Religion and HIV/AIDS in Nigeria

As the HIV/AIDS crisis has spread throughout the world, HIV rates among Christian populations have remained significantly higher than among Muslim populations. This trend can be seen through the example of Nigeria, a state known for conflict between Muslim and Christian populations. With an HIV positive population of over 3 million, Nigeria has the second highest burden of HIV infection in sub-Saharan Africa.1 Within Nigeria, the highest prevalence rates are found in Christian areas of the country, such as Benue where 10% of the population is HIV positive. All of the states with an HIV prevalence rate above 6% are in the Christian area of the country.2 The prevalence rates within Muslim states, on the other hand, generally fall between 2-4%.3

Given the religious conflict in Nigeria, many Muslims and Christians present different explanations for the variance in HIV rates. Muslims can argue that Christians are more lax in following the moral code set forth by their religion and are thus more likely to contract HIV. Christians, on the other hand, explain these rates by arguing that the societal enforcement of the Islamic code is more oppressive. While both arguments are common, neither captures the complexity of the issue. Religion does play a large role in shaping the HIV/AIDS crisis in Nigeria, but not because of underlying differences in beliefs and moral choices between Christians and Muslims.

On a fundamental level, Christians and Muslims in Nigeria have similar views on the why HIV continues to spread: both groups see promiscuous behavior as the root cause of the HIV crisis. Promiscuity is frowned upon heavily because of religious teachings and because of underlying cultural traditions within Nigerian society. Even before Christianity and Islam were introduced, Nigerian cultural tradition emphasized the importance of sexual discretion and believed that sex should be reserved for marriage.4 Leaders in both the Christian and Muslim communities discourage their followers from pre-marital and extra-marital sex, and teach that procreation is the main reason for sex.

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With this similar aversion to risky sexual behavior that could lead to contracting HIV, it would seem that the infection rates among both groups should be comparable, but they are not. To explain the discrepancy Christians and Muslims tend to look at how each group puts their beliefs into practice. Many Christians come to the conclusion that Islam is more repressive and less forgiving than Christianity. The lower rates are therefore not a reflection of the merits of the religion, but rather a result of the inherent oppressive nature of the religion. While Christians do not believe people should engage in sexual behavior before marriage, a social stigma is the harshest punishment a person would receive from society if their extra-marital sex is discovered. Individuals are held accountable by God for their decisions, so any punishments for extra-marital sex would come from God rather than from the community. Muslims, on the other hand, could be punished for their decisions about sex through the system of shari'a law.

If shari'a law has had an impact on risky sexual behavior, one of the best places to witness it would be Nigeria. In 1999 the governments of some of the northern states began to formally adopt a system of shari'a law. There are currently 13 states that operate under a Nigerian form of shari'a law, which allows for flogging or stoning as a punishment for extra-marital sex. Many critics of this form have complained that it is not an authentic shari'a, grounded in the underlying philosophy of Islam. In its Nigerian version, shari'a has lost many of the fundamental elements of the original form, including the importance placed upon forgiveness and understanding. Instead, in many cases, the new form eliminated the need for multiple witnesses to extra-marital sex and imposed harsher punishments than would be used in other forms.5

Ordinarily, one would assume that the threat of flogging or death by stoning would serve as a deterrent against extra-marital sex. A widespread complaint about Nigerian shari'a, however, is that the general public was not informed about its implications.6 Because the switch was mainly to feed into the power struggle with the Christian government, Muslim officials did not explain what the new consequences of extra-marital sex would be. It is also unlikely that the punishments would deter many people because in practice punishments are often altered or cancelled in Nigeria's justice system. As of September 2004, six people had been sentenced to death for sex crimes, but none of the stonings had been carried out.7 There have been cases of flogging, but not on a large scale. Because of the problems in the implementation of shari'a in Nigeria, it is therefore unlikely that it has played a large role in the difference in HIV rates between Christians and Muslims. Apart from codified shari'a, however, Islam's moral code does of course stigmatize sexually irresponsibility, yet the results of a number of studies show that this moral code does not have a great impact on the average Muslim. Some Muslims follow the rules their religion sets out for them, but in other cases the same sexual behavior is observed in Muslim and non-Muslim communities.8 There is no evidence that there is a strong link between being Muslim and not participating in risky sex.

Instead of explaining away the difference in HIV rates with a dubious assumption that Muslims are sexually repressed while Christians are not, we should examine two other key factors that distinguish these two religious communities: alcohol and circumcision. Christianity does not advocate excessive drinking of alcohol, but it is not altogether forbidden. By contrast, alcohol usage is forbidden within Islam, which could account for part of the discrepancy in HIV rates because alcohol consumption makes it dramatically more likely that individuals will engage in high-risk sexual behavior. In general, Muslims throughout the world are significantly more likely to adhere to the guidelines set forth about alcohol consumption.9 Without the influence of alcohol, Muslims are more likely to select less risky sexual partners and use protection, thereby decreasing their chance of contracting HIV.

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Alcohol has had a large presence in Nigerian society throughout history, and a substantial percentage of Nigerians today consume either traditional beverages, like palm wine and ogogoro, or more Westernized beers and wines.10 When looking at who is actually consuming the alcohol, however, there is a clear divide among the population. In keeping with the general trend throughout the world, Muslims are significantly less likely to consume alcohol than Christians.11 Muslims are more likely to adhere to this rule than to rules about extra-marital sex because of the nature of the action. Whereas a person could engage in extra-marital sex secretly, alcohol is generally consumed in public, where the habit is visible to the entire community. Since the habit is forbidden, a Muslim would not want to be associated with alcohol consumption, and would most likely want to avoid it entirely. Although drinking is not encouraged among Christians, it is still socially acceptable in many situations and would not be frowned upon as heavily. Because of this, Nigerian Christians are more likely to consume alcohol and impair their judgment than Nigerian Muslims.

Even more significant than alcohol in accounting for the divergent HIV rates is circumcision. One recent study trying to identify better ways to prevent the spread of HIV shows that circumcision resulted in a 60% reduction of HIV infection.12 Men who have not been circumcised have a much greater risk of contracting HIV than do circumcised men. This statistic is not generally thought to be important in the West, because circumcision is a relatively common practice. In other parts of the world, however, it is not. Whether or not a man is circumcised depends almost entirely on his religion. Circumcision has serious implications for the spread of HIV in Nigeria because it is very common among Muslims. Christians are generally not circumcised, but circumcisions among Muslims are either strongly recommended or mandatory, depending on how certain Hadith are interpreted.13 In short, because of circumcision Muslim men are less likely to contract HIV than Christians regardless of their sexual behavior. As with so many other issues, there have been many who have tried to turn the spread of HIV/AIDS into a contest between Christianity and Islam. Ultimately the discrepancies between rates among Christians and Muslims cannot be explained by the claims that Christians are more promiscuous and Muslims are more repressed. There are many Christians who adhere faithfully to a strict moral code, and there are many Muslims who would ignore the possibility of punishment by shari'a law to engage in risky sexual behavior. The most important sources of the HIV difference are actually alcohol usage and circumcision. Therefore, while religious leaders should still attempt to use their moral clout to dissuade their followers from risky sexual behavior, they must first realize that the spread of HIV is a complex issue, and not simply a black-and-white moral battleground.

Endnotes

1. See http://www.nigeria-aids.org/pdf/2005SentinelSurvey.pdf.

2. Ibid.

3. Ibid.

4. Eno Blankson Ikpe, Human Sexuality in Nigeria: A Historical Perspective.

5. Human Rights Watch, "Political Shari'a?" Human Rights and Islamic Law in Northern Nigeria Vol. 16, No. 9 (September 2004). 6. Ibid.

7.Ibid.

8. Peter B. Gray, "HIV and Islam: Is HIV Prevalence Lower among Muslims?" Social Science & Medicine Vol. 58, No. 9 (May 2004): 346.

9. Ibid.

10. World Health Organization, Alcohol, Gender, and Drinking Problems: Perspectives from Low and Middle Income Countries.

11. Ibid. In the WHO study, 36% of those who reported alcohol consumption in the past year strongly identified themselves as Christians, whereas only 8% identified themselves as Muslims.

12. Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, and Puren A, "Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 trial." PLoS Med 2005; 2: 298.

13. See al-Baqarah 2:138, Bihar al-anwar, 12:10.