arranged or strongly influenced by parents 2, 3. Nowadays, premarital sex is quite common in Mali. Demographic data indicates that, although median age at first sex in Bamako is around 15 yearsold for men and 14 years-old for women, only 2% of 15-24 year-old men and 27% of women the same age are currently married 4. Beyond these figures, the processes guiding decisions about sexual behaviour and partnerships in this part of the world remain largely unknown, and so far, there is a dearth of information with regards to the social factors which place young people’s sexual health in jeopardy. Yet, the risk of HIV transmission is potentially high in this country due to the persistence of unsafe sexual behaviour 5. Condom use remains relatively low in youth, even in nonmarital or non-cohabiting partnerships (use at last intercourse: 14% in women and 30% in men) and high rates of adolescent pregnancy have also been reported 4.

The symbolic meanings which are attached to sexual acts, the sense of morality, and what is deemed to be valued have important implications for the ways young people choose to have sexual relationships. Through a continuous process of social interaction and negotiation, precise sexual norms are adopted by social groups 6, 7. Different cultures construct pluralistic landscapes of sexual values.

Gender roles in the negotiation of sexual conduct are crucial in shaping sexual risk. Unequal gender relations, including expectations of female passivity, sexual violence 8, 9, and providing sex as a contractual obligation towards men restrict the freedom to negotiate during sexual interactions, which in turn affect preventive strategies 10, 11 . Poverty and the limited ability of young women to achieve economic independence also strongly impact on their options for prevention and increase their vulnerability. Transactional sex and temporary sexual partnerships have been reported in high HIV incidence regions such as Central and Eastern Europe 12, 13 and are also well rooted among unmarried young people in many countries in Africa 14-16 .

Increasing recognition of the interplay between gender and HIV outcomes has contributed to the formulation of policies aimed at challenging patriarchal gender norms 17,

. Pragmatic approaches drawn from ideas of social construction of gender roles and sexual norms have been proven to be valuable in developing prevention strategies against sexually transmitted infections 19-23 . Better comprehension of the implication of gender in the negotiation of sexual conduct is needed, yet very few studies address this crucial issue. The goal of this paper was therefore to examine how young men and women construct sexual norms in the context of HIV/AIDS prevention.


Qualitative data were collected from ten focus group discussions (FGD) (Table 1) and 16 individual interviews (Table 2) conducted from November 2003 to January 2004. Two FGD were women-only, two were men-only and six were mixed sex groups. Each FGD consisted of six to ten participants. A sample of men and women aged 15-24 residing in Bamako were recruited. Heterogeneity of the sample was sought in order to reflect the diversity seen among young people in Bamako. Efforts were made to have equal numbers of women and men and to include young people attending school as well as those not attending school. Participants were selected; from a variety of sites (schools, the market, garages and repair shops, community centers, football fields, households and the street) in 11 different neighbourhoods.

The goal of the FGD was to assess the socially acceptable norms with regards to sexual conduct. FGD are well suited to gather information on social norms in a relatively short period of time since they provide a general idea of the current consensus and contradictions surrounding a particular issue. During FGD, participants were first asked what they thought of young people’s sexual behaviour, and then asked specifically about premarital sex, multiple partnering and condom use. The issue of transactional sex emerged from the preliminary analysis of the first two FGD, and interview guides were modified to allow further exploration of this theme. We chose to conduct one-sex and mixed-sex focus groups in order to observe if topics were addressed differently depending on the audience, and if men and women spoke freely in the presence of the opposite sex. We found that, although respondents did not openly disagree with one and other, women spoke as often as men during the discussions, especially if they were inschool.

Individual interviews were conducted to address more personal matters and focused essentially on how participants actually experienced relationships rather than on what they believed was acceptable. During the interviews participants were asked to give examples based on their own experiences.

FGD were facilitated by moderators, and observers helped with the organization and analysis. At the end of each FGD and individual interview, a stipend of $1.25CDN was provided. Each interview was recorded, transcribed and by comparing original transcriptions from translated from Bambara into French. independent translations on a randomly Accuracy of translations was measured selected sample of two FGDs and two interviews.

Narratives were analyzed in three steps. First, content analysis of each theme was done to detect underlying views and beliefs, and to prune the corpus of text 24 . Coding aimed at roughly categorizing the text according to which sexual behaviour it addressed. Second, emergent codes were refined by an iterative process to eliminate redundant coding and to add details where needed. Third, narratives were sorted by gender and subsequently by peer or parental reference within each group defined by gender to identify differences or similarities in values and beliefs between young men and women.

The use of two distinct data sources and different observers (interviewers and moderators) gives support for the credibility of our research findings. Furthermore, to ensure validity of coding and reflexivity of interpretation, a peer editing exercise was conducted. Interviewers and invited peers countercoded a selected sample of narratives and assessed the fit between these narratives and their subsequent interpretation.


Findings related to young men and women’s sexual norms as well as parental sexual norms are classified under four major sexual conducts: premarital sex and multiple partnering (sexual experiences), condom use and transactional sex.

Young people’s perceptions about sexual conducts were shaped by external influences from the media and internal influences from kin or elders in their community. Participants were generally well informed about the threats of the epidemic. Information about reproductive and sexual health was accessed through multiple sources such as the media, school, NGOs and health centers, but informal information networks were the most valued source of information, especially by young men. In Mali, relationships are knitted by unofficial and spontaneous gatherings around teabrewing, called “grain”. Throughout these gatherings, young men and women discuss various issues.

“My friends know a lot about condoms, since no one in my “grain” has sex without using a rubber. Proof is that we talk about everyone’s private affairs during tea-time “grain”; we all know what each of us is up to.” (Male, electrician, 20 years-old, individual interview)

“Talking to elders about it (sex) is not possible, so I usually get my information during discussions with friends from my group and also from the radio.” (Female, women-only FGD, households in Missira).

Sexual experiences

Sex was acknowledged as a natural and pleasurable act that strengthens the bond between men and women. However, conflicts between contemporary sexual mores, and traditional models of gender and family were expressed. Tensions were present between traditionalists who expressed regret for the loss of older generations’ values and more progressive young people who considered elders to be out-of sync with their life-styles and needs. Debates surrounding these traditionalist-progressive ideas were frequent and visibly demonstrated the coexistence of opposing views among youths. There was a general sense of pessimism related to the fact that sex has become pervasive in the community. Explanations given about why young people are becoming over-sexed were constructed around the idea that modernity, as portrayed in European films, leads to moral decay:

“We left behind our ancestors’ traditions. We are now faced with a European culture that is not ours. Before, finding a girl virgin on her wedding day was the pride of the family and gifts would come from all over…But now, we have abandoned our culture. This is because of the media, television, and the cinema. In European movies we see the actors making love, there is no taboo.” (Male, out of school, men-only FGD, in the street in Badialan III)

Young men often held women responsible for the increase in sexual behaviour because of their sexual provocative conduct. There was a simultaneous attraction and repulsion towards “modern” women who are sexually affirmative:

“The spread of sexuality nowadays is due to the fact that girls are not serious, they are provocative. It’s a disaster; just by looking at I get excited.” (Male, welder, 20 yearsold, individual interview)

At the same time, abstinence until marriage was considered unrealistic, partly because marriage occurs at an older age for many men and women.

“(Abstinence until marriage) is recommended in the village where I am from, it makes our families proud. Only the husband can have his wife (…) but this seems impossible nowadays.” (Female, housemaid, 17 years-old, individual interview)

For certain men, sexual expression was considered not only normal, but an essential part of any fulfilled relationship, as stated by this young student;

“Woman can marry a man who has experience in love-making; it will help the relationship.” (Male, inschool, men-only FGD, Lycée Technique de Bamako)

Young people held an uncompromising critique of multiple partnering practices. Participants strongly categorized women who have more than one partner as prostitutes. Men were considered ruthless and unfaithful. Both women and men believed that the opposite sex could not be trusted and that fidelity was almost impossible to expect. Reasons given to explain sexual promiscuity were genderspecific. From men’s point of view, men sought different partners when they were betrayed by women and to satisfy their sexual needs, whereas women did so in order to fulfill material and monetary needs.

“A man who has been disappointed many times can no longer love one girl only. If that man doesn’t become a drinker or a drug addict; he will chase women…Why should he limit himself to one if that one will betray him?” (Male, in school, mixed-sex FGD, Lycée Prosper Kamara)


Condoms were generally recognized as a good means to prevent HIV infection, but there was a persistent feeling of discomfort among both women and men when it came to buying condoms. Many women told us about the dilemma they faced with condoms. On one hand they were being convinced of the importance of risk reduction, and on the other hand, they were ostracized for being too bold:

“My friends know they (condom) protect from diseases but they tell me that they are for sex workers.” (Female, housemaid 19 years-old, individual interview)

There also seemed to be a misconception about the norms attributed to the purchasing of condoms. While young women generally thought they would be criticized for buying or carrying condoms, young men generally thought of girls who buy condoms as responsible and intelligent.

“I like when girls buy condoms, I think they are clear-minded and intelligent by doing so”. (Male, high-school student, 23 years-old, individual interview)

Transactional sex

The topic of transactional sex raised controversy among respondents. Although it was recognized that sexual relationships were sometimes means by which one could acquire material goods, most female respondents personally denied having received any money from their partners. Young men had a tendency to believe money and gifts are expected in a relationship as a sign of gratitude; however, female respondents perceived these gifts as strategies used by men to buy relationships.

“Receiving gifts in sexual relations is frequent; in certain cases one has sex just because of the money”. (Female, out-of-school, mixted-sex FGD, Carrefour des Jeunes)

“After sex, what is recommended is the cost of soap for cleansing.” (Male, out-of-school, men-only FGD, in the street in Badialan III)

Some respondents, however, viewed money or gifts in the context of sexual relationships as tokens of love or signs of appreciation.

“…If he offers you a little gift, it’s an act of love that proves he loves you.” (Female, student, mixed-sex FGD, Lycée Prosper Kamara)

“By the fact that you satisfied me, I have the right to give you something. It’s an encouragement” (Male, student, mixed-sex FGD, Lycée Prosper Kamara)

Parental norms

Although participants affirmed that parents can give occasional advice about sex, they emphasized that talking about sex with parents was difficult. Participants generally kept their sexual lives secret due to the belief that parents no longer have control over the sexual lives of their own children, and because they assumed that their parents would disagree with their sexual behaviour.

Parental norms with regards to sexual experiences

Generally, participants perceived that their parents and elders would disagree with them having premarital sexual relationships, and women seemed most concerned that these behaviours represented dishonour for the family and would lead to a loss of social rank.

“I cannot come to an agreement with my parents when it comes to sex before marriage, but they have to accept me the way I am.” (Male, unemployed, 19 years-old, individual interview)

Parents were often blamed for their children’s improper behaviour because they neglected to educate them. This view was mostly shared by men.

“We see it (premarital sex) when the head of the family cannot assume his responsibility of educating his children.” (Male, welder, 20 yearold, individual interview )

“Our elders value virginity, but this is a notion that has lost all its importance. In the nuptial room, newly-weds simply agree to hide what they know from the rest of their family.” (Male, mechanic, 21 yearold, individual interview)

Parental norms with regards to condoms

Young women often thought their parents had negative views of condom use, whereas young men thought that their parents and elders had erroneous beliefs about condoms.

“My family thinks condom are for prostitutes, they rather I avoid men.” (Female, housemaid, 19 years-old, individual interview)

“In my family, the old ladies do not understand the problem of AIDS, or condoms. They believe that condoms are infecting us and also incite us to have sex. They keep telling us that in their time AIDS did not exist because there were no condoms. That’s why they believe condoms bring AIDS here.” (Male, electrician, 20 yearsold, individual interview)

Despite their own positive attitudes toward condoms, respondents were well aware of the conflicts between their norms and the norms of elders in their community. The following quote illustrates how some young people felt criticized for having sex:

“If I go to the shop to pay for condoms, the salesperson will criticize me because he thinks I have too much of “it” (sex), often, that’s what discourages me (to go)…” (Male, student, mixed-sex FGD, Ntomikorobougou Fundemental School)

Parental norms with regards to transactional sex

Although this issue was not thoroughly discussed, some participants voiced their concerns about how parents may encourage their daughters to seek sexual partnerships for monetary relief.

“In the olden days, each time a girl would have sexual relationships before marriage; it was humiliating for the family. Nowadays, it’s the mother who pushes her own daughter to go get money for the breakfast bread, way before she is wed.” (Male, welder, 20 years-old, individual interview)


The aim of this paper was to analyze the narratives of young Malians to get insight on what constitutes their views about sexuality with a gender perspective.

Sexuality generated contradictions. Sexual relationships were associated with intimacy and pleasure but were also perceived as a source of disease, and as a manifestation of moral decay. A general view was that, increasing urbanisation and access to western movies, music and fashion have blended to produce a change in young people’s sexual culture. It was thought that “modernization” or “Western influence” triggered an unhealthy sexual opening-out in youths. This view is not uncommon in African countries where AIDS prevention efforts have been loaded with medico-moral messages about sexual risk 25 .

Sexual activity was generally more stigmatizing for women. Women were held responsible for seducing men and were perceived as promiscuous for buying condoms, but were also expected to behave responsibly; hence they were faced with an impossible array of expectations when negotiating sex. This points out how gender plays a role in structuring inequality and sexual division at the detriment of women 10, 11 .

Money or material goods came out as powerful aspects of sexual relationships that, not only were thought to strengthen romantic ties, but also to create tension between men and women. From men’s point of view, women seek boyfriends out of materialistic need, and if men cannot provide gifts or money, they will seek more rewarding relationships. Similar thoughts have been reported from studies conducted among young people in Ivory Coast 26. Women did not admit pursuing relationships as a source of income. They perceived that receiving money and gifts was not merely a transaction but was a symbol of shared affection. This view was noted in a Tanzanian study on adolescent girls, many of whom maintain relationships with older men 27 . Although the phenomenon of transactional sex may reflect economic gender inequalities, women are not helpless subjects in sexual negotiations. Lack of opportunity and desire to attain a certain level of prestige may push women to adopt profit-making seduction strategies towards men, maximizing their gains by having relationships with older and more privileged men. Lack of financial stability is the foremost factor for entry into prostitution among young women in Mali 28 .

Sexuality was also a source of dispute between generations. Although norms imposed by parents were perceived differently by men and women, they were generally considered obsolete and unrealistic. Parents did not seem to hold a direct role in sexual education, as it has been reported in other African settings 29 . Having explicit discussions about sexual matters with parents was unthinkable; however, informal information networks, such as small-group gatherings around tea-time, were the most popular form of sexual education. Nevertheless, young people’s sexual behaviour and the resulting social consequences were cited to be directly related to their parents’ upbringing. Peer education programs have been developed to reach youths using informal gatherings as vectors to spread preventive messages. While these strategies are promising in terms of raising awareness among harder to reach, and more marginalized populations, supporting parents’ effort through education and communication skillbuilding interventions may also be valuable in this context.

Lastly, we found that there was infrequent but noteworthy concern about the influence of mothers on the daughters’ unsafe sexual practices. Like others have previously reported 30, 31, in some instances, mothers incite their daughters to seek boyfriends to provide financial security to the household.

Preventive messages are condemned to failure if they are fraught with misunderstandings of young people’s perceptions of sexuality, their lifestyle and the social pressures that dictate how they act and feel about sex. In this work, we have uncovered significant inter and intra generational tensions and contradictions in the attitudes towards premarital sex, condom use and transactional sex while there is an overwhelming rejection of multiple partnerships. Empowering youth for open debates on sexuality may be an avenue for HIV/AIDS prevention in Mali.


We would like to acknowledge people working for the “West Africa Project to Combat AIDS and STIs (WAPCAS)” in Bamako. Special recognition for the fieldwork team; Mamadou Sissoko (Ntomikorobougou Fundamental School), Kadidiatou Doumbia (ASDAP), Djibril Boua Camara, Mariam Traoré, Maïmouna Kéïta, and Amara Sidiki Dagnoko (Coordination des Clubs Scolaires et Universitaires Anti-SIDA) and Sidi Yaya Traoré for the translation. We would like to express our appreciation to all the participants who kindly shared their thoughts for this study. This study was supported by grants from the International Development Research Center (IDRC/ CRDI). Additional support was granted by the “WAPCAS”.


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