Condom use: a less travelled route among minibus taxi drivers and their taxi queens in KwaZulu-Natal, South Africa

Abstract

Background: Despite significant gains in the HIV epidemic in South Africa, with reduction in mortality and elimination of vertical transmission, national HIV prevalence remains high, with women rather than men continuing to bear higher bur- den of the disease. Population subgroups, through ignorance, disbelief or recklessness, continue to engage in risky sexual behaviour. A substantial proportion of minibus taxi drivers engage in risky sex, seldom seeing themselves at risk for STIs or HIV/AIDS. These taxi drivers have been linked with so-called taxi queens, with whom they engage in transactional and intergenerational relationships.
 Objectives: The study explored condom use and condom negotiation strategies among taxi drivers and taxi queens in Kwa- Zulu-Natal, South Africa.
 Methods: Applying explorative qualitative design, we conducted focus group discussion and individual interviews among participants who were purposively recruited in KwaZulu-Natal.
 Results: Qualitative data analysis revealed that condom use and negotiation are sources of conflict for the participants. In addition, the strategies employed by participants to ensure condom usage are not always sustainable and are likely to be problematic due to a variety of complex factors.
 Conclusion: Our study concludes by recommending a nested public health response that takes cognizance of factors that promote sustainable condom use strategies among this population subgroup.
 Keywords: Condom use; minibus taxi drivers; KwaZulu-Natal; South Africa.

“I always prefer to withdraw than use a condom”: contextualising condomless sex among East Asian and sub-Saharan African international students in Sydney

“…Furthermore, the implication of alcohol use in condomless sex as reported in previous studies [45,56,57] also resonates in the present study. Against this backdrop, the population of the present study could benefit from sexual health programs that embed socio-decision making and self-regulation skills, which have been found to be protective against risky sexual practices [58,59] as well as unhealthy drinking and condomless sex [60][61][62].…”

“…Sexual agency demonstrated by some female participants in negotiating condom use-in line with previous studies [44,45]-contradicts traditional stereotypes that portray East Asian and sub-Saharan African women as compliant and lacking power to negotiate condom use [11,46,47]. However, considering that some female participants may still feel less confident to access and negotiate condom use, it may be necessary for interventions to focus on improving sexual assertiveness and negotiation skills of international students to boost their confidence in accessing, negotiating and using condoms as low condom negotiation among women in particular increases likelihood of condomless sex [48].…”

“I Always Prefer To Withdraw Than Use A Condom”: A Phenomenological Study of Condomless Sexual Practice Among International Students in Sydney

“…Furthermore, the implication of alcohol use in condomless sex as reported in previous studies 45,56,57 also resonates in the present study. Against this backdrop, the population of the present study could bene t from sexual health programs that embed socio-decision making and self-regulation skills, which have been found to be protective against risky sexual practices 58, 59 as well as unhealthy drinking and condomless sex [60][61][62] .…”

“…Sexual agency demonstrated by some female participants in negotiating condom use-in line with previous studies 44,45 -contradicts traditional stereotypes that portray East Asian and sub-Saharan African women as compliant and lacking power to negotiate condom use 11,46,47 . However, considering that some female participants may still feel less con dent to access and negotiate condom use, it may be necessary for interventions to focus on improving sexual assertiveness and negotiation skills of international students to boost their con dence in accessing, negotiating and using condoms as low condom negotiation among women in particular increases likelihood of condomless sex 48 .…”

Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa

“…Although in this study we did not classify whether condomless sex was with a regular or casual partner, the decision not to use condoms could also be influenced by the type of sexual relationship a person is involved in [33][34][35][36]. Previous studies conducted in this rural setting found that low condom use at last sex was associated with having a regular sexual partner or an older partner [37,38].…”