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Gender dynamics in the primary sexual relationships of
young rural South African women and men
LUCIA F. O’SULLIVAN
1
, ABIGAIL HARRISON
2
, ROBERT MORRELL
3
,
ALIZA MONROE-WISE
4
& MURIEL KUBEKA
5
1
Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA,
2
Department of Medicine, Division of Infectious Diseases and Population Studies and Training Center,
Brown University, RI, USA,
3
School of Education, University of KwaZulu-Natal, Durban, South
Africa,
4
Johns Hopkins School of Public Health, MD, USA, and
5
Medical Research Council, Durban,
South Africa
Abstract
A substantial body of South African research describes the importance of gender dynamics within
sexual relationships as factors underlying HIV risk, yet we know little about these factors among
young adults—a group at exceptionally high risk of infection. Our primary objective was to explore the
ways that young adult men and women interpret and enact gender roles within their established
primary partnerships, and how these dynamics influence sexual behaviour in relation to HIV risk. We
employed script theory to frame our analysis of the dynamics of gender. Fifty students (25 women, 25
men) at secondary schools in a rural district of KwaZulu/Natal, South Africa completed in-depth
interviews about sexual interactions with their primary partner. While many participants indicated
that the standards of sexual conduct within relationships reflect dominant gender role norms, our
findings indicate that there are important variations in these roles with some male and female
respondents accepting and reinforcing the rights of women to determine the nature of sexual
interactions. Efforts aimed at improving acceptance and adoption of alternative scripts for women and
men may help to broaden young people’s repertoire of HIV prevention options.
Keywords: Gender, sexual behaviour, relationships, South Africa, young adults
Introduction
South Africa faces a severe HIV epidemic with over 5 million South Africans currently
infected (UNAIDS 2004). A recent national survey indicates that 10.2% of the 15–24 year
age group are infected, and that there is considerable gender disparity in rates. Among
young adults aged 20–24, 24.5% of women are infected compared to 7.6% of men (Pettifor
et al. 2004). The epidemic has spread rapidly, with the steep rise in prevalence over a
10-year period reflected in levels of infection among women tested at antenatal clinics. In
Correspondence: Lucia F. O’Sullivan, Department of Family & Social Medicine, Albert Einstein College of Medicine, 1300
Morris Park Avenue, Mazer 100, Bronx, NY10461, USA. Email: losulliv@aecom.yu.edu
Culture, Health & Sexuality, March–April 2006; 8(2): 99–113
ISSN 1369-1058 print/ISSN 1464-5351 online # 2006 Taylor & Francis
DOI: 10.1080/13691050600665048
1994, 7.6% of pregnant women were infected nationally compared to 26.5% in 2003
(Department of Health 2005). The eastern province of KwaZulu/Natal has continuously
experienced the highest prevalence (Department of Health 2005), with over one-third of
pregnant women now infected.
Despite the high HIV prevalence reported from large-scale surveys among young people
within the age range of 15–24 years (Pettifor et al. 2004), research examining risk factors
and subsequent prevention efforts has focused on adolescents (13–18 years) in particular.
Comparatively little research attention has been directed toward young adults (18–24
years), despite the highest prevalence rates among this group, especially young adult
women (Department of Health 2005).
The vulnerability of young adult women is heightened by the gendered nature of their
roles within heterosexual relationships. Women’s relative disempowerment with regard to
men is a critical factor influencing women’s greater risk of infection—placing gender issues
at the centre of the HIV prevention challenge (Amaro 1995). We use the term gender here
to refer to the social construction of roles, responsibilities, and obligations associated with
being a woman or a man (Gagnon and Parker 1995). Gender roles are culturally defined
sets of behaviour that differentiate maleness and femaleness (Gibbons et al. 1997), and are
incorporated into ‘scripts’, which are culturally stereotyped, sequential interactions
between two people who are responding to each other’s cues and actions (Abelson
1981). Scripts characterize the ways in which gender, sexuality, and relationships are
negotiated at the three interrelated levels of mutually shared conventions: the cultural,
interpersonal, and individual levels.
Script theory (Simon and Gagnon 1984, 1987, Gagnon 1990) provides a useful
framework for analysing the cultural construction of gender roles. One dominant form that
cuts across the three levels is referred to as the ‘traditional sexual script’ in most work in the
area. In script theory, the ‘traditional’ script proscribes men as the initiators and aggressors
in sexual interactions, pursuing all sexual opportunities with women that arise. Girls and
women, on the other hand, are expected to adopt the role of ‘gatekeepers’, that is,
socialized to be passive sexually and to accept or refuse men’s sexual advances (Byers 1996,
Seal and Ehrhardt 1999). In support of this script, research has documented fairly universal
double standards endorsing greater sexual freedom for men and rights of sexual expression,
assertion, and determination for men as compared to women (Gupta and Weiss 1993,
Amaro 1995).
Script theory has been re-examined recently in light of more theoretical approaches to the
organization of gender and gender role norms. The work of Connell (2000) and others
(Brown et al. 2005, Hunter 2005, Morrell 2001) has emphasized the socially constructed,
fluid and contested nature of gender norms as a way of addressing the critique of universalism
and essentialism present in some gender theories. While it is possible, therefore, to suggest
that a ‘traditional’ sexual script involves men initiating sexual interactions with women, and
women acquiescing to their male partners’ sexual needs (Byers 1996), it is important to note
that such generalizations need to be understood as being contingent on local gender
paradigms and sociocultural contexts. It is quite possible, for example, that such a script is
challenged, defied, improvised or replaced altogether with new scripts.
Perhaps most importantly, the concept of a ‘traditional’ script is problematic in South
Africa, as well as sub-Saharan contexts more broadly, where conservative social more´s are a
product of contemporary social change as well as historical beliefs and practices. Observers
of the historical context note that gender roles have become more, rather than less,
restrictive over time (Marks 2002). Historically, such trends have occurred in response to
100 L. F. O’Sullivan et al.
mission Christianity and the simultaneous introduction of Victorian-era social norms,
which often frowned upon indigenous practices related to sexuality (Gaitskell 1981, Hunter
2005, Marks 2002). The development of a racialized labour system involving migrant mine
labour had a notable impact on African men. African men were held in subordinate social
positions and subjected to systemic violence, which in turn was reflected in their relations
with other men and women (Moodie 1994, Morrell 1998). Rapid social changes in the
post-apartheid era including legislative, policy, socio-economic changes and the maturing
HIV epidemic (Hunter 2004) have produced a conservative backlash that has strong
implications for the interpretation and enactment of gender roles (Leclerc-Madlala 2001,
Scorgie, 2002). While in many respects the world has opened up for young South Africans
over the last decade, particularly for those in urban areas, strong societal reactions against
these changes are evident. These reactions are most pronounced in rural locations (Walker
and Reid 2005).
In South Africa, the ways in which gender inequalities operate at a societal level to
reinforce prevailing power structures have been well described (Strebel 1996, Wood et al.
1998, Susser and Stein, 2000, Campbell and MacPhail 2002). Young South African
women face significant sociocultural restrictions in the arena of sexuality (Lambert and
Wood 2005), with an emphasis on maintaining modest behaviour, protecting their
virginity, and avoiding sexual relations until involved in a regular partnership (Wood et al.
1998, Leclerc-Madlala 2001, Harrison 2002, Scorgie 2002). Young women’s vulnerability
to HIV infection in the face of these gender dynamics is compounded often by having older
partners, being sexually inexperienced, and having few sources of social support or
guidance (Wood et al. 1998, Harrison et al. 2001a, b, Jewkes et al. 2002). These gender
dynamics influence women’s risk for HIV in a number of important ways (Strebel 1996,
Susser and Stein 2000, 2004). Women are more often disadvantaged with regard to
decision-making within relationships (Varga 2003), with less power to negotiate the timing
of sex (Varga 1997) and condom use (MacPhail and Campbell 2001), or to dictate the
terms of relationships (Strebel 1996). A growing literature has described aspects of
gendered power relations within young people’s relationships, demonstrating the over-
whelming degree to which gender and power affect relationship dynamics (Varga 1997,
MacPhail and Campbell 2001, Varga 2003), especially the use of sexual coercion (Varga
and Makubalo 1996, Wood et al. 1998, Campbell and MacPhail 2001, Jewkes et al. 2001).
Young South African men are not discouraged from demonstrating their virility through
sexual experimentation and pursuit of multiple partners (Hunter 2005, Morrell 2001), and
considerable emphasis is placed on men being firmly in control of sexual interactions with
women (Wood and Jewkes 2001). Expectations of men as being ever-ready, ever-ardent,
and interested in sexual access to any woman as opportunities arise imply that they would
be unlikely to refuse a woman’s initiation of sexual activity, even unsafe sexual activity, an
important implication in studies of vulnerability to HIV infection. Even so, it is clear that
not all boys assert their masculinity at the expense of girls. New configurations of
masculinity amongst young African men suggest the emergence of male gender roles that
are more tolerant and respectful of women (Morrell 2003, Sideris 2004). Women are
agents, not simply passive victims, in their lives, and deviations from accepted gender role
norms do occur (Hunter 2002, Selikow et al. 2002). Missing from the literature is a more
nuanced understanding of how gender roles are negotiated in intimate contexts and how
such negotiation influences sexual risk interactions between women and men (Jewkes et al.
2003). The primary objective guiding our research was to explore the ways in which the
dynamics of gender roles and the enactment of those roles within relationships are
Gender dynamics in sexual relationships 101
important in terms of participation in sexual behaviours related to HIV risk. Using
qualitative methods, our research explored the extent to which ‘traditional’ and alternative
scripts characterize the heterosexual relationships of young adults in rural South Africa—a
context of a severe HIV epidemic and rapid societal change.
Method
Participants
The sample comprised 50 students at a high school in a rural district of KwaZulu/Natal,
South Africa. Half were men and half were women. Participants were recruited by
announcements and distribution of fliers in classrooms. Those between 18 and 24 years
and currently sexually active in a primary heterosexual relationship were eligible. The mean
age of the participants was 19.2 years. Almost all (93.7%) had been born in nearby towns.
Most were currently full-time students (97.9%). They typically reported household
monthly incomes of R1000–R4999 (64.6%) or less than R1000 (22.9%), indicating that
they were living in impoverished circumstances for South African residents.
Data were collected at two secondary schools within the Hlabisa District, a rural area in
northern KwaZulu/Natal. This district has a population of approximately 220,000 and is at
the centre of the HIV epidemic. KwaZulu/Natal is South Africa’s most populous province,
and contains one-fifth of the country’s population. Africans, primarily Zulu-speaking,
comprise 76% of the population. In South Africa, education tends to be prolonged for
many young people, with typical age distributions within secondary schools ranging from
age 12–25, particularly in rural regions. Approximately 20% still attend school past age 18.
The wide age distribution is a result of high failure rates, frequent migration, and
intermittent attendance due to lack of funds or the need to earn money in support of
extended family members, and frequent migration (Stewart and Harrison 2000).
Training and assessment
Interviewers were Zulu-speaking women who had experience conducting research with
populations of young people as well as experience with sexuality-related interviews. All
interviewers received additional interviewer training. The interviewer read a consent form
to the participants, which explained the purpose of the study, confidentiality procedures,
and their rights as research participants. During the interview, participants provided
demographic information and completed a measure assessing their sexual histories. To help
ensure that participants recalled actual interactions that they had with their primary partner
rather than generalizations or presumptions about these interactions, they were asked first
to monitor their sexual interactions using a structured one-page diary designed for this
purpose over a 3-week period preceding their interview. Those data are a focus of another
set of analyses and are presented elsewhere (see Hoffman et al. 2006). Participants’
descriptions of their experiences during this period were the focus of the in-depth
interviews, and those data are presented here.
In-depth interviews
After the 3 week period, participants completed in-depth interviews designed to explore a
number of aspects relating to young adults’ sexual interactions. Considerable attention was
given to having participants distinguish in their own words between primary and secondary
102 L. F. O’Sullivan et al.
relationships. The first portion of the interview was designed to outline the timeline of the
participants’ primary relationship and provide general information about how the
relationship developed and functioned on a number of dimensions (e.g., expressions of
intimacy and emotion, decision-making, communication). The second portion asked
participants to reconstruct the interactions that occurred within specific sexual encounters,
including the initiation of sexual activity and expression of power in sexual interactions.
The third portion asked participants to describe the gender scripts that they had learned
growing up and those that they believed were active in their current relationship. The
fourth portion explored participants’ broader views of power dynamics in their relationship.
Thus, gender roles in relation to scripts guiding sexual interactions, not necessarily HIV
risk-related interactions, were the focus of these analyses.
Data analysis
All interviews were conducted in isiZulu, audiotaped and then translated and transcribed
into English using standard procedures of translation and proofing. A structured coding
scheme was developed within each of the major domains of inquiry (Berg 1998). The data
analytic approach involved initially examining study transcripts to identify primary coding
categories as well as a range of themes present within each category. Coding categories and
themes were then organized into a formal codebook, and illustrative quotes relevant to
these themes were extracted from the interview transcripts. Next, transcripts were formally
content coded. New themes, which did not appear to fit into the original code book were
discussed by the coding team and modifications were made when deemed appropriate.
When suggested by associations, overlap, or diversions in the data, thematic categories were
refined, merged, or subdivided. Decision trails were noted and documented to assure that
interpretations were supported by the data (Sandelowski 1986, Hall and Stevens 1991).
Coded data are summarized here in several ways. First, individual data patterns are
described to obtain a general understanding of the range of participants’ experiences and
perspectives. Next, differences and similarities between genders are explored. In addition,
our data are summarized in terms of concordance and discordance from traditional gender
scripts for sexual interactions at the individual and relationship levels.
The results are organized so that they summarize participants’ relationships and sexual
histories then the analyses corresponding to four primary dimensions of sexual interactions.
These dimensions are (1) initiating sexual encounters; (2) responding to a partner’s
initiation of sexual contact or expressing reluctance; (3) use of pressure, coercion, or
violence against a partner; and (4) complying with unwanted sexual interactions. Relevant
quotes from the interviews are included to further elucidate the range of perspectives
offered for each dimension.
Results
Relationship and sexual histories
Most participants (94%) reported being in a steady relationship. All were unmarried.
Although the current data explore their primary sexual relationships, participants reported
an average of two current sexual partners (range 1–4). More men (84%) than women
(48%) reported having concurrent sexual relationships. Secondary partnerships are
examined in a separate analysis. Women reported primary relationships that were longer
in duration (mean53.9 years; SD51.5) compared to men (mean52.1 years; SD51.0),
Gender dynamics in sexual relationships 103
F(1, 46)524.75, p,.001; however, for both women and men, these numbers reflect
relatively long-term relationships. Sex occurred in these relationships on an average of 7.4
times (range 1–15) over the preceding 2 months, with women reporting a greater number
of sexual encounters (mean58.36; SD52.9) compared to men (mean56.7; SD52.8), F(1,
46)533.18, p,.05. Somewhat less than two-thirds (64%) reported consistent condom use
on occasions involving sexual intercourse.
Initiating sexual encounters with a partner
Although we recruited both men and women at the same site and used identical eligibility
criteria, they were not recruited on the basis of being in relationships with each other. Thus,
women may have described different relationships from those described by men. Even so,
according to both women and men, men initiated most of the sexual interactions that
occurred in their relationships. Both men and women often explained this by referring to
differences in the physical needs of men and women, as well as to gendered beliefs in
appropriate roles for men and women. Some men implied that regular sex was essential for
their healthy functioning: ‘To grow up without having sex is not good … I cannot live
without a girlfriend’. Other participants said, ‘He is the person who becomes sexually
aroused first’, or that men were generally more interested in sex compared to women (e.g.,
men’s blood is ‘hot’). Still other men expressed beliefs that they would suffer personally and
socially without a girlfriend. Male peers were frequent referents in this respect: ‘I think the
other boys will laugh at me if I don’t have a girlfriend’.
More commonly, participants referred to social roles, describing how it is the man’s
‘duty’ to initiate sex with their girlfriends and an essential aspect of being a man. For
instance, one man explained that he always initiated, ‘…Because I want to show her that
there is nothing I don’t know about sex’. One man felt it was important that he initiate
‘Because if I break up with her, I don’t want [her] to go everywhere telling people that she
told me many things about sex’. Such interactions mainly supported the assumptions of the
‘traditional’ sexual script, which reinforced an expectation that men must lead women in
sexual encounters. Women’s expected role is to be acquiescent; their interest in sex is
subsequently less relevant.
Despite dominant support for the ‘traditional’ sexual script, many young men and
women endorsed the view that it was acceptable and appropriate for women to lead in their
sexual encounters with boyfriends on occasion. Indeed, many women did initiate a number
of sexual interactions in their relationships. One man said, ‘Most of the time we are
together, if she wants to initiate sex, she must feel free to do that. She mustn’t be afraid’.
Other men, too, felt that social prohibitions restraining women’s interest were wrong: ‘I can
say females are shy when it comes to sex. They see it is not good for them to tell the man
that they want sex. It’s like if you say so, they think you’ll say she is a person who is not
behaving. But it’s not like that’. When asked to elaborate how they would like it to be, these
men often emphasized that they would like their female partners to feel confident
expressing their sexual interests and needs and that the burden of initiating should be
shared rather than be men’s burden alone. However, most men also acknowledged that,
while it might be ideal for their girlfriends to initiate, in practice, men initiated more
frequently than their female partners and women were reluctant to assume this proactive
role. Some men found this appropriate, whereas others wished that their girlfriends would
take a more assertive role. Contradictions were inherent in many of the accounts provided
by the men, suggesting ambivalence in their experiences or in their comfort expressing
these views.
104 L. F. O’Sullivan et al.
A few women said that initiating sex showed that they loved their partner, but this was
not a common theme. Most women indicated that they initiated simply because ‘they
wanted sex’. Among our sample of young adults, the view that women should ‘feel free’ to
express their sexual interests was common among both men and women. This pattern
indicates that traditional standards dictating that men always control the onset of sex are
not governing all encounters. Many women emphasized that they were able to
communicate desire to their partners: ‘It’s important because if I want to have sex now,
I need to tell him, not just to simply shut my mouth and not talk to him and he asks what’s
wrong with me now and I tell him there is nothing wrong’. Implied in this statement, and
others like it, is a view that denying oneself the right to communicate openly one’s wishes or
needs ultimately strains the relationship.
To initiate sex, women typically chose to use subtle or indirect means, relying more on
paralanguage than language itself. For example, one woman said, ‘I only look into his eyes
and he will see that I want to have sex, he is going to see that there is something that I want
from him’. Other strategies were more symbolic, such as showing up at a boyfriend’s house
to signal their sexual interest. Other women used more direct, although still nonverbal
means: ‘Sometimes he wants to have sex, but I don’t, so he must first see whether I like to
have sex with him or not. And if it’s that I would like to have sex with him, I have my ways,
my styles where I touch him and then we can have sex’. Other approaches were far from
subtle. For example, one woman said, ‘I kiss him, I stroke him, and I know that if I touch
his penis right here in the front, I know that it will stand erect. Then, he will end up doing
what I want him to do’. Others have argued that communication about sex between women
and men is almost always indirect, and direct or directive communication that indicates one
has sexual experience is often avoided (Lambert and Wood 2005).
Thus, young women and men may still be largely conforming to ‘traditional’ gender
scripts regarding men’s initiation of sexual activity, but this standard was not universally
upheld. Some men were clear that their regular partners should be able to communicate
their desires and act on them, although they did not always endorse this in practice.
Regardless of occasional inconsistencies, the idea that women could and should initiate sex
within a relationship was a prominent minority view. Women were generally clear about
their need to act upon their own desires, although this was not always achieved. Overall,
these findings indicate that there are important variations in young men’s and women’s
perceptions of appropriate gender roles in the context of established partnerships.
Responding to a partner’s initiation of sexual activity
Another gender role component of the ‘traditional’ sexual script for heterosexual
encounters is the role of responder (or ‘gatekeeper’). A question arises in analysing the
endorsement and expression of the traditional sexual script, which is whether women and
men are both able to accept or reject a partner’s sexual advance. This type of
communication represents a key prevention strategy in situations in which an individual
can not insist on condom use (Harrison 2002). The ‘traditional’ sexual script posits that
men are expected to exploit any sexual opportunities that arise with women, refusing none,
whereas women are expected to be reluctant or indifferent to sex, acquiescing only in
response to a partner’s pressure.
Both male and female participants described the importance of expressing sexual interest
to their partner whenever they wanted. One woman reported, ‘It happens that both of us
we see that we cannot resist if we want sex so everyone is free to say if she or he wants sex’.
Gender dynamics in sexual relationships 105
A man stressed, ‘In our relationship, there is respect and enjoyment’. A strong emphasis on
sharing, mutuality and trust was apparent in many interviews. When asked to describe how
her current situation fit with her ideal, one woman said, ‘I like it the way it is because it
enables me to be free to say anything to him—I’m also very interested sex’. Only two
women attributed sexual arousal or seeking sexual pleasure as a factor in their sexual
interest.
Another key component of sexual interactions is the freedom to express reluctance to
participate sexually, with those interests respected by one’s partner. Amongst our
participants, women still assumed this restrictor role, but not exclusively so. One woman
said, ‘It doesn’t happen that I have sex with him other than my desire. Also, if he doesn’t
want to have sex with me, maybe he’s tired or sick, he tells me’. According to women
informants, some men continue to try to live up to men’s sexual expectations, performing
even when they are not interested in sex at that time. A woman explained, ‘He was sick, but
we ended up having sex. Like he squeezes me and says all those words and we end up
having sex, but I know that he doesn’t want to’. A man reported engaging in sex reluctantly
on occasion, ‘If I’m home from school and I find that she is at home waiting for me, then we
have sex because there is no reason that I can chase her away if she has come’. For the most
part, however, participants indicated that it was important for men and women to
communicate their lack of interest, problems or concerns.
In line with the ‘traditional’ sexual script, most women reported being able to
communicate a lack of interest directly. There were some exceptions, however. For
example, ‘He can see that I don’t want to have sex, like if he touches me, I just sit and don’t
respond, then he can see that I don’t want to have sex with him and then we can stop
having sex’. This quote illustrates some lingering inhibitions about directly acknowledging
the sexual context of their encounter, and reluctance to be explicit in communicating about
sex, even with an established partner.
Use of pressure, coercion, and violence in sexual interactions
Both women and men reported that men were more likely to control sexual interactions
than were women, indicating that patriarchal expectations surrounding gender roles persist
in this respect. The entitlement of men to sex has often been identified as a factor
contributing to women’s heightened sexual risk (Wood and Jewkes 2001). When women
refuse to engage in sex with a partner, they may be forced into it anyway. In this study,
however, relatively few participants (one man and two women) reported using physical
force against a partner. Four women, but no men, reported experiencing physical force
from a partner. However, various types of coercive behaviours were common, especially
pressure to engage in sexual activity.
Men routinely explained that they did not physically force their partners to engage in sex,
often for fear of severe social repercussions. As one man told his interviewer, ‘Me, I think if
I want to have sex with my partner and if she doesn’t want to, I cannot force her. Instead, I
can look forward’. The interviewer clarified, ‘Look forward? You mean to go to others?’,
‘Yes, to go to others … I learn that from my brother. He says if you force your girlfriend to
have sex with you, then she can sue you and you may end up in prison’. In other areas of
their relationship, men frequently reported using their greater power relative to their female
partners to get what they wanted: ‘As I am a man, I tell my girlfriend I don’t like her to do
things like if I find her walking at night with her other friends. I tell [her] if I find her doing
that, I will hit her’.
106 L. F. O’Sullivan et al.
The finding of relatively few reports of sexual coercion must be treated with caution. It is
notoriously difficult to assess the nature of coercion and violence given the extreme socially
sensitive nature of such questions. High rates of coercion were found in a somewhat
younger sample of youth, whereby their sexual interactions appeared to transpire in an
environment characterized by often extreme, adversarial relations between women and men
(Harrison 2002), as well as in studies of adults (Jewkes et al. 2003, Wood 2005). Almost all
of the women in our study had a story about another woman’s coercion or rape, yet they
rarely reported being victimized themselves. In one extreme case, a woman recalled a girl
being dragged out of her home and publicly gang-raped by four men, each of whom was
allegedly one of her boyfriends, and each was jealous about her involvement with other
men. The woman said she learned from this incident that ‘It is important to behave well
and have [just] one partner’. Further, both women and men commonly emphasized the
value of women ‘behaving themselves’; this was absent in discussions about men. Similarly,
Wood’s (2005) ethnographic work in South Africa describes how group rape (or
‘streamlining’) is often justified as a means men use to correct the behaviour of girls or
women viewed as transgressive or disrespectful to the authority or sexual rights of men.
Complying with unwanted sexual interactions
The vast majority of sexual interactions among the current sample was not characterized by
the use of physical force by men against women and indeed were characterized by a
negotiation and respect for the other person’s desire. Unwanted consensual sexual
interactions are interactions in which one partner has consented in some way to participate
despite not desiring sex (O’Sullivan and Allgeier 1998), these interactions are not
necessarily (but often likely) a result of pressure from a partner or feelings of obligation.
Such scenarios need to be distinguished from coercive sex whereby one partner has not
consented to participate and is forced into the sexual activity. Although both women and
men reported complying with unwanted sex, men reported doing so less frequently, in line
with differences in the rates of initiation by women and men.
When asked to elaborate on these experiences, in many instances women described
feeling compelled to agree to sex with their partner for reasons such as, feeling obliged or
pressured or not daring to refuse. These interactions have direct implications for the study
of HIV risk, especially with regard to feeling unable to refuse risky sexual encounters. For
example, one woman explained that she engaged in sex when she did not want it because,
‘He tells me that we must have sex’, and ‘I end up having sex with him because there is no
way I cannot have sex with him’. In addition, a common explanation from men when asked
if their partner ever had sex with them for reasons other than their desire to do so was the
following, ‘I first ask for sex. If she doesn’t want sex, then I start to plead with her and then
she will end up agreeing. If I’m with my usual partner, she knows that if we are together, we
will have sex’. Other researchers have found that women are usually expected to give
priority to their partners’ sexual needs and demands and to make efforts to please their
partners or else risk losing the relationship altogether (Jewkes et al. 2003).
In some instances, consent was not explicitly provided by women nor was it withheld.
Perhaps of particular importance, it was not clear from these scenarios whether the male
partners understood that the women were reluctant. At times they apparently were aware of
their partners’ reluctance, crossing the line into coercion. For example, one woman said,
‘He saw that I was not in a mood to have sex, but we continued with it’. Even when tired or
sick, women frequently reported complying with their partners’ sexual demands. When
Gender dynamics in sexual relationships 107
asked if they were scared of being physically hurt for refusing, they fairly uniformly
indicated that they were not. In many cases, women expressed views that they simply could
not validly refuse. When asked to elaborate, they often simply replied, ‘I don’t know how I
can tell him that I don’t want to have sex with him’. Both women and men may feel obliged
to engage in sexual activity if they are in a relationship, and especially if the couple shares a
sexual history. In essence, couples develop what may be ‘implicit contracts’ to engage in
sexual activity, whereby they lose the option to refuse sexual access to an established sexual
partner unless they have extremely strong prohibitions at some point. Future research
might address this issue further, uncovering what reasons may be considered valid as
refusals.
Conclusions
The current study explored changes in the gender dynamics that guide or influence the
ways in which young adult women and men interact in heterosexual relationships,
including those involving risk of HIV. To this end, gender roles were considered within the
broader conceptual framework of sexual script theory. There are emergent variations in
dominant gender role paradigms for both men and women within relationships, yet many
contradictions are apparent in the accounts of both men and women regarding the ways in
which the scripts associated with these beliefs are enacted. These contradictions are
incredibly important aspects of the data collected here. They likely reflect such factors as an
ongoing evolution in gender dynamics, inconsistency among those who deviate from
dominant sociocultural standards of behaviour, ambivalence about new developments for
women and men, and possibly, a lack of an integrated conceptualization of what alternative
gender roles might entail. Contradictions within the same interview show how such
variations are contested at the individual level and, therefore, also within relationships as
these issues are discussed and played out.
In the context of the epidemic, it is important to investigate how men and women
negotiate sex, the choice of the form that sex will take, and the ability to refuse to
participate altogether. Some of the men in this study had internalized the ideal of sexual
negotiation, did not insist on perceived rights to sexual access, and wanted women to feel
free to be sexual. Enacting these beliefs, however, was often difficult although our
interviews provided evidence of accommodating and communicative sexual behaviour
amongst many of the male respondents. For their part, some women appear to be
expressive of their desires both in initiating sexual encounters with their partners on
occasion and in the more ‘traditional’ role of responding to a partner’s initiation. Unlike
previous characterizations of the sexual lives of South African young adults (Jewkes et al.
2002), most reports of sexual interactions among the current sample were characterized by
an endorsement of the ideas of negotiation and respect for partners’ interest and desire.
However, sexual encounters continue to be conducted in a context where young men
lack new models of relationship behaviour and ‘traditional’ sexual scripts still endorse male
assertiveness and control and female passivity. Both women and men expressed
considerable ambivalence or hesitancy in discussing the possibility of women’s proactive
role, as noted by others (e.g., Lambert and Wood 2005). Thus, gender roles derived from
accepted social norms remain dominant for most of the young people in the sample and
within most of their sexual encounters. One way in which this was clear was the frequency
with which women reported engaging in unwanted sexual interactions. Whether encounters
are always consensual and truly desired by both partners is questionable of course. Models
108 L. F. O’Sullivan et al.
of sexual negotiation and activity are often idealized, positing that both partners desire
sexual communion strongly and simultaneously, express their desires equally clearly, and
experience similar levels of sexual satisfaction. Though the ideal is unlikely to be realized
for either men or women, the model of mutual gratification and consent suggests an
important deviation from the expectation of ‘traditional’ script theory.
Age is also a critical factor in understanding variations in scripts endorsed by young
people. Work with younger girls indicates that scripts designating men as the sexual
initiators and aggressors still characterize most sexual encounters between women and men
(Varga 1997, Jewkes et al. 2002, Harrison 2002, Jewkes et al. 2003), with younger women
less experienced, and, therefore, less assertive within relationships (Harrison 2001b). The
current sample includes slightly older women (18–24) than in most other studies, and
therefore they may be applying different meanings to the sexual scripts guiding their
interactions. Further, all were sexually experienced, and were participating in established
relationships. Within that context, many appeared confident in their ability to exercise
sexual agency in spite of the restrictive gender role norms surrounding them.
The most interesting among our findings is the range of perspectives regarding women’s
and men’s ideals of masculinities and femininities within the context of some relationships.
Notably, some women balked at the restrictive standards dictating their sexual roles yet
experienced obstacles negotiating new rules for their relationships. This finding is
interesting in light of the wide body of South African literature that details links between
gendered power relations, sexual violence, and risk for HIV (Pendry 1998). Some research
has suggested that young women have greater agency than in the past (Bhana 2002, Hunter
2002). Other studies on masculinity suggest that men and masculinities are changing
within the contemporary South African context (Hunter 2004, Sideris 2004). Much of this
change may be occurring at the individual level, with longer-term and sustained changes
needed to shift societal norms. Future research should monitor changes in sexual scripts
over time to truly assess whether, how, and in which direction, shifts are occurring.
There are a number of important limitations to the study. The sample was relatively
small and comprised a self-selected group of sexually active young adults who agreed to
participate in a study addressing sexual issues. In addition, the participants were secondary
school students in a rural district of South Africa, attending school at a relatively late age
(18–24), which indicates that they represent a minority of the in-school population as well
as of young adults in South Africa. The interview findings of the current study may reflect
social desirability factors, especially given that we relied on self-reports (an inherent bias
with such methods) and we were only able to use female interviewers at the time of the
study. Using female interviewers may have influenced some of the discourse around gender
dynamics in ways for which we cannot fully account. Although our interviewers were
extensively trained and experienced in sex interviews, it is important to note the possibility
of bias here. The study should be considered exploratory and the conclusions provisional
and context-specific at this time. It remains to be seen to what extent the findings capture
the experience of other more representative samples of young people in South Africa.
These findings have important implications for HIV prevention efforts. Women are not
able in every instance to insist on condom use by their male partners or adopt other
measures, such as refusing sex or using other forms of protection. By the same token,
constructions of masculinity make it difficult for young men consistently to protect their
own health and that of their partners (Campbell 2001). For both young women and men in
relationships, acceptance of socially normative gender roles remain obstacles to enacting
either of two fundamental protective strategies—use some form of protection during sex or
Gender dynamics in sexual relationships 109
avoid sex altogether. Whether there are ways to alter these often deeply entrenched systems
of interaction, or else incorporate aspects of the scripts in novel ways is unknown. A
number of points of intervention are suggested, however. Men’s sanctioned protective
role of women and children could be emphasized in ways to promote adoption of protective
strategies within intimate relationships. The standard for women to regulate contraception
might be applied more directly to the use of condoms as birth control. Women’s right to
refuse male ‘sexual access’ outside of committed relationships might be legitimately
and usefully extended to refusing risky sexual scenarios with established partners. A
minority but notable number of both men and women expressed egalitarian norms—
perhaps voices that could be strengthened and emphasized in peer leadership roles.
Each of these points of intervention involves shifting ‘traditional’ forms further to
encourage acceptance and possibly adoption of alternative scripts while broadening
individuals’ repertoires of strategies designed to protect against HIV and other negative
sexual health outcomes.
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Re´sume´
Si de nombreux travaux de recherche en Afrique du Sud ont souligne´ l’importance de la
dynamique du genre au sein des relations sexuelles en tant que facteur de risque pour le
VIH, nous connaissons peu le roˆle joue´ par ce facteur chez les jeunes adultes – groupe,
pourtant, a` risque extreˆmement e´leve´ au regard de cette infection. Notre objectif premier
e´tait de de´couvrir comment les jeunes adultes, hommes et femmes, interpre`tent et mettent
en acte les roˆles lie´s au genre au sein de leurs relations principales de´clare´es, d’une part, et,
d’autre part, comment cette dynamique agit sur leur comportement sexuel, compte tenu du
risque d’attraper le VIH. Nous avons utilise´ la the´orie du sce´nario en tant que cadre
d’analyse de la dynamique du genre. 50 lyce´ens (25 femmes, 25 hommes) d’une re´gion
rurale de KwaZulu/Natal en Afrique du Sud, ont participe´a` des entretiens approfondis
portant sur leurs interactions sexuelles avec leur partenaire ave´re´. Si chez beaucoup de
participants la nature de leur comportement sexuel au sein de cette relation refle`te les
normes pre´dominantes des roˆ les lie´s au genre, force est de constater qu’il existe des
variations importantes: certains sujets, aussi bien des hommes que des femmes,
reconnaissent et soutiennent le droit des femmes de de´cider la nature des interactions
sexuelles pratique´es. Des tentatives visant a` promouvoir l’acceptation et l’adoption de
sce´narios diffe´rents pour les femmes et pour les hommes pourraient aider a`e´largir, chez le
jeune adulte, le re´pertoire de choix possibles afin de se pre´munir contre le risque d’attraper
le VIH.
Resumen
Gran parte de la investigacio´ n sobre Suda´frica describe la importancia de las dina´micas de
los sexos en las relaciones sexuales como factores importantes en el riesgo de contraer VIH.
No obstante, tenemos pocos conocimientos de estos factores en los jo´ venes, un grupo con
un excepcional alto riesgo de infeccio´n. Nuestro principal objetivo fue examinar de que´
modo los jo´venes, hombres y mujeres, interpretan y desempen˜ an los roles sexuales en sus
primeras relaciones fijas y que´ influencia tienen estas dina´micas en el comportamiento
sexual con respecto al riesgo de VIH. Para estructurar nuestro ana´lisis de las dina´micas de
sexos empleamos la teorı´a del guio´ n. Cincuenta estudiantes (25 mujeres, 25 hombres) de
una escuela secundaria de un distrito de KwaZulu/Natal, Suda´frica, participaron en
112 L. F. O’Sullivan et al.
entrevistas exhaustivas sobre las interacciones sexuales con sus parejas principales. Aunque
muchos participantes indicaron que los patrones de la conducta sexual en las relaciones
reflejan las normas dominantes del rol sexual, nuestros resultados indican que existen
variaciones importantes en estos roles dado que algunos entrevistados, tanto hombres como
mujeres, aceptan y refuerzan los derechos de las mujeres para determinar la naturaleza de
las interacciones sexuales. Serı´a de gran ayuda aunar esfuerzos para mejorar la aceptacio´n y
adopcio´ n de guiones alternativos para las mujeres y los hombres a fin de ampliar el
repertorio de los jo´venes sobre sus opciones para prevenir el contagio de VIH.
Gender dynamics in sexual relationships 113
