Exploring the associations between physical and sexual gender-based violence and HIV among women who use substances in South Africa: the role of agency and alcohol

Objective: South Africa has the highest prevalence of HIV among women, the highest prevalence of gender-based violence (GBV), and the highest rates of per capita alcohol consumption in the world. The nuanced associations between GBV, alcohol misuse, and HIV must be explored and protective factors identified. This study examines the associations between physical and sexual GBV and HIV infection and explores how alcohol misuse and sexual agency may mediate the GBV-HIV association. Method: Participants were 361 Black African women (Mean age=28.39, SD = 7.92) who reported using alcohol and/or drugs weekly in the past 3 months, engaging in condomless sex, and having a boyfriend. Women were recruited from disadvantaged communities in Pretoria, South Africa. Individuals who met the eligibility criteria and enrolled in the study consented and completed a computer-assisted personal interview assessing GBV, alcohol misuse, and sexual agency and underwent HIV testing (i.e., blood test). Results: The indirect effect of physical assault on HIV status at enrollment through alcohol misuse was significant (log odds = 0.23, SE = 0.12, 95% CI [0.0151, 0.4998]). Conclusions: HIV prevention efforts focusing on reducing alcohol misuse may be more effective, which might reduce the HIV burden among this group of vulnerable South African women.

Deconstructive Discourse Analysis: Extending the Methodological Conversation

Discourse analysis is increasingly becoming a methodology of preference amongst qualitative researchers. There is a danger, however, of it being viewed as a bounded and uncontested domain of research practice. As discourse analysis is inextricably linked with theoretical issues, it is a dynamic practice that is constantly in a process of revision. In this paper I reflect on some of the conceptualisations undergoing the notion of discourse – conceptualisations that have important implications in terms of how the practice of discourse analysis proceeds. I highlight some of the dualisms that may plague discourse analysis, and offer some solutions to these. Finally, I outline the deconstructive discourse analysis that I utilised in my doctoral work. The purpose of the latter is not to provide a recipe of methodology, but to illustrate how elements of various theorists' work (in this case Foucault, Derrida and Parker) may be profitably drawn together to perform specific discourse analytic work.

“He's a Man, and I'm a Woman”

In South Africa, woman abuse is a pervasive social problem. This article explores how abused women give meaning to their experiences. Narrative interviews were used to investigate 15 women's experiences of violence from their partners. In their narratives, women constructed particular gendered identities, which reflected contradictory and ambiguous subjective experiences. Meanings women attached to their experiences of abuse were filtered through the particular social context—characterized by poverty and deprivation—within which their experiences occurred. Women's naming of the violence was linked to broader sociocultural mechanisms that construct woman abuse as a social problem in South Africa.

When Sex and Power Collide: An Argument for Critical Sexuality Studies

Attentive to the collision of sex and power, we add momentum to the ongoing development of the subfield of critical sexuality studies. We argue that this body of work is defined by its critical orientation toward the study of sexuality, along with a clear allegiance to critical modalities of thought, particularly feminist thought. Critical sexuality studies takes its cues from several other critical moments in related fields, including critical psychology, critical race theory, critical public health, and critical youth studies. Across these varied critical stances is a shared investment in examining how power and privilege operate, understanding the role of historical and epistemological violence in research, and generating new models and paradigms to guide empirical and theoretical research. With this guiding framework, we propose three central characteristics of critical sexuality studies: (a) conceptual analysis, with particular attention to how we define key terms and conceptually organize our research (e.g., attraction, sexually active, consent, agency, embodiment, sexual subjectivity); (b) attention to the material qualities of abject bodies, particularly bodies that are ignored, overlooked, or pushed out of bounds (e.g., viscous bodies, fat bodies, bodies in pain); and (c) heteronormativity and heterosexual privilege, particularly how assumptions about heterosexuality and heteronormativity circulate in sexuality research. Through these three critical practices, we argue that critical sexuality studies showcases how sex and power collide and recognizes (and tries to subvert) the various power imbalances that are deployed and replicated in sex research.

Resisting the binarism of victim and agent: Critical reflections on 20 years of scholarship on young women and heterosexual practices in South African contexts

The last 20 years have seen a proliferation of research, spurred by the imperatives of the HIV epidemic and reportedly high rates of gender-based violence, on heterosexual practices in the South African context. Research has focused on how poverty, age and gender within specific cultural contexts shape sexual agency and provide a context for unequal, coercive and violent practices for young women. This paper takes stock of what we currently 'know' about heterosex and critically reflects on the political and ideological effects of such research, specifically in the light of young women's agency. A primary concern is that efforts to address gender inequality and the normative gender practices that shape inequitable heterosexual practices may have functioned to reproduce the very discourses that underpin such inequalities. The paper 'troubles' the victim-agency binarism as it has been played out in South African research on heterosex, raising concerns about how the research may reproduce gendered, classed and raced othering practices and discourses and bolstered regulatory and disciplinary responses to young women's sexualities. The paper argues for critical, feminist self-reflexivity that should extend to re-thinking methodologies entrenched in frameworks of authority and surveillance.

The Psychological Society of South Africa sexual and gender diversity position statement: contributing towards a just society

In this article, we outline the position statement on sexual and gender diversity adopted by the Psychological Society of South Africa’s Council on 24 September 2013. In line with the Society’s constitution, the statement contributes to transforming and redressing silences in South African psychology in order to promote human well-being and social justice for all. The commemoration of the 20th anniversary of the formation of the Society as well as that of democracy in the country in 2014 makes the aforementioned contribution all the more significant. The statement provides psychology professionals in South Africa and elsewhere, with a framework for understanding the challenges that individuals face in societies that are patriarchal and heteronormative and which discriminate on the basis of sexuality and gender. An affirmative view of sexual and gender diversity is taken as the foundation for providing support and guidance to professionals in all areas of psychological practice when dealing with sexually and gender diverse individuals. We contend that by assuming an affirmative stance towards sexual and gender diversity, psychology professionals can assist in the transformation of unjust sexual and gender systems, the harmful effects of which extend beyond their influence on lesbian, gay, bisexual, transgender, and intersex individuals to all persons in South Africa. In light of recent related developments in other African countries and the imminent launch of the Pan-African Psychology Union, South African psychology may, in fact, in this manner also contribute to similar regional initiatives.

An Exploratory Study of Male Adolescent Sexuality in Zimbabwe: The Case of Adolescents in Kuwadzana Extension, Harare

Although young people in Zimbabwe are becoming sexually active at a very early age, there is no unified body of knowledge on how they regard sex and construct sexuality and relationships. In many circumstances adolescence sexual agency is denied and silenced. This study explored adolescents’ discourses on sexuality, factors affecting adolescent sexuality, and sexual health. Fusing a social constructionist standpoint and an active view of agency, we argue that the way male adolescents perceive and experience sexuality and construct sexual identities is mediated by the sociocultural context in which they live in and their own agency. Although adolescents are mistakenly regarded as sexual innocents by society, we argue that male adolescents are active social agents in constructing their own sexual realities and identities. At the same time, dominant structural and interactional factors have a bearing on how male adolescents experience and generate sexuality.

Negotiating heteronormativity: Exploring South African bisexual women’s constructions of marriage and family

Although heteronormativity remains firmly in place in many contexts, challenges to a construction of heterosexuality as natural and superior increasingly emerge. However, despite increasing visibility of such challenges, bisexuality remains largely absent from such debates. Bisexual women occupy a potentially interesting position in discourses around heteronormativity and this paper explores how heteronormativity functions in the accounts of 13 South African bisexual women. Through a discourse analysis of interview data, a discourse of heterosexual marriage as normative and socially valued is identified as exerting a powerful influence on participants’ constructions of relationships and families. The findings further explore ways in which bisexuality is complicated by such a heteronormative marriage discourse and indicate a lack of integration of a bisexual identity in participants’ accounts. We suggest that drawing bisexuality into debates around heteronormativity can contribute to increased positions from which to challenge the coercive effects of heteronormativity.

Everywhere you go, everyone is saying condom, condom. But are they being used consistently? Reflections of South African male students about male and female condom use

Young men in South Africa can play a critical role in preventing new human immunodeficiency virus (HIV) infections, yet are seldom targeted for HIV prevention. While reported condom use at last sex has increased considerably among young people, consistent condom use remains a challenge. In this study, 74 male higher education students gave their perspectives on male and female condoms in 10 focus group discussions. All believed that condoms should be used when wanting to prevent conception and protect against HIV, although many indicated that consistent condom use was seldom attained, if at all. Three possible situations for not using condoms were noted: (i) when sex happens in the heat of the moment and condoms are unavailable, (ii) when sexual partnerships have matured and (iii) when female partners implicitly accept unprotected sex. Men viewed it as their responsibility to have male condoms available, but attitudes about whose decision it was to initiate condom use were mixed. Almost all sexually active men had male condom experience; however, very few had used female condoms. Prevention initiatives should challenge traditional gendered norms that underpin poor condom uptake and continued use and build on the apparent shifts in these norms that are allowing women greater sexual agency.

The cool, the bad, the ugly, and the powerful: identity struggles in schoolboy peer culture

Drawing upon a one-year-long ethnography of boys' constructions of their gender and sexual identities in one South African high school, this paper seeks to empirically explore and theorise how 58 grade 10 and grade 11 working-class boys create and seek out spaces among their male peers from which to cultivate their masculinities through heterosexual discourses, including being 'at risk' of getting AIDS. In this study, boys' daily struggles of trying to straddle the divide between hypersexual versus homosexual/effeminate versions of masculinity both subverted and reinforced hegemonic gender/sexual relations in the school context. Being caught up in this restrictive grip of heteronormativity meant that there were few spaces in male peer culture to resist hegemonic masculinity. The 'responsible male/controlled' position is indicative of one such space in which boys attempted to resist forms of hyper-sexuality. While this position cannot really be viewed as progressive, it nevertheless allowed boys to re-position themselves as moral agents through an assertion of control over their sexuality. Given the presence of these identity struggles, this paper, in general, suggests that interventions with boys need to cautiously explore these tensions/contradictions in identity making as opportunities to cultivate more gender sensitive and less violent discourses on masculinity.

The Cycle of Violence and Abuse in Women Who Kill an Intimate Male Partner: A Biographical Profile

Numerous women experience domestic violence and abuse on a daily basis, and some retaliate and kill their intimate male partners. Our aims in this study were (1) to explore the biographical profile of women who have killed their intimate male partners, and (2) to compare women who used a third party in the murders with those women who did not. Biographical questionnaires were completed by 60 women incarcerated in five prisons in South Africa. The results suggest that various biographical factors may influence a woman's decision to murder her partner. This study adds to the body of knowledge on intimate partner violence in the South African context, and it is hoped that it will lead to early identification programmes of women at risk of killing their intimate male partners.

Gender, Power and Resistance to Change among Two Communities in the Western Cape, South Africa

This study investigates how women and men in the Western Cape, South Africa, construct their gender identities and roles. As part of the development of an HIV prevention intervention for men, key informant interviews and focus group discussions were conducted. Several themes regarding the construction of gender were identified. First, participants reported that traditional gender relations of male dominance and female subservience were still in evidence, along with traditional gender roles that mandated a division of labour between the household and paid workforce. Second, participants reported a shift in gender roles and relations in the direction of increased power for women. Last, hostile resistance to changes in gender power relations was evident in the discussions. Redefining masculinity and femininity and shifting gender relations in the direction of `power with' instead of `power over' is perhaps a necessary prelude to lasting social change and curbing the HIV epidemic in South Africa.

Social constructions of gender roles, gender-based violence and HIV/AIDS in two communities of the Western Cape, South Africa

The links between gender roles, gender-based violence and HIV/AIDS risk are complex and culturally specific. In this qualitative study we investigated how women and men in two black communities in the Western Cape, South Africa, constructed their gender identities and roles, how they understood gender-based violence, and what they believed about the links between gender relations and HIV risk. First we conducted 16 key informant interviews with members of relevant stakeholder organisations. Then we held eight focus group discussions with community members in single-sex groups. Key findings included the perception that although traditional gender roles were still very much in evidence, shifts in power between men and women were occurring. Also, gender-based violence was regarded as a major problem throughout communities, and was seen to be fuelled by unemployment, poverty and alcohol abuse. HIV/AIDS was regarded as particularly a problem of African communities, with strong themes of stigma, discrimination, and especially 'othering' evident. Developing effective HIV/AIDS interventions in these communities will require tackling the overlapping as well as divergent constructions of gender, gender violence and HIV which emerged in the study.

Mothers, daughters and sexual agency in one low-income South African community

Statistics indicate that sexual health problems like HIV/AIDS and teenage pregnancies are prevalent among young South African low-income women. To improve the effectiveness of preventative programmes for adolescents it is important to focus on adolescents' own understanding and experience of their sexual behaviour within the contexts in which it occurs. Female adolescents' experiences of their own sexuality are shaped by a range of contexts: from the very specific context of their intimate relationships to the broader contexts of gender, ethnicity and social class. It is therefore imperative to adopt a research approach that stratifies groups and develops interventions that are based on the needs, interests, sexual beliefs and behaviours of specific communities rather than developing general educational messages. The current paper is part of a larger study exploring female adolescent sexuality in a South African low-income rural coloured community. Twenty-five adolescent coloured women aged 14-18 years were interviewed about how they viewed their sexuality. The grounded theory analysis indicated that the participants demonstrated a limited sense of sexual agency in these constructions of their sexuality. The mothers of these young women were powerful agents in the young womens' constructions of their own sexuality and they unintentionally contributed to their daughters' limited sense of sexual agency. Mothers presented sex as a dangerous activity to their daughters. This discourse of sex as danger contributed towards a mutual understanding that sex should not be talked about. Daughters' deception of their mothers about their sexual activity maintained mother-daughter connections, but left them without an interactional space where they could talk freely to their mothers about sexuality.

Woman Abuse: The Construction of Gender in Women and Men's Narratives of Violence

Violence against women is a widespread social problem affecting millions of women. For more than three decades, researchers have explored the experiences of women in abusive relationships. Victims' accounts have been the main focus, often deflecting attention away from men who are most frequently the perpetrators. Consequently, woman abuse has come to be regarded as a ‘woman's problem’ – blaming women and rendering them responsible for change. The literature on perpetrators and victims of violence seems to be developing independently of each other and commonly provide one-sided accounts (mostly from victims and less often from perpetrators). This article reports on an ongoing research project that aims to explore how both partners in a violent heterosexual relationship understand and attach meanings to their experiences. In-depth interviews were conducted with five couples. An analysis of the narratives revealed that women and men's understandings of violence are both similar and different. They construct particular forms of gendered identities, which are sometimes contradictory and ambiguous. In their talk about violence and relationships, they ‘perform’ gender and enact hegemonic constructions of femininity and masculinity. The analysis also shows that women's and men's talk about violence is linked to broader socio-cultural mechanisms that construct woman abuse as a serious social problem in South Africa.

Reflections on the Sexual Agency of Young Women in a Low-Income Rural South African Community

Reproductive health issues are pertinent in the mental health development of young women in South Africa, especially young women in low-income communities. The prevalence of problems such as HIV/AIDS and unplanned or unwanted pregnancies among South African female adolescents specifically warrants urgent attention. It is argued that inadequate theoretical frameworks and inadequate data on sexuality in different South African communities hamper effective preventative interventions in the female reproductive health arena. This article reports and discusses some of the findings of a larger study exploring female adolescent sexuality in one specific low-income South African community. Twenty-five adolescent women from low-income, ‘coloured’1 households in the Western Cape were interviewed about their first experiences of sexual intercourse. It was found that the participants demonstrated limited sexual agency in their first experiences of sexual intercourse. The authors conclude that a new discourse of female sexual agency may be needed.

The Effectiveness of the Vignette Methodology: A Comparison of Written and Video Vignettes in Eliciting Responses about Date Rape

Most research addressing issues of victimization, such as date rape, has made use of written vignettes. In this study we investigated whether the same patterns of blame attribution are given for written and video vignettes. Three videos depicting hypothetical heterosexual date rape incidents were made. Each one was based on one of three variables that have been shown to have relevance to evaluations of date rape: “owing”, “leading on” and “alcohol”. The videos were transcribed into written vignettes. Participants were randomly assigned to one of six experimental groups, watched one of the videos or read one of the vignettes, and completed a questionnaire to assess attribution of blame and the degree to which the situation was defined as rape. The two methodologies differed significantly for the alcohol scenario, where participants blamed the victim more and were less likely to define the situation as rape when the written vignette methodology was used. The implications of these findings are discussed with reference to further research and education in the field of date rape.