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Kawango Agot
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 Project
Coordinator, UNIM Project Lumumba Health Center
University of Nairobi, Kenya
Research: Empowering HIV-Positive Widows to Modify Subordinating
Sexual Norms: The Case of Bondo District, Kenya
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Dr. Kawango Agot is the Project Coordinator and Co-Investigator
of a collaborative research project of the Universities
of Nairobi, Illinois and Manitoba (UNIM). The study is investigating
the association between Male Circumcision and HIV infection
among young men in Kisumu, Kenya. She is also a Principal
Investigator of several studies, including a National Institutes
of Health (NIH)-funded prospective cohort study of the association
between HIV infection and the cultural practice of widow
inheritance among the Luo ethnic community in Kenya, and
a study on the promotion of Voluntary HIV Counseling and
Testing among the youth in Nyanza Province, Kenya, funded
by the Social Science Research Council. In addition, Dr.
Agot is a co-investigator of a study on Behavioral Disinhibition
associated with Male Circumcision in Kisumu District, Kenya,
supported by the Fogarty International Center (FIC), NIH.
She is also consulting for a study: Phase III Randomized
Placebo-Controlled Trial of HSV-2 Suppression to Prevent
HIV Transmission Among HIV-Discordant Partners. The study
is supported by the Bill & Melinda Gates Foundation.
Dr. Agot received her Bachelor of Education from the University
of Nairobi, Kenya in 1984 and a MPhil in Medical Geography
from Moi University, Kenya in 1991. She joined Moi University
in 1992 as a Lecturer of Medical Geography. In 1996, Dr.
Agot received a Fulbright Junior Staff Development Fellowship
to pursue a PhD in Medical Geography and a concurrent MPH
in Epidemiology (International Health Program) at the University
of Washington, Seattle, completing both programs in 2001.
She received additional funding from the FIC/NIH, through
the International AIDS Research and Training Program (IARTP)
of the University of Washington and the International Peace
Scholarship of the Philanthropic and Educational Organization
(PEO/IPS). Her major research interest is in risk factors
for HIV infection and transmission, particularly those that
touch on women and cultural practices in Kenya, and Africa
at large.
Selected Publications:
Agot KE, Ndinya-Achola JO, Kreiss JK, Weiss NS. HIV-1 in
rural Kenya: a comparison of circumcised and uncircumcised
men. Epidemiology. 2004;15(2):157-163
Agot KE. HIV/AIDS interventions and the politics of the
African woman's body. In: T. Sieger & L. Nelson (eds).
A Companion to Feminist Geography. London: McMillan
Publishers (accepted; forthcoming in October 2004)
Agot, KE. Effects of the Home and School Environments on
the Development of Spatial Interaction in Kenyan Children:
A Gender-Focused Study. Journal of the Geographical Association
of Tanzania. 2000; 29:107-120.
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Empowering HIV-Positive Widows to Modify Subordinating
Sexual Norms: The Case of Bondo District, Kenya
Widow inheritance and sexual cleansing among the Luo ethnic
community in Kenya are cultural practices that are nurtured
and perpetuated by gendered socialization processes that
put most decisions about women, including their sexuality,
within the control of men. Because sex is an integral part
of the two practices even when a widow is HIV-positive,
both have been associated with the rapid spread of HIV in
this community, and in other populations where the practices
are still valued. In an ongoing study by Dr. Agot on association
between HIV acquisition and widow inheritance in Kenya,
1063 of the 1662 widows screened by February 2004 tested
positive for HIV. Of the positive widows, over 80% reported
having had unprotected sex since the death of their spouses,
69% of them through sexual cleansing or inheritance. This
study provides evidence that widows form a critical core
transmitter group, besides being themselves at risk of co-infection
by other sexually transmitted diseases or cross infection
by different variants of HIV.
The goal of the proposed study is to set up Post-Test Clubs
(PTCs) to provide HIV-positive widows with forums share
experiences, receive Reproductive Health Education (RHE),
and strategize on ways to modify gendered sexual norms that
put their health at additional risk. A behavioral questionnaire
will be administered at the start of the study to document
the prevalence of widow inheritance, history of sexual cleansing
and casual sex, number of sexual partners, condom use, disclosure
of HIV status and writing of wills. These variables will
be assessed again a the end of the study to assess any change
in the prevalence of inheritance, sexual cleansing, and
other behaviors associated with risk for STD acquisition
and HIV transmission, re-infection or co-infection. A questionnaire
similar to the one administered at baseline will be used
to obtain the information on these variables. It is anticipated
that through personal sharing among widows and participation
in a series of reproductive health education sessions, the
widows will be empowered to modify cultural norms that subordinate
them and undermine their sexual health.
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