Looking to the future: South African men and women negotiating HIV risk and relationship intimacy

Abstract

This paper examines the approaches heterosexual men and women in South Africa use to engage their partners in discussions of HIV and risk factors in their relationships. These strategies entail balancing the risks of infection while managing the challenges of maintaining a relationship. In a context in which there is a great deal of insecurity in relationships it is especially challenging to discuss HIV risks with partners. Our findings reveal that concerns about children or the desire to have children provided a legitimate basis for discussing HIV risk with partners. The focus of these discussions is on the future for their children. Research in South Africa should attend to men's and women's desires to have and to raise children. HIV prevention and treatment programs can capitalise on concerns regarding children, and the future of the family, to engage men and women in discussing mutually acceptable strategies for preventing infection and ensuring safe conception.

Attitude towards sexual control among women in conjugal union in the era of the HIV/AIDS epidemic in Mahikeng, South Africa

“…The alluded powerlessness of women in sexual control seems to be entrenched in protracted cultural tenets (Langen, 2005;Jewkes et al, 1999;Jewkes & Morrell, 2010), socio-economic dependency on men and limited education to women (Wodi, 2005;Ackerman & de Klerk, 2002;Mindry et al, 2011).…”

“…Socio-economic dependency of women on men has uncompromisingly conferred on men the decision-making power in reproductive issues and may continue to be a challenge to women's sexual control (Jewkes & Morrell, 2010;Mindry et al, 2011).…”

“…Cohabitation happens when a man and a woman decide to live together like a husband and wife but do not have a legal document. Cohabiting relations are generally accepted in South Africa (Matshidze et al, 1998;Swart-Kruger & Richter, 1997;Mindry et al, 2011). For the purpose of this paper, married and cohabiting women are studied together because they have more or less similar experiences on sexual control.…”

Problematising the Discourse of ‘Post-AIDS’

“…In the South African context, for example, the relationship between poverty, socioeconomic status, socio-cultural norms, gender and HIV risk are highly complex and made more so by very high levels of gender-based violence and serious inadequacies in the health services which impact on the diagnosis and management of HIV, AIDS and TB (Natrass et al 2012;Natrass 2014;Hunter 2015;Johnston et al 2015). Navigating and managing relationships and safe sexual practices, including HIV testing and condom use, in this context is understandably fraught, where the influences of economic insecurity, unemployment, socio-economic inequality and long term historical patterns of migration will often have the last, if not determining, word (Hunter 2007;Hosegood 2009;Mindry et al 2012). The HIVepidemic in South Africa thus continues to impact negatively and unevenly on individuals, families and communities despite the clear and evident advances in limiting and managing the epidemic through a range of interventions including ART.…”

“Safe Sex Talk:” Negotiating Safe Sex Practices in Heterosexual Relationships

“…Clearly, HIV and AIDS has become a gendered phenomenon, infecting and affecting more women than men, especially in sub-Saharan Africa, where heterosexual sex is the main mode of transmission (Akeroyd, 2004;Magadi, 2011;Mindry et al, 2011;Nattrass, 2008;Quinn and Overbaugh, 2005;Schoepf, 1988;UNAIDS, 2010). According to recent UNAIDS (2012) statistics, about 34.0 million people worldwide were living with HIV at the end of 2011.…”