Preparing for Compulsory Unprotected Sex: HIV/AIDS and Sexual and Reproductive Decision Making among Young Adults in Zimbabwe

Ravai Marindo, Population Council
John Casterline, Population Council

Preparing for compulsory unprotected sex: HIV/AIDS and sexual and reproductive decision making among young adults in Zimbabwe Introduction The HIV epidemic has created many challenges in terms of sexual and reproductive decision making among young adults in Zimbabwe. The link between childbearing and HIV infection places a lot of conflict among young adults especially in societies where marriage is considered the norm and where childbearing is considered an important status symbol. Zimbabwe combines an essentially pro natalist culture (Bassett and Mhloyi, 1991) and a high HIV prevalence rate. An estimated 25% of adults are believed to be infected by HIV (UNAIDS, 2000). These two factors exacerbate the challenges that young adults, who are about to start childbearing face. In seeking for solutions and strategies to deal with the epidemic, studies have focused on young people or adolescents (Marindo et al., 2002, ZNFPC, 1998) or married people and how they make decision relating to childbearing in the context of HIV (Rutenberg et al. 1997 and Grisier et al. 2001). Few if any studies have examined young adults who are on the brink of family building. This study tries to fill that gap. This study focuses on young adults aged between 18 and 30 most of whom are unmarried. The objectives of the study are to examine how young adults select sexual and marriage partners, what factors they think influence the timing of sexual unions, marriage and childbearing as well as an examination of the costs and benefits of sexual relations. The study also explores expectations from future relationships. Data and Methods: Data for the study comes from 95 in-depth interviews carried out among young Zimbabweans from all walks of life aged between 18 and 30 years. 40 females and 45 females were interviewed between May and July 2002. Young adults were identified through advertisements in papers, door-to-door requests and snowballing. An in-depth discussion guide was used during the interview. All interviews were audio recorded. The guide covered five areas, presented below; · History of past and current relationships · Factors influencing selection of sexual and marriage partners · Timing of sexual, marriage and childbearing · Costs and benefits of sexual relationships · Goals and expectations from current and future relationships Each interview took an hour to complete. All interviews were translated and transcribed into text. Standard analysis techniques for qualitative data were used. Results An extract from some of the interviews is presented below as an example of the role that HIV plays in partner choice. What role does HIV play in partner selection? 20 young men and 10 young women reported that HIV was the main determinant in the choice of partner. One of the strongest views is expressed below by a male security guard aged 21 years. R: I know myself. I know I am clean. There is no way in this world that I am going to date someone who does not have a current, valid HIV test and I want to be there when they collect the results. Look, I have very good plans for my life. I shall not and I will not let myself be killed by some promiscuous women who do not know how to control their sexual urges. If someone refuses to be tested, I say ‘Go” I will find someone who thinks like me. When I meet a woman I ask her about whether she would like to have a test. If she says no, I don’t even pursue her. Some of the proponents of this view used a religious argument. One young female schoolteacher aged 19 years stated R: My body is a temple of Christ and I shall not allow it to be defiled. I will only marry a man who is virgin, because I am a virgin. I think about HIV as one of the punishments from God. So yes, I think about it all the time. Our church checks people for virginity and talks openly about AIDS. I don’t even want to have friends whose relatives died of AIDS. Other young adults had different opinions. Choice of sexual and marriage partners was determined by looks, age, wealth, personality, family, religious beliefs, education levels and other social factors. Most young adults felt that one cannot spend one’s life thinking about AIDS. One young man expressed this sentiment R: AIDS is there. It’s always there. But when I meet someone I don’t go “Well, is she HIV negative?” What I say is “I like her. I am going to try my luck.” If she likes me I will date her. HIV might be a factor later, when the excitement has died down, or when someone I know dies. To tell the truth, if I like the girl and my family likes her and approves. I will marry her without talking about AIDS. 22-year-old male medical student, Harare. Zimbabwe. Another opinion was that thinking and taking AIDS into consideration would be too overwhelming. A young woman selling tomatoes expressed this view. R: You experts, you think about AIDS all the time, it’s your job. If you love someone, you love him or her. AIDS is not written on the forehead. Who knows who is infected and who is not? I try not thinking about it. If I did I will become paralyzed and not even have a life. There was also the view that a lot of things in life were predestined so there was nothing one could do about AIDS. A young female university student expressed this below R: I believe that AIDS is not a question of making decision or not. You can be wise and still die of AIDS. You can have a Ph.D. and still die of AIDS. It comes to you whether you are old or young. Its not about wisdom, its about predestination. I don’t think I have any control over whether I get it or not. It’s a matter of luck. What can I do? I want to have children and one day I will have unprotected sex whether I like it or not. Conclusion: Young adults do think about HIV/AIDS in various forms. However decisions about dating marriage and having children may be influenced by other socio-cultural and social-economic factors that have nothing to do with the HIV/AIDS epidemic or the result of an HIV test. There is still some lingering belief that fate, ancestral spirits and luck have a role to play in one’s chances of being infected by HIV. This might explain why condoms and HIV testing do not feature as the major strategies for avoiding infection. Religion and culture seem to be impediments to sexual decision making for both men and women since both tend to leave decision making in the hands of a higher hand, thus not taking responsibility for their own sexual lives. However, some positive findings were obtained. A number of young adults reported feelings of empowerment and being in control of their own sexual lives because HIV/AIDS has given them justification to discuss and get information about sexuality and sexually transmitted infections. Some young women especially those with university degrees, had very pragmatic views about the importance of being tested before falling pregnant, using condoms and delaying childbearing. References Bassett, Mary and Marvellous Mhloyi (1991). Women and AIDS in Zimbabwe: The Making of an Epidemic. International Journal of Health Services, 21(1): 143-156. Grieser Mira, Joel Gittelsohn; Anita V. Shankar; Todd Koppenhaver; Thomas K. Legrand; Ravai Marindo; Webster M.Mavhu ; Kenneth Hill (2001) Reproductive Decision making and the HIV/AIDS epidemic in Zimbabwe. Journal of Southern African Studies. Volume 27, number 2. Marindo Ravai, Steve Pearson, Lazarus Zanamwe, Nelia Matinhure, Ishmael Magaisa and Lawrence Tongoona (2002) Young people’s baseline reproductive health survey in Zimbabwe. Unpublished UNAIDS report. Harare. Rutenberg, Naomi, Ann Biddlecom, Fred Kaona and Kathleen Siachitema. 1997. Reproductive decision-making in the context of HIV/AIDS in Zambia. Paper presented at the annual Population Association of America Meeting, Washington, D.C., 27-29 March. UNAIDS and WHO (2000) Epidemiological fact sheet on HIV/AIDS and sexually transmitted infections, 2000 update. UNAIDS/WHO Geneva. Zimbabwe National Family Planning Council (1998), Young people’s reproductive health survey. Unpublished report. Harare.