title: East African discourses on khat and sex.
abstract: OBJECTIVE
  The study aims to review and analyse the varied East African discourses on the effects of khat use on libido, fertility, transmission of HIV, prostitution and rape.
  
  
  METHODS
  The data were gathered between 2004 and 2009 in Kenya and Uganda. Between 2004 and 2005 across Kenya and Uganda a broad survey approach was adopted, involving identification of and travel to production areas, interviews with producers and consumers in rural and urban settings. In addition, a survey of 300 Ugandan consumers was carried out in late 2004. Between 2007 and 2009, an in-depth study of khat production, trade and consumption was conducted in Uganda. This study also employed a mixture of methods, including key informant interviews participant-observation and a questionnaire survey administered to 210 khat consumers.
  
  
  RESULTS
  Khat is associated, by consumers and its detractors alike, with changes in libido and sexual performance. Although there is no evidence to support their claims, detractors of khat use argue that khat causes sexual violence, causes women to enter sex work, and that chewing causes the spread of sexually transmitted diseases, including the HIV virus.
  
  
  CONCLUSIONS
  In East Africa the discourse on khat and sex has led to consumption of the substances being associated by many people with uncontrolled sexual behaviour. There is no evidence that khat use fuels promiscuity, commercial sex, sexually transmitted diseases or rape. The current discourse on khat and sex touches on all these topics. Local religious and political leaders invoke khat use as a cause of what they argue is a breakdown of morals and social order. In Kenya and Uganda it is women khat consumers who are seen as sexually uncontrolled. In Uganda, the argument is extended even to men: with male khat chewers labelled as prone to commit rape.
authors.affiliation: School of Health and Social Studies, University of Warwick, Coventry CV47AL, UK. Susan.beckerleg@warwick.ac.uk
authors.forename: Susan
authors.initials: S
authors.lastname: Beckerleg
mesh_terms: D029754:Catha; D003625:Data Collection; D005260:Female; D005298:Fertility / Q000187:drug effects; D015658:HIV Infections / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007630:Kenya; D007989:Libido / Q000187:drug effects; D008297:Male; D009014:Morals; D011619:Psychotropic Drugs / Q000494:pharmacology*; D011902:Rape; D011477:Sex Work; D012725:Sexual Behavior / Q000187:drug effects*; D012749:Sexually Transmitted Diseases / Q000635:transmission; D014454:Uganda
chemical_list: D011619:Psychotropic Drugs