Couples' communication on sexual and relational issues among the Akamba in Kenya

Ann Neville Miller, Lenette Golding, Kyalo Wa Ngula, Mary Anne Wambua, Evans Mutua, Mary N. Kitizo, Caroline Teti, Nancy Booker, Kinya Mwithia, Donald L. Rubin

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


A large portion of HIV transmission in sub-Saharan Africa occurs among married couples, yet the majority of research on safer-sex communication has focused on communication between couples in casual relationships. This paper explores how committed Kamba couples in Machakos District, Kenya, communicate about sensitive relational issues. The findings from focus group discussions with five groups of males and five groups of females are presented. The couples freely shared their thoughts about daily and economic issues and certain aspects of family planning and sexuality. Methods for raising sensitive issues with partners included monitoring the spouse's mood, gradual or indirect revelation, mentioning topics during sex, and use of third-party intermediaries. Interference by extended family members, especially husbands' mothers, and male authoritarian roles emerged as hindrances to effective communication between couples. The implications for HIV prevention regarding gender differences and the role of families in couples' communication are discussed.

Original languageEnglish
Pages (from-to)51-60
Number of pages10
JournalAfrican Journal of AIDS Research
Issue number1
Publication statusPublished - Apr 2009
Externally publishedYes


  • Determinants of health
  • East Africa
  • Gender issues
  • HIV prevention
  • Health communication
  • Marriage
  • Relationships
  • Safer sex


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