Intimate partner violence among rural South African men: alcohol use, sexual decision-making, and partner communication

Abstract

Nearly one-third of South African men report enacting intimate partner violence (IPV). Beyond direct health consequences for women, IPV is also linked to varied risk behaviours among men who enact it, including alcohol abuse, risky sex, and poor health care uptake. Little is known about how to reduce IPV perpetration among men. We conducted retrospective, in-depth interviews with men (n=53) who participated in a rural South African program that targeted masculinities, HIV risk, and IPV. We conducted computer-assisted thematic qualitative coding alongside a simple rubric to understand how the program may lead to changes in IPV perpetration. Many men described new patterns of reduced alcohol intake and improved partner communication, allowing them to respond in ways that did not lead to the escalation of violence. Sexual decision-making changed via reduced sexual entitlement and increased mutuality about whether to have sex. Men articulated the intertwined nature of each of these topics, suggesting a syndemic lens may be useful for understanding IPV. These data suggest that alcohol and sexual relationship skills may be useful levers for future IPV programming, and that IPV may be a tractable issue as men learn new skills for enacting masculinities in their household and in intimate relationships.

Exploring opportunities for coordinated responses to intimate partner violence and child maltreatment in low and middle income countries: a scoping review

“…Two of the studies were based in South Africa, two in Uganda, one in Liberia and one in Thailand. Of the six studies, two described programmes that were designed to address IPV and CM jointly (Ashburn, Kerner, Ojamuge, & Lundgren, 2016;Hatcher, Colvin, Ndlovu, & Dworkin, 2014;Van den Berg et al, 2013); one was designed to address IPV, but reported unintended outcomes for CM (Abramsky et al, 2014(Abramsky et al, , 2016Kyegombe et al, 2015); and three were designed to address CM, but reported unintended outcomes for IPV (Cluver, Lachman et al, 2016;Cluver, Meinck et al, 2016;Sim, Annan, Puffer, Salhi, & Betancourt, 2014). Table 1 presents four studies which used a randomised controlled trial with a nested qualitative component: REAL Fathers in Uganda (Ashburn et al, 2015); SASA!…”

“…Although the two fatherhood programmes in this review included components that address traditional gender norms in relation to caregiving, female caregiver involvement was minimal or absent (Ashburn et al, 2015;Hatcher et al, 2014;Van den Berg et al, 2013). There is growing recognition that fatherhood programmes need to work alongside efforts to support and protect women and children exposed to family violence.…”

“…Some evaluations relied on men's reports of IPV with no corroborating evidence from women (Ashburn et al, 2015;Hatcher et al, 2014;Van den Berg et al, 2013). Similarly, reports of changes in relation to harsh and abusive parenting practices were based on caregiver accounts (Ashburn et al, 2015;Kyegombe et al, 2015; and only two studies included follow-up interviews with children (Cluver, Lachman et al, 2016;Cluver, Meinck et al, 2016;Sim, Annan, et al, 2014).…”

“…One of the key themes identified focused on a shift in parenting style from disciplinary and authoritarian, to a more caring and nurturing role, with men reporting less use of violence and corporal punishment and improved communication with their children. Hatcher et al (2014) also conducted interviews with 53 men within six months of completing the programme. Three key themes were identified which included reduced alcohol intake which was linked to shifting ideals of manhood; improved communication with more equal and shared decision-making between men and their partners; and shifting views around sexual entitlement and more shared sexual decision-making.…”

Men’s moralising discourses on gender and HIV risk in rural KwaZulu-Natal, South Africa

“…While we found that men were using moralising discourses and surveillance strategies to monitor women's behaviour and assess their relative risk of infection, over the course of the intervention we found that they increasingly expressed awareness of the need to reduce their own sexually risky practices and were more likely to report discussing the need for both partners to test for HIV (see also Hatcher et al 2014). This is consistent with the quantitative data from the same project reported by Coates et al (2014) and the qualitative findings reported by Maman et al (2014), which show increased rates of HIV testing over time.…”