The dynamics of sexual risk amongst South African youth in age-disparate relationships

IntroductionSouth Africa has the highest burden of HIV in the world with over 8 million people living with HIV. Young women and girls account for a quarter of new HIV infections while making up only 10% of the population. A key driver of HIV incidence is transactional and survival sex between adoles...

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Main Authors: Phiwokazi Qoza, Alastair van Heerden, Zaynab Essack
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-07-01
Series:Frontiers in Reproductive Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/frph.2023.1125552/full
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author Phiwokazi Qoza
Alastair van Heerden
Alastair van Heerden
Zaynab Essack
Zaynab Essack
author_facet Phiwokazi Qoza
Alastair van Heerden
Alastair van Heerden
Zaynab Essack
Zaynab Essack
author_sort Phiwokazi Qoza
collection DOAJ
description IntroductionSouth Africa has the highest burden of HIV in the world with over 8 million people living with HIV. Young women and girls account for a quarter of new HIV infections while making up only 10% of the population. A key driver of HIV incidence is transactional and survival sex between adolescent girls or young women and older men (the latter referred to as ‘sugar-daddies’ or ‘blessers’). This paper expands on the existing literature on age-disparate and intergenerational relationships to provide social and behavioural interpretations of how young men, commonly omitted from studies on this topic, and women in concurrent relationships with both their peers and older partners perceive and navigate sexual risk.MethodWe conducted a qualitative study in a rural setting of uMgungundlovu District, KwaZulu-Natal Province, with purposively selected male and female participants aged 18–24 years old in age-disparate relationships. Semi-structured in-depth interviews (IDI) were conducted and analysed using interpretative phenomenological analysis (IPA) to explore existing information, motivations, and behavioural practices around relationships and sexual risk.ResultsThe themes and related sub-themes found through IPA included the following: (1) navigating dating: narratives that show a strong preference for being in an age-disparate relationship; the challenges that young people face when choosing an older person as a side partner; and social media applications seen as creating opportunities to meet side partners; and (2) the distribution of love and trust in a multi-party sexual network: condom (mis)use differentiates between straights—those in a serious relationship—and sides; and the power of eye-test seroguessing, the praxis of testing people visually for HIV in nullifying existing knowledge about sexual and reproductive health risk.DiscussionThis research offers an understanding of how schemas of non-condom use are organised. We observed that while condom-less sex is often viewed as essential to building social capital in a serious relationship, it is not the only factor that determines sexual relationship power. Eye-test seroguessing not only develops consortium (trust, reciprocity, and solidarity), but it fulfils the psycho-social need to belong to a network of serious relationships. Moreover, it is critical to the enactment of masculinities because it consolidates femininity to keep men happy, i.e., by being passive in the sexual encounter, women constrain their self-efficacy to act contrary to the conventions of reputable women. Therefore, it is plausible that in the serosorting that occurs prior to unprotected sexual acts, the power of eye-test seroguessing limits the ability to engage in safe sexual practices.
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spelling doaj.art-1ba00176f860491ca5ee8ffcedb1ad642023-07-18T08:30:24ZengFrontiers Media S.A.Frontiers in Reproductive Health2673-31532023-07-01510.3389/frph.2023.11255521125552The dynamics of sexual risk amongst South African youth in age-disparate relationshipsPhiwokazi Qoza0Alastair van Heerden1Alastair van Heerden2Zaynab Essack3Zaynab Essack4Centre for Community Based Research, Human Sciences Research Council, Pietermaritzburg, South AfricaCentre for Community Based Research, Human Sciences Research Council, Pietermaritzburg, South AfricaSAMRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaCentre for Community Based Research, Human Sciences Research Council, Pietermaritzburg, South AfricaSchool of Law, University of KwaZulu-Natal, Pietermaritzburg, South AfricaIntroductionSouth Africa has the highest burden of HIV in the world with over 8 million people living with HIV. Young women and girls account for a quarter of new HIV infections while making up only 10% of the population. A key driver of HIV incidence is transactional and survival sex between adolescent girls or young women and older men (the latter referred to as ‘sugar-daddies’ or ‘blessers’). This paper expands on the existing literature on age-disparate and intergenerational relationships to provide social and behavioural interpretations of how young men, commonly omitted from studies on this topic, and women in concurrent relationships with both their peers and older partners perceive and navigate sexual risk.MethodWe conducted a qualitative study in a rural setting of uMgungundlovu District, KwaZulu-Natal Province, with purposively selected male and female participants aged 18–24 years old in age-disparate relationships. Semi-structured in-depth interviews (IDI) were conducted and analysed using interpretative phenomenological analysis (IPA) to explore existing information, motivations, and behavioural practices around relationships and sexual risk.ResultsThe themes and related sub-themes found through IPA included the following: (1) navigating dating: narratives that show a strong preference for being in an age-disparate relationship; the challenges that young people face when choosing an older person as a side partner; and social media applications seen as creating opportunities to meet side partners; and (2) the distribution of love and trust in a multi-party sexual network: condom (mis)use differentiates between straights—those in a serious relationship—and sides; and the power of eye-test seroguessing, the praxis of testing people visually for HIV in nullifying existing knowledge about sexual and reproductive health risk.DiscussionThis research offers an understanding of how schemas of non-condom use are organised. We observed that while condom-less sex is often viewed as essential to building social capital in a serious relationship, it is not the only factor that determines sexual relationship power. Eye-test seroguessing not only develops consortium (trust, reciprocity, and solidarity), but it fulfils the psycho-social need to belong to a network of serious relationships. Moreover, it is critical to the enactment of masculinities because it consolidates femininity to keep men happy, i.e., by being passive in the sexual encounter, women constrain their self-efficacy to act contrary to the conventions of reputable women. Therefore, it is plausible that in the serosorting that occurs prior to unprotected sexual acts, the power of eye-test seroguessing limits the ability to engage in safe sexual practices.https://www.frontiersin.org/articles/10.3389/frph.2023.1125552/fullsexual risk behavioursexual risk perceptionsocial capitalIPAseroguessingage-disparate relationships
spellingShingle Phiwokazi Qoza
Alastair van Heerden
Alastair van Heerden
Zaynab Essack
Zaynab Essack
The dynamics of sexual risk amongst South African youth in age-disparate relationships
Frontiers in Reproductive Health
sexual risk behaviour
sexual risk perception
social capital
IPA
seroguessing
age-disparate relationships
title The dynamics of sexual risk amongst South African youth in age-disparate relationships
title_full The dynamics of sexual risk amongst South African youth in age-disparate relationships
title_fullStr The dynamics of sexual risk amongst South African youth in age-disparate relationships
title_full_unstemmed The dynamics of sexual risk amongst South African youth in age-disparate relationships
title_short The dynamics of sexual risk amongst South African youth in age-disparate relationships
title_sort dynamics of sexual risk amongst south african youth in age disparate relationships
topic sexual risk behaviour
sexual risk perception
social capital
IPA
seroguessing
age-disparate relationships
url https://www.frontiersin.org/articles/10.3389/frph.2023.1125552/full
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