Masculinities, alcohol consumption, and sexual risk behavior among male tavern attendees: A qualitative study in North West Province, South Africa.

Rich, Eileen; Nkosi, Sebenzile; Morojele, Neo K.

doi:10.1037/a0038871

Cited by 26 publications

(17 citation statements)

References 55 publications

(92 reference statements)

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“…Indeed, complex relationships appear to exist between alcohol and sex. For example, while some individuals use alcohol to pay for sexual intercourse [ 15 – 17 ] or to do gender in sexual contexts [ 18 ], others use drunkenness as a ready-made excuse to engage in unplanned sexual activities [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Gendered sexual uses of alcohol and associated risks: a qualitative study of Nigerian University students

Dumbili

2016

BMC Public Health

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BackgroundAlcohol misuse among young people is a global phenomenon. In many countries, young people engage in heavy drinking and this exacerbates risky sexual behaviour. In Nigeria, alcohol held multiple roles in the traditional era but was mainly consumed by adult males for pleasure. Adult females and young people were culturally constrained from drinking in most communities. In contemporary Nigeria, young people’s drinking is increasing, and many engage in sexual intercourse under the influence of alcohol.MethodsThis study draws on the traditional gender and social sexual scripts to explore the factors that motivate young people to use alcohol for sexual purposes. In-depth interviews were conducted with 19 to 23-year old male and female undergraduate students from a Nigerian university. Thematic analysis was conducted with the aid of NVivo 10 software.ResultsMen drink to become confident to initiate sexual relationships, stimulate sexual urges, prolong erection, increase sexual satisfaction and become more aggressive during sexual intercourse. Women also drink to be bold in initiating sexual relationships, for sexual arousal and to increase satisfaction. Relatedly, not every brand of alcohol is used for sexual purposes. For example, while men use ‘herbal’ alcoholic beverages and a mixture of locally-produced gin and marijuana, women use champagne and other flavoured alcoholic beverages. The results also revealed that young people use alcohol or salt in a bid to prevent conception after sexual intercourse.ConclusionsAdherence to the traditional gender (masculinity) and social sexual scripts amongst men and the enactment of what appears to be a new form of femininity script amongst women contribute to a culturally specific understanding of the motivations to use alcohol for sexual purposes. Evidence-based strategies should be employed to distribute information about the consequences of sexual intercourse under the influence of alcohol.

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Section: Introductionmentioning

confidence: 99%

Gendered sexual uses of alcohol and associated risks: a qualitative study of Nigerian University students

Dumbili

2016

BMC Public Health

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“…Our findings chime with those from Zimbabwe (Skovdal et al, 2011) and Uganda (Mburu et al, 2014) where participants also noted how their male relative did not want to accept the patient-persona, deliberately ignoring instructions received by the health worker, and instead turned to harmful behaviours, such as drinking alcohol, as a way perhaps to ‘normalise’ or ‘end’ life. A number of studies in sub-Saharan Africa have highlighted how alcohol use is linked to men’s concern about demonstrating masculinity (Brown, Sorrell, & Raffaelli, 2005), and the implications of this for HIV-related behaviour (Nkosi, Rich, Kekwaletswe, & Morojele, 2016; Rich, Nkosi, & Morojele, 2015; Woolf-King & Maisto, 2011). This study supports the ample literature that highlights how masculine norms come to shape men’s engagement with HIV risk, prevention methods and treatment services.…”

Section: Discussionmentioning

confidence: 99%

The rebellious man: Next-of-kin accounts of the death of a male relative on antiretroviral therapy in sub-Saharan Africa

Skovdal

Ssekubugu

Nyamukapa

et al. 2019

Global Public Health

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The HIV response is hampered by many obstacles to progression along the HIV care cascade, with men, in particular, experiencing different forms of disruption. One group of men, whose stories remain untold, are those who have succumbed to HIV-related illness. In this paper, we explore how next-of-kin account for the death of a male relative. We conducted 26 qualitative after-death interviews with family members of male PLHIV who had recently died from HIV in health and demographic surveillance sites in Malawi, Tanzania, Kenya, Uganda, Zimbabwe and South Africa. The next-of-kin expressed frustration about the defiance of their male relative to disclose his HIV status and ask for support, and attributed this to shame, fear and a lack of self-acceptance of HIV diagnosis. Next-of-kin painted a picture of their male relative as rebellious. Some claimed that their deceased relative deliberately ignored instructions received by the health worker. Others described their male relatives as unable to maintain caring relationships that would avail day-to-day treatment partners, and give purpose to their lives. Through these accounts, next-of-kin vocalised the perceived rebellious behaviour of these men, and in the process of doing so neutralised their responsibility for the premature death of their relative.

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“…The hazardous drinking that occurs in alcohol-serving venues may increase women’s vulnerability to sexual objectification, and female venue patrons may experience stigma because alcohol-serving venues are traditionally seen as “masculine establishments” (24,36,37). Women who choose to attend venues may be different from the broader population of women in South Africa with regard to their alcohol use, sexual risk behaviors, and their social support outside of the venues.…”

Section: Discussionmentioning

confidence: 99%

“…Venue-specific social support was not shown to reduce HIV-related sexual risk behaviors among men in this setting. Because venues are traditionally male-dominated spaces, support from other venue patrons may instead promote traditional gender norms around masculinity (36,37). Prior research conducted in South Africa has demonstrated that inequitable gender attitudes are associated with risky sexual behaviors as a mechanism for men to exert dominance and control over women (41,42,43).…”

Section: Discussionmentioning

confidence: 99%

“…Prior research conducted in South Africa has demonstrated that inequitable gender attitudes are associated with risky sexual behaviors as a mechanism for men to exert dominance and control over women (41,42,43). Male venue patrons may encourage one another to have multiple sex partners and purchase alcohol for female patrons in exchange for sex (19,36,37). Masculinity and venue attendance is also more likely to be associated with hazardous and harmful alcohol use among men, which can lead to high-risk sexual behaviors; venue-specific social support may be insubstantial in mitigating this association between alcohol use and sexual risk (12).…”

Section: Discussionmentioning

confidence: 99%

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HIV-Risk Behaviors and Social Support Among Men and Women Attending Alcohol-Serving Venues in South Africa: Implications for HIV Prevention

et al. 2017

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Background Alcohol use is associated with increased HIV-risk behaviors, including unprotected sex and number of sex partners. Alcohol-serving venues can be places to engage in HIV-related sexual risk behaviors, but are also important sites of social support for patrons, which may mitigate risks. We sought to examine the relationship between alcohol-serving venue attendance, social support, and HIV-related sexual risk behavior, by gender, in South Africa. Methods Adult patrons (n=496) were recruited from six alcohol-serving venues and completed surveys assessing frequency of venue attendance, venue-based social support, and recent sexual behaviors. Generalized estimating equations tested associations between daily venue attendance, social support, and sexual behaviors, separately by gender. Interaction effects between daily attendance and social support were assessed. Models were adjusted for venue, age, education, and ethnicity. Results Daily attendance at venues was similar across genders and was associated with HIV-related risk behaviors, but the strength and direction of associations differed by gender. Among women, daily attendance was associated with greater number of partners and higher proportion of unprotected sex. Social support was a significant moderator, with more support decreasing the strength of the relationship between attendance and risk. Among men, daily attendance was associated with a lower proportion of unprotected sex; no interaction effects were found for attendance and social support. Discussion Frequent venue attendance is associated with additional HIV-related risks for women, but this risk is mitigated by social support in venues. These results were not seen for men. Successful HIV interventions in alcohol-serving venues should address the gendered context of social support and sexual risk behavior.

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Masculinities, alcohol consumption, and sexual risk behavior among male tavern attendees: A qualitative study in North West Province, South Africa.

Cited by 26 publications

References 55 publications

Gendered sexual uses of alcohol and associated risks: a qualitative study of Nigerian University students

Gendered sexual uses of alcohol and associated risks: a qualitative study of Nigerian University students

The rebellious man: Next-of-kin accounts of the death of a male relative on antiretroviral therapy in sub-Saharan Africa

HIV-Risk Behaviors and Social Support Among Men and Women Attending Alcohol-Serving Venues in South Africa: Implications for HIV Prevention

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