Reappraising men's sexual behaviors and gendered attitudes from the sexual-history narratives of South African men and women in a time of HIV/AIDS.
Doctoral Thesis
2013
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University of Cape Town
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While the frequent positioning of men's sexual behaviours as driving the HIV epidemic in South Africa has generated much interest in men's sexuality, much research to date has presented men as a homogenous group, or treats male sexuality as a set of isolated, individually driven behaviours. As a result, the current body of knowledge provides only a partial basis for meeting men's sexual and reproductive health (SRH) needs and addressing HIV-prevention among men. A narrative approach, which foregrounds the diversity and meaning in participant's lived experiences, was used in this study to examine the subjective and social impact of dominant norms of masculinity on South African men's sexual behaviours and gendered attitudes. This was expected to yield more nuanced, and contextualised understandings of men's SRH, with practical consideration for what means of men's sexual health can be enhanced. Fifty sexual-history interviews and ten focus group discussions with men, and twenty-five sexual-history interviews with women, were conducted with participants purposely sampled from three age categories (aged 18–24, 25–54, and 55+ years), a range of language and racial backgrounds, and urban and rural sites across five provinces in South Africa. The interviews were structured to elicit accounts of early knowledge of sex and sexual experimentation and to explore the range of sexual relationships and experiences among men and women throughout their adulthood. Participants' engagement with the risk of sexually transmitted infections, including HIV, and their reproductive health management were also explored. The data were analysed using the principles of thematic and narrative analysis, with NVivo software used for data management. The data appreciates the diversity and fluidity in men and women's lived experiences while recognising the social and cultural norms that structure sexuality. The narratives reveal a number of footholds for understanding how individual men both conform to and resist gender norms that can be damaging to their SRH. Such findings provide insights to inform how programmes and services could better engage men in HIV prevention and care. Especially, the study points to the value of a narrative approach to more deeply understand men's sexual risk and agency and the social structures, meanings and experiences that underlie it.
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Stern, E. 2013. Reappraising men's sexual behaviors and gendered attitudes from the sexual-history narratives of South African men and women in a time of HIV/AIDS. University of Cape Town.