Exploring discrepant knowledge of partner sexual behaviour to inform self-risk assessment in a high HIV burdened district in rural KwaZulu-Natal

ABSTRACT

Understanding the sexual relationships of young women is critical for preventing HIV infections. This study aimed to describe the sexual behaviour of partners, comparing the accuracy of sexual health knowledge between partners. The study took place in 2017 in KwaZulu-Natal, South Africa. Purposive sampling was used to select 18–27-year-old sexually active women. Consenting female participants completed a structured and semi-structured interview, while consenting male sexual partners identified through the female participant completed a structured questionnaire on sexual health information. Using a reflexive inductive approach and thematic analysis, we identified key discrepancies in the assumptions partners make about each other’s sexual health information. Twenty-three sexual dyads were identified and four key discrepancies were identified: Age: partners either over or underestimated the age of their partners, HIV status: where partners were unaware of, or incorrectly assumed their partner’s status, Lack of awareness of partner’s concurrent relationships and more general knowledge of the partner’s sexual health behaviours. Discussions about sexual health are mediated by relationship length, type of partner, power and perceived fidelity. While it is possible to undertake dyadic level research, ethical tensions remain. Sex-positive and egalitarian sexual health interventions that target the individual, as well as the sexual relationship, are needed.

KEYWORDS:

• HIV
• young women
• dyad
• sexual health
• relationships

Acknowledgements

The authorship team would like to thank all the study staff, the CAPRISA Vulindlela Community Research Support Group, the Vulindlela community for their willingness to contribute to and participate in the study. We also thank our participants for their participating in our research and making this project possible. Finally, we thank our funders for their support. HH completed the primary draft paper and completed all additional drafts after feedback from additional authors. HH, SP, MM, CML, SM, LK and QAK were involved in data collection. HH, LK and QAK contributed to data analysis and interpretation. All authors contributed to either the preparation of or edits to the final manuscript and approved the revisions

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

Additional information

Funding

This study was funded through the MAC AIDS Foundation via the Tides Foundation [grant number: TFR13–02228]. The career development of HH was supported by the Columbia University-Southern African Fogarty AIDS International Training and Research Programme (AITRP) supported by the Fogarty International Center, National Institutes of Health (United States) [grant number: #D43TW00231]. The study research was conducted as part of the DST-NRF Centre of Excellence in HIV Prevention, which is supported by the Department of Science and Innovation (South Africa) and the National Research Foundation (South Africa).