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Kedzior SGE, Moore VM, Manning N, Oswald TK, Calabretto H, Lassi ZS, Rumbold AR. 'Like fumbling around in the dark': Young people's perceptions and realities of healthy relationships. CULTURE, HEALTH & SEXUALITY 2024; 26:93-107. [PMID: 37014229 DOI: 10.1080/13691058.2023.2189929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/08/2023] [Indexed: 04/05/2023]
Abstract
Learning to negotiate relationships is a key feature of adolescence, yet insight into young people's perspectives on what constitutes healthy relationships is lacking. In this study, therefore, insights were sought on healthy relationship qualities, common issues encountered, and relevant educational experiences. Semi-structured interviews were undertaken with 18 young people (11 self-identified as female, 5 male, and 2 trans/gender-diverse) aged 14-20 years, residing in Adelaide, South Australia. Relationships with parents, siblings, peers and intimate partners were topics for discussion. Reflexive thematic analysis was utilised to generate codes and themes. The Five Cs of Positive Youth Development were used to aid understanding of findings. Young people's accounts suggested a disjuncture between desired relationship qualities, realities and education on relationships and sexual health. Young people articulated tensions navigating peer norms and societal expectations in relation to dating and sex, including unrealistic representations, gender stereotyping and strong 'sexpectations'. Participants in this study relied more heavily on personal experience and observation than formal education to develop an understanding of healthy relationships. Achieving healthy relationships was generally perceived to be complex and requiring skills or understanding informants were unsure about. Positive Youth Development could provide a framework for meeting the needs expressed by young people, notably by building communication skills, confidence and agency.
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Affiliation(s)
- Sophie G E Kedzior
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Vivienne M Moore
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
- Fay Gale Centre for Research on Gender, University of Adelaide, Adelaide, SA, Australia
| | - Nathan Manning
- Fay Gale Centre for Research on Gender, University of Adelaide, Adelaide, SA, Australia
- School of Social Sciences, Department of Sociology, Criminology and Gender Studies, The University of Adelaide, Adelaide, SA, Australia
| | - Tassia K Oswald
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | | | - Zohra S Lassi
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Alice R Rumbold
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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Ruark A, Green EC, Nunn A, Kennedy C, Adams A, Dlamini-Simelane T, Surkan P. Navigating intimate sexual partnerships in an era of HIV: dimensions of couple relationship quality and satisfaction among adults in Eswatini and linkages to HIV risk. SAHARA J 2019; 16:10-24. [PMID: 30987536 PMCID: PMC6484492 DOI: 10.1080/17290376.2019.1604254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Couple relationship functioning impacts individual health and well-being, including HIV risk, but scant research has focused on emic understandings of relationship quality in African populations. We explored relationship quality and satisfaction in Eswatini (formerly Swaziland) using data from 148 in-depth interviews (117 life-course interviews with 28 adults and 31 interviews with 29 marriage counselors and their clients) and 4 focus group discussions. Love, respect, honesty, trust, communication, sexual satisfaction, and sexual faithfulness emerged as the most salient characteristics of good relationships, with both men and women emphasising love and respect as being most important. Participants desired relationships characterised by such qualities but reported relationship threats in the areas of trust, honesty, and sexual faithfulness. The dimensions of relationship quality identified by this study are consistent with research from other contexts, suggesting cross-cultural similarities in conceptions of a good relationship. Some relationship constructs, particularly respect, may be more salient in a Swazi context.
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Affiliation(s)
- Allison Ruark
- Department of Medicine, Brown University, Providence, RI, USA
| | - Edward C. Green
- Anthropology, George Washington University, Washington, DC, USA
| | - Amy Nunn
- Brown University School of Public Health, Providence, RI, USA
- Rhode Island Public Health Institute, Providence, RI, USA
| | - Caitlin Kennedy
- Johns Hopkins University Bloomberg School of Public Health, International Health, Baltimore, MD, USA
| | - Alfred Adams
- University of Amsterdam, Amsterdam Institute for Social Science Research, Amsterdam, Netherlands
| | | | - Pamela Surkan
- Johns Hopkins University Bloomberg School of Public Health, International Health, Baltimore, MD, USA
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Heard E, Fitzgerald L, Va'ai S, Collins F, Whittaker M, Mutch A. 'In the Islands people don't really talk about this stuff, so you go through life on your own': An arts-based study exploring intimate relationships with young people in Samoa. CULTURE, HEALTH & SEXUALITY 2019; 21:526-542. [PMID: 30280969 DOI: 10.1080/13691058.2018.1492021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 06/14/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
This study explores conceptualisations and understandings of intimate relationships with young people in Samoa - an at-risk group experiencing high rates of intimate partner violence and alienation from sexual and relationship health promotion. Insights contribute to the immediate need to advance knowledge and practice around prevention with this group. An arts-based approach, which included a two-day interactive drama workshop coupled with follow-up, peer-led focus groups, was used to explore perceptions and understandings related to intimate relationships with 15 tertiary educated young people (nine female and six male) from across Samoa. Intersectionality informed the data collection and thematic analysis, examining participants' lived experiences and the ways multiple and intersecting identities interact within social and cultural systems to influence and inform these experiences. Outcomes highlight important tensions for young people, including the way in which age, gender, religion and sexuality interact with social hierarchies and power structures, socially prescribed gender norms, family structures and globalisation. This research provides insights that can inform the development of prevention strategies to address the root causes of intimate partner violence, building the knowledge and skills required for establishing intimate relationships free from violence with young people.
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Affiliation(s)
- Emma Heard
- a School of Public Health, University of Queensland , Herston , Queensland , Australia
| | - Lisa Fitzgerald
- a School of Public Health, University of Queensland , Herston , Queensland , Australia
| | - Sina Va'ai
- b Department of English and Foreign Languages, National University of Samoa , To'omatagi , Samoa
| | - Fiona Collins
- b Department of English and Foreign Languages, National University of Samoa , To'omatagi , Samoa
| | - Maxine Whittaker
- c College of Public Health, Medical and Veterinary Sciences James Cook University , Townsville , Queensland , Australia
| | - Allyson Mutch
- a School of Public Health, University of Queensland , Herston , Queensland , Australia
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Khuzwayo N, Taylor M. Exploring the socio-ecological levels for prevention of sexual risk behaviours of the youth in uMgungundlovu District Municipality, KwaZulu-Natal. Afr J Prim Health Care Fam Med 2018; 10:e1-e8. [PMID: 29781679 PMCID: PMC5843945 DOI: 10.4102/phcfm.v10i1.1590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/13/2017] [Accepted: 10/19/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Prevention of youth sexual risk behaviour among the youth in uMgungundlovu District Municipality continues to be a primary challenge for public health and health promotion. Current prevention interventions are targeted at an individual level, whilst youth behaviour is influenced by many social and environmental factors. AIM The aim of the study was to explore the factors influencing sexual risk behaviours of the youth at different socio-ecological levels in uMgungundlovu District Municipality. METHODS An explorative and descriptive qualitative study design was used, using in-depth interviews and focus group discussions for data collection. A framework analysis was used to develop themes derived from the socio-ecological theory. RESULTS Four themes were identified that influence youth to engage in sexual risk behaviours: (1) individual factors, related to role modelling behaviour, gender and negative stereotypes towards females; (2) the microsystem in which youth function including the influence of family and peers; (3) the exo-system comprising the disadvantaged socio-economic status of the communities where the youth live; and (4) the macrosystem where negative social norms were reported to influence youth health outcomes. CONCLUSION Sexual risk behaviour among youth in uMgungundlovu is influenced by many factors at multiple social levels. Interventions directed at these multiple levels are needed urgently.
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Affiliation(s)
- Nelisiwe Khuzwayo
- School of Nursing and Public Health Medicine, University of KwaZulu-Natal.
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Kallberg L. The ethics of separating conjoined twins: two arguments against. THEORETICAL MEDICINE AND BIOETHICS 2018; 39:27-56. [PMID: 29446009 DOI: 10.1007/s11017-018-9435-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
I argue that the separation of conjoined twins in infancy or early childhood is unethical (rare exceptions aside). Cases may be divided into three types: both twins suffer from lethal abnormalities, only one twin has a lethal abnormality, or neither twin does. In the first kind of case, there is no reason to separate, since both twins will die regardless of treatment. In the third kind of case, I argue that separation at an early age is unethical because the twins are likely to achieve an irreplaceably good quality of life-the goods of conjoinment-that separation takes away. Evaluation of this possibility requires maturation past early childhood. Regarding the second type, I point out that with conceivable but unrecorded exceptions, these cases will consistently involve sacrifice separation. I present an argument that sacrifice separation is unethical, but in some cases a moral dilemma may exist in which separation and refraining from separation are both unethical. Perhaps in such cases a decision can be made on non-moral grounds; however, the possibility of such a decision serves not to mitigate but to underscore the fact that the separation is unethical. My conclusion, which applies to all three types of cases, is that it is unethical to separate conjoined twins before their developing personalities give some reliable indication as to whether they desire separation and whether they will achieve those goods of conjoinment.
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Affiliation(s)
- Luke Kallberg
- Philosophy Department, Saint Louis University, Adorjan Hall 130, 3800 Lindell Blvd., Saint Louis, MO, 63108, USA.
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Belus JM, Kline T, Carney T, Myers B, Wechsberg WM. Measuring Relationship Functioning in South African Couples: A Strategy for Improving HIV Prevention Efforts. SEXUAL AND RELATIONSHIP THERAPY 2018; 35:2-14. [PMID: 32728347 PMCID: PMC7388832 DOI: 10.1080/14681994.2017.1419559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 11/15/2017] [Indexed: 10/18/2022]
Abstract
Over the past decade there has been increased focus on targeting couples in HIV prevention efforts, particularly in sub-Saharan Africa where HIV transmission primarily occurs through heterosexual contact, in the context of intersecting alcohol use and intimate partner violence (IPV). However, little is known about couples' general relationship functioning. This understanding is needed to augment couple-based HIV prevention programs and address risk for IPV. This paper presents data on domains of relationship functioning with 300 South African couples who were recruited for an HIV prevention study. Exploratory and confirmatory factor analyses were conducted to determine the relevance of 17 individual items, as well as the overall factor structure of the questions. Results revealed three independent factors of relationship functioning: relationship satisfaction, arguing, and open communication; an overarching construct of relationship functioning for these three domains was not observed in the data. Results provide insight into the structure of relationship functioning questions and subscales that can be used to assess South African adult romantic relationships. This may allow for a greater focus on aspects of relationships within couple-based HIV prevention programs going forward.
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Affiliation(s)
- Jennifer M. Belus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Davie Hall CB # 3270, Chapel Hill, NC, 27599, USA
| | - Tracy Kline
- Statistics and Epidemiology, RTI International, 3040 Cornwallis Rd., Research Triangle Park, NC, 27709, USA
| | - Tara Carney
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie van Zijl Drive, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schurr Hospital, Observatory, Cape Town, South Africa
| | - Bronwyn Myers
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie van Zijl Drive, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schurr Hospital, Observatory, Cape Town, South Africa
| | - Wendee M. Wechsberg
- Substance Use, Gender and Applied Research, RTI International, 3040 Cornwallis Rd., Research Triangle Park, NC, 27709, USA
- Health Policy and Management, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
- Psychology in the Public Interest, North Carolina State University, 640 Poe Hall, CB#7650, Raleigh, NC, 27695, USA
- Psychiatry and Behavioral Sciences, Duke University, 4584 White Zone, Duke South, CB#3950, Durham, NC, USA
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John NA, Seme A, Roro MA, Tsui AO. Understanding the meaning of marital relationship quality among couples in peri-urban Ethiopia. CULTURE, HEALTH & SEXUALITY 2017; 19:267-278. [PMID: 27684713 PMCID: PMC5525023 DOI: 10.1080/13691058.2016.1215526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study explores the meaning of marital relationship quality (MRQ) among couples in peri-urban Ethiopia. We examined the factor structure of MRQ by assessing the reliability and validity of four validated Western scales capturing domains of trust, commitment, satisfaction and communication through exploratory factor analysis. Although most of the items of the original Western scales were relevant for the study population, the domains did not mirror the original Western scales and varied by gender. Interestingly, while the domains of commitment and trust followed the Western scales and were very similar across gender, the third domain, which we labelled conflict differed by gender. For women, items from the constructive communication scale seemed relevant, indicating an interest in resolving conflicts, whereas for men, items from the satisfaction scale appeared more important, indicating a desire to avoid or reduce conflict in their relationships. Our study highlights the usefulness of adapting existing validated scales in a new context after assessing their psychometric properties. Such applications provide opportunities for broadening understanding of fundamental MRQ domains that may universally be shared cross-culturally.
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Affiliation(s)
- Neetu A John
- a Bloomberg School of Public Health , Johns Hopkins University , Baltimore , USA
| | - Assefa Seme
- b School of Public Health , Addis Ababa University , Addis Ababa , Ethiopia
| | | | - Amy O Tsui
- a Bloomberg School of Public Health , Johns Hopkins University , Baltimore , USA
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Conroy AA, McGrath N, van Rooyen H, Hosegood V, Johnson MO, Fritz K, Marr A, Ngubane T, Darbes LA. Power and the association with relationship quality in South African couples: Implications for HIV/AIDS interventions. Soc Sci Med 2016; 153:1-11. [PMID: 26859436 PMCID: PMC4788545 DOI: 10.1016/j.socscimed.2016.01.035] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 01/09/2016] [Accepted: 01/22/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Power imbalances within sexual relationships have significant implications for HIV prevention in sub-Saharan Africa. Little is known about how power influences the quality of a relationship, which could be an important pathway leading to healthy behavior around HIV/AIDS. METHODS This paper uses data from 448 heterosexual couples (896 individuals) in rural KwaZulu-Natal, South Africa who completed baseline surveys from 2012 to 2014 as part of a couples-based HIV intervention trial. Using an actor-partner interdependence perspective, we assessed: (1) how both partners' perceptions of power influences their own (i.e., actor effect) and their partner's reports of relationship quality (i.e., partner effect); and (2) whether these associations differed by gender. We examined three constructs related to power (female power, male equitable gender norms, and shared power) and four domains of relationship quality (intimacy, trust, mutually constructive communication, and conflict). RESULTS For actor effects, shared power was strongly and consistently associated with higher relationship quality across all four domains. The effect of shared power on trust, mutually constructive communication, and conflict were stronger for men than women. The findings for female power and male equitable gender norms were more mixed. Female power was positively associated with women's reports of trust and mutually constructive communication, but negatively associated with intimacy. Male equitable gender norms were positively associated with men's reports of mutually constructive communication. For partner effects, male equitable gender norms were positively associated with women's reports of intimacy and negatively associated with women's reports of conflict. CONCLUSIONS Research and health interventions aiming to improving HIV-related behaviors should consider sources of shared power within couples and potential leverage points for empowerment at the couple level. Efforts solely focused on empowering women should also take the dyadic environment and men's perspectives into account to ensure positive relationship outcomes.
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Affiliation(s)
- Amy A Conroy
- Center for AIDS Prevention Studies, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
| | - Nuala McGrath
- Faculty of Medicine, University of Southampton, Southampton General Hospital, Mailpoint 805, South Academic Block, Level C Room AC23, Tremona Road, Southampton SO16 6YD, UK; Africa Centre for Population Health, University of KwaZulu-Natal, Mtubatuba, South Africa.
| | - Heidi van Rooyen
- Social, Behavioural and Biomedical Interventions Unit, HIV/AIDS, STIs and Tuberculosis Programme, Human Sciences Research Council, P.O Box 90, Msunduzi 3200, South Africa.
| | - Victoria Hosegood
- Africa Centre for Population Health, University of KwaZulu-Natal, Mtubatuba, South Africa; Division of Social Statistics and Demography, University of Southampton, Southampton SO17 1BJ, UK.
| | - Mallory O Johnson
- Center for AIDS Prevention Studies, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
| | - Katherine Fritz
- Global Health, International Center for Research on Women, 1120 20th Street NW, Suite 500 North, Washington, D.C., USA.
| | - Alexander Marr
- Center for AIDS Prevention Studies, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
| | - Thulani Ngubane
- Social, Behavioural and Biomedical Interventions Unit, HIV/AIDS, STIs and Tuberculosis Programme, Human Sciences Research Council, P.O Box 90, Msunduzi 3200, South Africa.
| | - Lynae A Darbes
- Center for AIDS Prevention Studies, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
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Chappell P. How Zulu-speaking youth with physical and visual disabilities understand love and relationships in constructing their sexual identities. CULTURE, HEALTH & SEXUALITY 2014; 16:1156-1168. [PMID: 25036419 DOI: 10.1080/13691058.2014.933878] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Popular socio-medical discourses surrounding the sexuality of disabled people have tended to subjugate young people with disabilities as de-gendered and asexual. As a result, very little attention has been given to how young people with disabilities in the African context construct their sexual identities. Based on findings from a participatory research study conducted amongst Zulu-speaking youth with physical and visual disabilities in KwaZulu-Natal, this paper argues that young people with disabilities are similar to other non-disabled youth in the way they construct their sexual identities. Using a post-structural framework, it outlines how the young participants construct discursive truths surrounding disability, culture and gender through their discussions of love and relationships. In this context, it is argued that the sexual identities' of young people with physical and visual disabilities actually emerges within the intersectionality of identity discourses.
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Affiliation(s)
- Paul Chappell
- a Department of Anthropology and Development Studies , University of Johannesburg , Johannesburg , South Africa
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