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By Carol Kemper, MD, FACP
Dr. Kemper is Clinical Associate Professor of Medicine, Stanford University.
Dr. Kemper does research for GSK Pharmaceuticals, Abbott Laboratories, and Merck. Editor Stan Deresinski, MD, FACP, Clinical Professor of Medicine, Stanford, Associate Chief of Infectious Diseases, Santa Clara Valley Medical Center, serves on the speaker's bureau for Merck, Pfizer, Wyeth, Ortho-McNeil (J&J), Schering-Plough, and Cubist, does research for the National Institutes of Health, and sits on the advisory board for Schering-Plough, Ortho-McNeil (J&J), and Cepheid. Peer reviewer Connie Price, MD, Assistant Professor, University of Colorado School of Medicine, reports no financial relationships related to this field of study.
Source: Njue A, et al. Disco funerals: A risk situation for HIV infection among youth in Kisumu, Kenya. AIDS. 2009; 23:253-255.
This article originally appeared in the March 2009 issue of Infectious Disease Alert.
In Kenya, where the prevalence of HIV infection runs anywhere from 10%-30% in most communities, funerals are common. But in an interesting twist, reminiscent of the macabre nights of the Day of the Dead or Mardi Gras, funerals are becoming big business, with up to 100 family and friends gathering to celebrate the life of their family member or friend, and to party. Families of the deceased host large gatherings as a way to raise funds for funeral expenses, complete with party favors and disc jockeys. People party, dance, and drink for days, sometimes up to two weeks. Sex is apparently commonplace, much of it unprotected and some of it coerced. It's considered a way to meet the neighbors, especially for young people, who are often left unattended.
These authors interviewed 44 young female and male participants, and observed six "disco matanga" or disco funerals. During their trip to this part of Kenya, about three disco funerals were held per week. Casual sex, even group sex, is common, and apparently condoned by older members of the family as a way to experiment. Many forego condoms in the interest of convenience. After conducting numerous interviews, the authors believe that alcohol plays a significant role in forced sex, especially with underage or teenage girls. Other studies have shown that young women who accept gifts, such as a drink or a ride home, have lost their bargaining power and cannot refuse sex or insist on condoms.
The authors caution that these events must be viewed in light of the cultural customs of this part of Kenya, where polygamy is common and premarital sex is condoned as a way to experiment and to get to know a future partner. The funerals are generally seen as a form of celebration. But these types of venues, similar to bare-backing parties in San Francisco, or large club gatherings, carry the same risk of rapid spread of HIV infection within a group in a very short time.