Journal Article

Sexual behavior experiences and characteristics of male-female partnerships among HIV positive adolescent girls and young women: Qualitative findings from Zimbabwe

Kruse-Levy, Natalie, Mugurungi, Owen, Rowley, Elizabeth, Ncube, Getrude, Leclerc-Madlala, Suzanne, Mavhu, Webster, Thior, Ibou

2018

Overview

New HIV infections among sub-Saharan Africa's adolescent girls and young women (AGYW, ages 15-24) greatly exceed those of their male peers. In addition, AGYW tend to acquire HIV at a much earlier age. Understanding the factors associated with HIV infection in AGYW could inform effective prevention and treatment interventions for these populations and their male sexual partners. This qualitative study, conducted October-November 2016, was a follow on to a quantitative survey that sought to characterize male sexual partners and sexual behaviors of sexually active HIV positive AGYW in Zimbabwe. The qualitative study explored sexual behavior experiences and characteristics of male-female partnerships among the same participants. We conducted in-depth interviews with purposively sampled AGYW (16-24 years). Audio recorded qualitative data were transcribed, translated into English, and thematically coded using NVivo. 28 AGYW (n = 14 urban, n = 14 rural) took part in the in-depth interviews. 50% were 16-19 years old. Discussions with 10/11 (91%) AGYW who were reportedly infected through sex suggested that they had acquired HIV from their husbands or romantic partners. Accounts also suggested that the age difference between respondents and their male sexual partners was ≥5 years. Overall, respondents described two types of male partners: those older (''sugar daddies'', men ≥35 years old) and younger (<35 years). Respondents felt unable to suggest condom use to both older and younger partners. Evident in respondents' accounts was a general low HIV risk perception, particularly with younger men, which was largely due to poor HIV knowledge. Discussions suggested that an AGYW's relationship with either male partner was characterized by some form of violence. Discussions highlighted the nature and characteristics of relationships between AGYW and their male sexual partners. Findings could inform interventions to engender risk perception among AGYW, promote female-controlled HIV prevention efforts and, foster risk-reduction among men.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acquired immune deficiency syndrome / Adolescents / Aggression / AIDS / Analysis / Antiretroviral drugs / Audio data / Biology and Life Sciences / Females / Girls / Health aspects / Health risks / HIV / HIV infections / Human immunodeficiency virus / Infections / Medicine and Health Sciences / Men / Partnerships / People and Places / Perception / Prevention / Qualitative analysis / Qualitative research / Research and Analysis Methods / Risk factors / Risk perception / Risk reduction / Sexual behavior / Sexual partners / Sexually transmitted diseases / STD / Studies / Sugar / Teenage girls / Teenagers / Violence / Young adults