Young women’s agency to negotiate condom use in sexual relationships: Compromising factors leading to condom use inconsistency among young South African women
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Background. South Africa experiences a high prevalence of HIV, and women are disproportionately affected. Promoting condom use in heterosexual relationships has been one attempt to constrain the spread of HIV. However, significant obstacles such as gender norms and gender inequalities are found to be the primary drivers of HIV transmission. Gendered divisions of labour and power act as barriers to South African women’s sexual and reproductive health and rights. Women’s ability to use a condom requires negotiation, promotion and acceptance by the other partner towards actual usage. Women engage in transactional sex to gain access to social and financial resources, and end up in power-imbalanced relationships where their partner has the behavioural control of condom use. Research objective. The literature calls for a critical examination of the gendered determinants of HIV transmission. The objective of this study is to explore young South African women’s sexual agency and their ability and desire to use condoms in heterosexual relationships. Data material and methods. This study is a 60-credit thesis with a qualitative approach to inquiry. Thirteen in-depth, semi-structured interviews were conducted in Atteridgeville, South Africa. The participants are young South African women between 19-30 years of age. During data analysis, thematic themes emerged and were identified based on the existing literature on condom negotiation, the analytical framework (the theory of gender and power, and agency), and concepts shared by participants. Findings. Participants in this study disclosed various reasons as to why the majority of them were unable to promote and negotiate condom use with their sexual partners. A consistent finding was that all participants engaged in transactional sex. The economic incentive and transaction in their relationships profoundly affected participants ability to use condoms with their sexual partners, in particular those who engaged in multiple sexual partnerships. With one exception, all participants preferred to use condoms, but the majority were unsuccessful due to the financial contributions and favours from their partners. The nature of the participants’ relationships influenced the likelihood of them promoting condom use. Gendered power-imbalanced positions in their relationships were found to be determinants of condom use. Findings show that there are many condom negotiation strategies, and they are mostly condom-avoidant and performed by men. Most men do not want condoms, and one of their strategies was to question their partner’s trust and fidelity. Conclusion. This study sought to explore women’s perception of their sexual agency with condom use, and further explore sociocultural, structural and collective components which influenced their agency and their ability to use condoms. Women in this study engaged in condomless sex because of partner dependency, low self-efficacy, power-imbalanced relationships, partner disapproval of condom use, and cultural and social factors and norms. Overall, the findings of this study suggest that women’s sexual and reproductive health is highly compromised by economic transactions in sexual relationships and gendered power-imbalances, and so is their sexual agency.