Substance Use and Sexual Risk Within the Context of Gender Inequality in South Africa

Abstract

This study examines substance use and sexual risk within the context of gender inequality among 163 women from an urban region of South Africa who were participating in a 2004–2006 study funded by the National Institute of Alcohol Abuse and Alcoholism. Items assessed patterns of substance use, gender inequality, risk communication, and psychological distress. Multivariate logistic regression analyses revealed that economic dependence on a main partner and traditional beliefs about a woman's right to refuse sex were associated with substance use prior to or during sex with that partner. The findings demonstrate that substance abuse prior to sex may reinforce traditional beliefs and that women with more progressive beliefs about gender ideology seem better able to control their substance use in risky environments.

Keywords:

• substance abuse
• sexual risk
• gender inequality
• sex work
• traditional women's roles
• partner communication
• South Africa

Notes

¹The South African census classifies people by population group. Membership in a group is based on self-perception and self-classification rather than legal definition. The four main population groups in South Africa are Black African, Coloured, White, and Indian.

²Using an exchange rate of US$1:ZAR6.

³The minimum monthly wage for domestic workers in urban settings—-predominantly Black African and Coloured unskilled women—-is US$166 (approximately ZAR997/-) (Republic of South Africa, 2005).