Risky intimacies across the lifespan

This collection of six articles based on research conducted in Sub-Saharan Africa, South Asia and the USA attempts to deconstruct the complex nature of interactions between people who have close and interdependent relationships with one another and who go to considerable lengths to maintain those relationships regardless of the social, psychological and physical consequences. Together, these articles explore the intimate features of such relationships across the lifespan, from pre-marriage (Brault and S. Schensul) through to partnered adulthood (Kostick and J. Schensul; Green et al.), marriage (Moonzwe and Kostick and J. Schensul; S. Schensul et al.), and older adulthood (J. Schensul et al.). The authors recognise that the quest for and desire to maintain intimacy is a human endeavour extending from life to death that entails the negotiation of various types of risks. The risks associated with intimacy are often thought to apply to ‘vulnerable’ women who depend on their male partners for financial and family support and marital status, and these articles are written through the lens of women’s experiences. However, men also face their own challenges in exposing their emotional vulnerabilities, their fears, loneliness and desires for social closeness. Although much of the literature on intimacy focuses on sexuality, these articles seek to disaggregate sexuality and intimacy, especially in the context of HIV risk, and move beyond sexual relations to consider other forms of physical, emotional and cognitive intimacy.

The articles concentrate primarily on relationships between sexual partners or potential sexual partners. Partner sexual intimacy may be especially challenging when it involves the risk of HIV transmission and the complexity of engaging in both treatment protocols and addressing the stigma associated with infection and associated prevention protocols noted by both Green et al. and Moonzwe. Our goal here is to explore the multiple ways that risk and intimacy are integrated and balanced within relationships as individuals pursue personal, social and cultural needs at different stages in the life course.

Most social science research on ‘risk’ addresses the context and circumstances under which social and public health risks – e.g. unprotected sex, drug use or interpersonal violence, and their consequences – can be prevented or minimised. Some behaviours such as sex outside of marriage or sex between men in an HIV endemic area may be evaluated as risky by health or religious institutions. These risks are institutionally defined and imposed, often in coordination with legislative powers and social influence, to shape interpersonal behaviours. However, as Mary Douglas notes, definitions of risk are resisted, reinterpreted and redefined through various interpersonal relationships ‘on the ground’, where they are balanced against individual, familial and social needs (Douglas 1992). Green et al.’s analysis of intimacy and disclosure between HIV sero-discordant couples shows that behaviours seen as risky in a societal context may not be viewed as risky by people who view trust, intimacy and maintenance of their relationship as a greater priority than the risk of HIV infection. In such cases, health promotion messages advocating condom use among, for example, sero-discordant couples may not always be perceived as relevant. In Moonzwe’s and Kostick’s articles, women calculate the personal risk of engaging in intimate sexual behaviours with partners, and of not engaging in these behaviours, alongside the costs that such scenarios may incur for them personally, socially and financially. In these articles we illustrate how the meaning of risk for individuals is socially constructed and reconstructed by multiple stakeholders in a given setting, and by individuals exerting their own agency in response to a set of prioritised goals situated within a larger social and cultural context.

As Green et al. note, intimacy may be defined by disclosure of dangerous secrets, the result of which can increase the depth of a relationship, cause it to stagnate, or end it. Green argues that HIV disclosure may sometimes serve to bring partners closer together, while at other times it may cause disgust, denial, stigmatisation and abuse, or it may trigger the ending of a relationship altogether, especially if the relationship is not faring well for other reasons. Steps taken to achieve or to maintain intimacy with others require the exposure of personal feelings, past experiences and limitations through verbal or nonverbal communication. Disclosures of intimacy enacted by women cited in both the Moonzwe and Kostick and J. Schensul articles result from women’s efforts to maintain intimate relationships with partners with whom they are dissatisfied because of their desire to fulfil gender expectations for family economic and other support. For similar reasons, women in the Kostick and J. Schensul article choose MDMA, an intimacy enhancing drug, to decrease their negative feelings about sex with their partner in order to avoid jeopardising the relationship and risking family destabilisation and child support.

All of the articles focus on women’s views and experiences because, as we suggest, women tend to be more vulnerable to or at least to experience more intimate partner sexual and physical abuse; however, we recognise too that men can also be abused, either structurally or through exploitative sexual and economic factors. Among the articles that consider male, female and family perspectives, those by Moonzwe et al. and Kostick and J. Schensul consider the structural factors that may make it difficult for men to perform their traditional male roles, thereby influencing intimacy dynamics with their sexual and romantic partners in both Zambia and the USA. In both the articles set in India, men in the low-income communities in which the research was conducted, live on the economic margins, struggling to bring in enough income to provide food for the household. Men’s frustration at their inability to achieve expected economic and household duties can result in excessive control over women’s independent efforts to generate income and make decisions for the household. The distance generated by lack of couple communication and expectations of women’s sexual and household practices is thus exacerbated by men’s failure to perform their economic and household duties. These challenges are also evident in the Kostick article that describes the difficulties faced by male partners of women interviewed and in the Moonzwe article that illustrates the challenges that men face in actualising their household responsibilities.

Similarly, the article by J. Schensul et al. examines the perspectives of both men and women living in subsidised senior housing towards balancing sexual risk with desire for intimacy, particularly with partners whom they pay for surrogate romance and support. Brault and S. Schensul’s article highlights family perspectives in an examination of how marital partner selection undermines or sustains family intimacy in ‘arranged’ versus ‘love’ marriages over time in Mumbai, India. While parents may attempt to protect their daughters from male violence and harassment through early arranged marriages, such marriages carry an increased risk of marital discord and abuse as women with little or no experience of relationships with men negotiate their first, often unpleasant sexual experiences and relationships with their husband’s family. S. Schensul et al.’s article on marital relationships shows that more than half of the sample has difficult and conflict-filled associations with their husbands in a similar low-income community of Mumbai.

Rather than depending on institutionally-defined forms of risk and oft-cited ‘risky behaviours’, these articles highlight how risk is better defined as social in nature, having cognitive, physical emotional, interpersonal and community implications. Some of the psychological literature suggests that risk, especially sexual risk, and intimacy are inversely related, whereby greater intimacy implies lower risk. However, the more ethnographic accounts contained in some of these articles such as those by J Schensul et al. or Green et al. suggest that there can be a direct relationship or no relationship at all. Enacted intimacies and risk-taking are nuanced and context-dependent, especially in economically marginalised environments where greater risk exposures place stronger pressure on individuals to maintain relationships that often constitute an individual’s sole source of resources and support.

J. Schensul et al.’s article describes how older men and women living in low income housing communities in the northeast USA are tolerant of and endorse intimate heterosexual relationships and seek intimacy themselves. At the same time, however, they are less sympathetic to men’s search for intimacy with sex workers. Men in these more instrumental relationships encounter negative normative feedback, stigma and isolation, and even physical or financial abuse in order to obtain emotional intimacy and support from women sex workers who meet their own needs for security from street violence through their associations with these men. Each of these actors strategically weighs different forms of risk. In another example described by Kostick and J. Schensul, some younger, low-income women in relationships engage in unprotected sex with partners whom they suspect of having other girlfriends, as a coping strategy to minimise the possibility that they may lose their relationship, and with it, their financial and social stability. Similarly, Moonzwe’s article provides an account of Zambian women’s desperate efforts to protect both their families’ economic survival and their respectability as married women by maintaining physical and intimacy with marital partners who offer little or no family support and who object to women’s economic independence. Thus, concerns about risk exposure may be inversely or directly related to intimacy, in many cases representing attempts to achieve equilibrium between sex and one’s individual needs.

Intimacy is best understood as a process of approximation that occurs over time and is sustained, rather than an emotion or association that is achieved through a single encounter. Kostick and J. Schensul, J. Schensul et al., Brault and S. Schensul, and S. Schensul et al. all reflect on the length of time required for intimacy to build. For some prospective partners, intercourse may take place almost immediately, but most respondents across these studies discuss intimacy in the context of trust, stressing how it takes time to get to know a partner and to feel comfortable and secure in a new intimate relationship. In the J. Schensul et al. article, intimacy between older men and women is expressed through both language and touch. The article recounts the steps that older adults consider culturally appropriate in order to achieve intimacy over time. Women express caution when engaging in a new relationship, preferring physical intimacy only after a complex process of mutual assessment towards emotional security. On the other hand, Indian women involved in arranged marriages are often deprived of this opportunity and expected to have sexual intercourse with their husbands immediately after the marriage ceremony. Although love marriages initially promote greater couple intimacy, they may alienate family members and upset the delicate balance between spousal and family relationships and result in the male partner imposing the same patriarchal values may lead to marital strains. In contrast to these longer-term dynamics, Green et al. show how disclosure can rupture intimate ties between partners almost immediately, sometimes without hope of repair.

Trust and fidelity are also characterised by women and men in Kostick and J. Schensul et al.’s article as central to defining the quality of their relationships, fostered over time and through mutual responsibilities (e.g. shared finances, children) but at other times they are compromised by men’s relationships with others outside of the primary relationship or marriage or by the disclosure of HIV. As S. Schensul et al., and Brault and S. Schensul note in their articles, husbands sometimes consider their wives’ needs in daily activities and during their sexual encounters, but more frequently the rules of arranged marriage and sexual expectations of men, coupled with lack of male female communication prior to marriage, distance women from their partners and can negatively affect the relationship for the duration of the marriage.

All of the articles in this special issue focus on balancing the quest for intimacy with the need to cope with the circumstances of resource-constrained environments. Taken together, they highlight the complex social, cultural and temporal factors contributing to variations in degree of relational satisfaction and shifts and breakdowns in intimacy over time. Ultimately, they seek to broaden the exploration of the ambivalences and tensions inherent in intimate relationships across the lifespan intrinsically linking risk and intimacy – concepts which are too often separated in contemporary social research.

Jean Schensul
Institute for Community Research, Hartford, CT, USA
[email protected] http://orcid.org/0000-0003-2786-2340Kristin Kostick
Baylor Medical School, Houston, TX, USA