‘Why don’t you just use a condom?’: Understanding the motivational tensions in the minds of South African women (original) (raw)
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Condom Usage Negotiation Among Customarily Married Women in Katlehong, Johannesburg
SAGE Open, 2017
South Africa has the highest number of HIV-infected people in the Southern African Region, and of great concern is the fact that cases of new infections among young people, especially young women and girls, are on the increase. The prevalence of HIV and deaths caused by AIDS are still on the increase, whereas condom use, particularly in rural areas, remains low. Consistent condom use is central to the prevention of unwanted pregnancies, HIV, and other sexually transmitted infections (STIs); yet, young men and women alike are hesitant to use condoms because of threats to their relationships, cultural roles, and, at times, economic survival. This study explored the views of customarily married housewives regarding condom use negotiation with their husbands. The findings point toward the need to empower women while they are still young so that they can be assertive, financially independent, and able to make their own decisions with regard to their sexuality.
Elements of Condom-Use Decision Making among South African Men Who Have Sex with Men
Journal of the International Association of Providers of AIDS Care, 2014
South African men who have sex with men (MSM) are at increased risk for HIV infection, and male condoms are fundamental to HIV prevention programs. We explored condom use experiences through in-depth interviews with 34 South African MSM from Cape Town and Port Elizabeth. For data analysis, we generated a codebook and used the constant comparison method. Condom use reinforcing elements included use of alternative sexual strategies, having a high level of self-worth that was linked to protective behaviors, and use of ready-made condom negotiation scripts. Elements inhibiting condom use included perceiving substantial declines in sexual pleasure/performance, experiences of condom failure (possibly related to petroleum-based lubricant), and being in trusted relationships. Our findings suggest nuanced HIV prevention approaches such as bolstering condom negotiation skills based on successful tactics already in use. Further research is needed to address how to mitigate perceptions and expe...
International Journal of Sexual Health, 2021
Condoms remain an important method for preventing HIV prevention and unintentional pregnancies, however their use in South Africa is sub-optimal. We analyzed survey data on reported condom use among 3009 sexually active adolescent girls and young women (AGYW) aged 15–24 years, and qualitative data from interviews and focus group discussions with 237 AGYW and 38 male peers. Our findings describe the current condom use landscape among adolescents and young people in South Africa, illustrating relationship dynamics, gendered power and notions of masculinity which influence condom negotiation and use in young heterosexual South Africans’ sexual encounters.
Journal of Sex Research, 2013
Although male partner cooperation is often essential for successful use of the female condom, only a few studies have directly assessed men's experiences of using the device. We examined barriers to and facilitators of female condom use via qualitative in-depth interviews with 38 young men (18 to 28 years) in South Africa whose partners, all university students, were enrolled in a female condom intervention trial. In all, 21 men used the female condom; the remaining 17 did not attempt use. The main facilitators to female condom use were convenience of use for men, curiosity to see how female condoms compared to male condoms, enhanced sexual sensation, and perceptions of better safety and comfort of the device compared to male condoms. The main barriers were men's limited familiarity with the device, insertion difficulties, and men's concerns about loss of control over sexual encounters. We recommend that human immunodeficiency virus (HIV) prevention and condom promotion ...
HIV Prevention in High-Risk Women in South Africa: Condom Use and the Need for Change
PloS one, 2012
Introduction: Young women are at disproportionate risk of HIV infection in South Africa. Understanding risk behaviors and factors associated with ability to negotiate safe sex and condom use is likely to be key in curbing the spread of HIV. Traditionally prevention efforts have focused on creating behavioral changes by increasing knowledge about HIV/AIDS.
The Pan African Medical Journal, 2021
Introduction female sex workers (FSWs) are the key vulnerable populations since they carry the high burden of HIV and sexually transmitted infections (STIs). However, the vulnerability of street-based FSWs to HIV/STIs is much higher than that of the establishment-based FSWs. The study aimed to explore street-based FSWs’ condom negotiation skills, barriers to condom use as well as the challenges and predicaments they face on a daily basis. Methods an exploratory qualitative approach using focus group discussions was conducted among FSWs working in a major provincial road in a district of Gauteng Province. Thematic content analysis using NVivo version 10 software was conducted. Results the age range of the FSWs was 19 to 44 years. The themes that emerged from the data on challenges to negotiation and condom use among FSWs revealed the ways condoms are used in early sex work and over time, ways of enforcing condom used, preferred types of condoms and the predicaments to working in the ...
Health Psychology Open, 2015
This article identifies correlates of condom use self-efficacy using concepts from self-determination theory and gender–power measures. A cross-section of Xhosa-speaking women ( n = 238) from Eastern Cape, South Africa, was used to conduct bivariate correlations and multivariate linear regression analyses. Gender equality beliefs and HIV knowledge were positively associated with condom use self-efficacy generally and in risky situations. Condom use self-efficacy generally was also positively associated with power balance attitudes, negative beliefs about intimate partner violence, and positive growth perspective, while the association with hopeless personal perspective was negative. Surprisingly, lack of social support was positively associated with condom use self-efficacy in risky situations. The predictors of condom use self-efficacy identified in this study that may serve as change objectives for future sexual health promotion interventions.
AIDS and Behavior, 2022
We examined power and decision-making in heterosexual relationships amongst South African adolescents and young people. A survey conducted with 515 adolescent girls and young women (AGYW) included items from the Sexual Relationship Power Scale (SRPS) adapted for South African women. Qualitative interviews with fifty AGYW aged between 15 and 24, and nine males aged 18 years and above, explored decision-making in heterosexual relationships, particularly relating to timing of sex and condom use. Theories of gendered power, sexual relationship power and sexual scripting were used in interpreting the data. Findings showed that the power AGYW have in sexual relationships determines their ability to use condoms, and that males generally control condom use and timing of sex. Both survey and interview data suggest that male control over female partners’ behaviour also extends beyond the sexual domain. Although while male power is pervasive and enduring, it is simultaneously contested and negotiated. Despite some young people believing that gendered power in decision-making should be equal, it is not always possible for AGYW to enact agency in the dyadic context of heterosexual relationships. Whilst adolescents and young people in South Africa move away from traditional cultural gendered expectations, relationship power inequity and hegemonic masculinities continue to legitimise men’s power over women, constraining the sexual agency of adolescent girls and young women and discouraging them from taking control of their own sexual interests and sexual health.
Partner negotiation and insertion difficulties are key barriers to female condom (FC) use in sub-Saharan Africa. Few FC interventions have provided comprehensive training in both negotiation and insertion skills, or focused on university students. In this study we explored whether training in FC insertion and partner negotiation influenced young women's FC use. 296 female students at a South African university were randomized to a one-session didactic information only minimal intervention (n ¼ 149) or a two-session cognitive-behavioral enhanced intervention (n ¼ 147), which received additional information specific to partner negotiation and FC insertion. Both groups received FCs. We report the 'experiences of' 39 randomly selected female students who participated in post-intervention qualitative interviews. Two-thirds of women reported FC use. Most women (n ¼ 30/39) applied information learned during the interventions to negotiate with partners. Women reported that FC insertion practice increased their confidence. Twelve women failed to convince male partners to use the FC, often due to its physical attributes or partners' lack of knowledge about insertion. FC educational and skills training can help facilitate use, improve attitudes toward the device and help women to successfully negotiate safer sex with partners. Innovative strategies and tailored interventions are needed to increase widespread FC adoption.
Condom Use Within Marital and Cohabiting Partnerships in KwaZulu‐Natal, South Africa
Studies in Family Planning, 2004
Traditionally, the major focus of condom-promotion strategies has been on increasing use outside marriage. This study explores the extent and determinants of condom use within marital and cohabiting partnerships in KwaZulu-Natal, South Africa. In focus-group discussions, in-depth interviews, and individual survey responses, knowledge of condoms as an effective method of dual protection against the risk of pregnancy and disease was found to be high. Consistent with numerous other studies, this study found widespread disapproval of condom use within marriage. Only 14 percent of men and 17 percent of women reported consistent or "occasional" condom use. Nevertheless, condom use is much higher among urban, more-educated individuals than among their rural, lesseducated counterparts. Apart from education, perceived risk of HIV infection from the partner is the most powerful determinant of use within marital and cohabiting partnerships, particularly for women. Resistance to condoms within marital and cohabiting partnerships is not immutable, however, and women may not be as powerless to protect themselves as is often reported. (STUDIES IN FAMILY PLANNING 2004: 35[2]: 116-124) Pranitha Maharaj is a Research Fellow,