CSIRO Publishing blank image blank image blank image blank imageBooksblank image blank image blank image blank imageJournalsblank image blank image blank image blank imageAbout Usblank image blank image blank image blank imageShopping Cartblank image blank image blank image You are here: Journals > Sexual Health   
Sexual Health
Journal Banner
  Publishing on sexual health from the widest perspective
 
blank image Search
 
blank image blank image
blank image
 
  Advanced Search
   

Journal Home
About the Journal
Editorial Structure
Contacts
Content
Online Early
Current Issue
Just Accepted
All Issues
Special Issues
Sample Issue
Call for Papers
For Authors
General Information
Scope
Submit Article
Author Instructions
Open Access
For Referees
Referee Guidelines
Review an Article
Annual Referee Index
For Subscribers
Subscription Prices
Customer Service
Library Recommendation
For Advertisers

blue arrow e-Alerts
blank image
Subscribe to our Email Alert or RSS feeds for the latest journal papers.

red arrow Connect with us
blank image
facebook twitter logo LinkedIn

red arrow Interview with Kit Fairley
blank image
Hear Kit Fairley speak about what is sexual health.

 

Article << Previous     |     Next >>   Contents Vol 10(4)

Leveraging changing gender norms to address concurrency: focus group findings from South African university students

Stephanie R. Psaki A E, Nono Ayivi-Guedehoussou B and Daniel T. Halperin C D

A Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
B The Pardee RAND Graduate School, RAND Corporation, Santa Monica, CA 90401, USA.
C Public Health Program, Ponce School of Medicine and Health Sciences, Ponce, Puerto Rico.
D Department of Health Behavior, Gillings School of Global Public Health, Chapel Hill, NC 27599-7400, USA.
E Corresponding author. Email: spsaki@jhsph.edu

Sexual Health 10(4) 369-376 http://dx.doi.org/10.1071/SH12209
Submitted: 8 December 2012  Accepted: 25 April 2013   Published: 1 July 2013


 
PDF (152 KB) $25
 Export Citation
 Print
  
Abstract

Background: This study aims to complement recent research on sexual concurrency in South Africa by providing a deeper understanding of women’s roles and motivations for engaging in and accepting their partners’ concurrency. Our goal is to inform the implementation of more effective interventions that embrace the powerful role that women can play in healthy sexual decision-making in consensual relationships. Methods: We conducted 12 focus groups with male and female students at the University of KwaZulu-Natal. Drawing on a subset of those focus groups, we examined the gender norms underpinning the apparently widespread acceptance of concurrent sexual partnerships. Our analysis focusses on women’s attitudes and behaviours towards concurrency – from both men’s and women’s perspectives – with a goal of identifying opportunities to engage women as agents of change in sexual partnership patterns in their communities. Results: Our findings indicate that: (1) concurrent sexual partnerships were the norm among male students and increasingly common among female students; (2) material gain and changes in women’s perceptions of their roles and power in relationships were the primary female motives for concurrency; (3) peer pressure, a perceived innate need and a fear of being alone were the primary male motives for concurrency; (4) women often know that their partners are cheating and stay with them because they believe they are the most important partner, for financial reasons, or because they worry they will not find another partner. Conclusions: HIV prevention interventions in populations where concurrency is common would benefit from emphasising women’s role and power in taking greater control of their own sexual decision-making in consensual and nonviolent relationships.

Additional keywords: femininity, HIV, masculinity, sexual scripts.


References

[1]  Morris M, Kretzschmar M. Concurrent partnerships and the spread of HIV. AIDS 1997; 11: 641–8.
CrossRef | CAS | PubMed |

[2]  Mah TL. Prevalence and correlates of concurrent sexual partnerships among young people in South Africa. Sex Transm Dis 2010; 37: 105–8.
CrossRef | PubMed |

[3]  Kenyon C, Boulle A, Badri M, Asselman V. ‘I don’t use a condom (with my regular partner) because I know that I’m faithful, but with everyone else I do’: The cultural and socioeconomic determinants of sexual partner concurrency in young South Africans. SAHARA J 2010; 7: 35–43.
| PubMed |

[4]  Shisana O, Rehle T, Simbayi L, Parker W, Zuma K, Bhana A. South African National HIV Prevalence, HIV Incidence, Behaviour and Communications Survey. Cape Town: HSRC Press; 2009.

[5]  Hudson CP. Concurrent partnerships could cause AIDS epidemics. Int J STD AIDS 1993; 4: 249–53.
| CAS | PubMed |

[6]  Morris M, Kretzschmar M. Concurrent partnerships and transmission dynamics in networks. Soc Networks 1995; 17: 299–318.
CrossRef |

[7]  Mah TL, Halperin DT. Concurrent sexual partnerships and the HIV epidemics in Africa: evidence to move forward. AIDS Behav 2010; 14: 11–6.
| PubMed |

[8]  Pilcher CD, Tien HC, Eron JJ, Vernazza PL, Leu SY, Stewart PW, et al Brief but efficient: acute HIV infection and the sexual transmission of HIV. J Infect Dis 2004; 189: 1785–92.
CrossRef | PubMed |

[9]  Wawer MJ, Gray RH, Sewankambo NK, Serwadda D, Li X, Laeyendecker O, et al Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda. J Infect Dis 2005; 191: 1403–9.
CrossRef | PubMed |

[10]  Epstein H, Swidler A, Gray R, Reniers G, Parker W, Parkhurst J, et al Measuring concurrent partnerships. Lancet 2010; 375: 1869.
| PubMed |

[11]  Harrison A, Cleland J, Frohlich J. Young people’s sexual partnerships in KwaZulu-Natal, South Africa: patterns, contextual influences, and HIV risk. Stud Fam Plann 2008; 39: 295–308.
CrossRef | PubMed |

[12]  Van Rossem R, Meekers D, Akinyemi Z. Consistent condom use with different types of partners: evidence from two Nigerian surveys. AIDS Educ Prev 2001; 13: 252–67.
CrossRef | CAS | PubMed |

[13]  Epstein H, Halperin D. Why is HIV prevalence so severe in southern Africa? The role of multiple concurrent partnerships and lack of male circumcision: implications for AIDS prevention. Southern African Journal of HIV Medicine 2007; 8: 19–24.

[14]  Epstein H, Morris M. Concurrent partnerships and HIV: an inconvenient truth. J Int AIDS Soc 2011; 14: 13–24.
CrossRef | PubMed |

[15]  Jewkes R, Morrell R. Gender and sexuality: emerging perspectives from the heterosexual epidemic in South Africa and implications for HIV risk and prevention. J Int AIDS Soc 2010; 13: 6–17.
| PubMed |

[16]  Lurie MN, Rosenthal S. Concurrent partnerships as a driver of the HIV epidemic in sub-Saharan Africa? The evidence is limited. AIDS Behav 2010; 14: 17–24.
CrossRef | PubMed |

[17]  Steffenson AE, Pettifor AE, Seage GR, Rees HV, Cleary PD. Concurrent sexual partnerships and human immunodeficiency virus risk among South African youth. Sex Transm Dis 2011; 38: 459–66.
CrossRef | PubMed |

[18]  Lagarde E, Auvert B, Carael M, Laourou M, Ferry B, Akam E, et al Concurrent sexual partnerships and HIV prevalence in five urban communities of sub-Saharan Africa. AIDS 2001; 15: 877–84.
CrossRef | CAS | PubMed |

[19]  Simon W, Gagnon JH. Sexual scripts: permanence and change. Arch Sex Behav 1986; 15: 97–120.
CrossRef | CAS | PubMed |

[20]  Leclerc-Madlala S. Cultural scripts for multiple and concurrent partnerships in southern Africa: why HIV prevention needs anthropology. Sex Health 2009; 6: 103–10.
CrossRef | PubMed |

[21]  Connell RW. Change among the gatekeepers: men, masculinities, and gender equality in the global arena. Journal of Women in Culture and Society 2005; 30: 1801–25.
CrossRef |

[22]  Devries KM, Free C. ‘I told him not to use condoms’: masculinities, femininities and sexual health of Aboriginal Canadian young people. Sociol Health Illn 2010; 32: 827–42.
CrossRef | PubMed |

[23]  Dunkle KL, Jewkes R. Effective HIV prevention requires gender-transformative work with men. Sex Transm Infect 2007; 83: 173–4.
CrossRef | PubMed |

[24]  Seal DW, Erhardt AA. Masculinity and urban men: perceived scripts for courtship, romantic and sexual interactions with women. Cult Health Sex 2003; 5: 295–319.
CrossRef |

[25]  Harrison A, O’Sullivan LF, Hoffman S, Dolezal C, Morrell R. Gender role and relationship norms among young adults in South Africa: measuring the context of masculinity and HIV risk. J Urban Health 2006; 83: 709–22.
CrossRef | PubMed |

[26]  Hunter M. The materiality of everyday sex: thinking beyond ‘prostitution’. Afr Stud 2002; 61: 99–120.
CrossRef |

[27]  MacPhail C, Campbell C. ‘I think condoms are good but, aai, I hate those things’: condom use among adolescents and young people in a Southern African township. Soc Sci Med 2001; 52: 1613–27.
CrossRef | CAS | PubMed |

[28]  Sathiparsad R. ‘It is better to beat her’: male youth in rural KwaZulu-Natal speak on violence in relationships. Agenda 2005; 66: 49–62.

[29]  Leclerc-Madlala S. Transactional sex and the pursuit of modernity. Social Dynamics 2003; 29: 213–33.
CrossRef |

[30]  Leclerc-Madlala S. Age-disparate and intergenerational sex in southern Africa: the dynamics of hypervulnerability. AIDS 2008; 22: S17–25.
CrossRef | PubMed |

[31]  Pettifor AE, Rees HV, Kleinschmidt I, Steffenson AE, MacPhail C, Hlongwa-Madikizela L, et al Young people’s sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS 2005; 19: 1525–34.
CrossRef | PubMed |

[32]  Varga CA. How gender roles influence sexual and reproductive health among South African adolescents. Stud Fam Plann 2003; 34: 160–72.
CrossRef | PubMed |

[33]  Kitzinger J. Qualitative research. Introducing focus groups. BMJ 1995; 311: 299–302.
CrossRef | CAS | PubMed |

[34]  Kitzinger J. Focus groups with users and providers of health care. In Pope C, Mays N, editors. Qualitative research in health care. London: BMJ Publishing Group; 1997.

[35]  Madriz E. Focus groups in feminist research. In Denzin NK, Lincoln YS, editors. Collecting and interpreting qualitative materials, 2nd edn. Newbury Park: Sage Publications; 2003.

[36]  Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory, 3rd edn. Thousand Oaks: Sage Publications; 2007.

[37]  Charmaz K. Constructing grounded theory: a practical guide through qualitative research. London: Sage Publications Inc; 2006.

[38]  Morgan DL. Focus groups as qualitative research, 2nd edn. Thousand Oaks: Sage Publications; 1997.

[39]  Campbell C, MacPhail C. Peer education, gender and the development of critical consciousness: participatory HIV prevention by South African youth. Soc Sci Med 2002; 55: 331–45.
CrossRef | PubMed |

[40]  O’Sullivan LF, Harrison A, Morrell R, Monroe-Wise A, Kubeka M. Gender dynamics in the primary sexual relationships of young rural South African women and men. Cult Health Sex 2006; 8: 99–113.
CrossRef | PubMed |

[41]  Spronk R. Female sexuality in Nairobi: flawed or favoured? Cult Health Sex 2005; 7: 267–77.
CrossRef | PubMed |

[42]  Jones R. Sex scripts and power: a framework to explain urban women’s HIV sexual risk with male partners. Nurs Clin North Am 2006; 41: 425–36.
CrossRef | PubMed |

[43]  Jones R, Oliver M. Young urban women’s patterns of unprotected sex with men engaging in HIV risk behaviors. AIDS Behav 2007; 11: 812–21.
CrossRef | PubMed |

[44]  Creswell JW. Qualitative inquiry & research design: choosing among five approaches, 2nd edn. Thousand Oaks: Sage Publications; 2007.


   
Subscriber Login
Username:
Password:  

 
    
Legal & Privacy | Contact Us | Help

CSIRO

© CSIRO 1996-2016