Small House Hure Sugar Daddies and Garden Boys

Small House, Hure, Sugar Daddies, and Garden Boys: A Qualitative Study of Heterosexual Concurrent Partnerships Among Men and Women in Zimbabwe, 2007 Noah Taruberekera, Linda Kaljee, Wellington Mushayi, Hibist Astatke, Michael Chommie, Navendu Shekhar International AIDS Conference, Mexico City August 3, 2008 Presenter: Wellington Mushayi, PSI Zimbabwe

Background Ø HIV interventions focus on partner reduction Ø Need to acknowledge overlapping sexual relationships Ø Concurrent Sexual Partnerships (CSPs) shown to amplify nascent HIV epidemics by as much as ten-fold Ø A 2006 PSI survey revealed that 33% men and 29% women reported more than one ‘regular sexual partner’ in Zimbabwe Ø Scarce data that describe CSPs and related psycho-social determinants Ø Need to describe CSPs and understand related psycho-social determinants among Zimbabweans in order to design and implement effective interventions to reduce CSPs

Research Objectives Ø To provide descriptive data on types and contexts of concurrent sexual partnerships Ø To explore potential psycho-social determinants of concurrent heterosexual partnerships Ø To describe associated HIV risk, including consistency of condom use, within different concurrent partnerships

Research Methods Ø Data Collection • 2 phase qualitative study including 24 focus group discussions (FGDs) with six individuals per group • FGDs were moderated utilizing interview guides • Phase 1 (16 FGDs): Explored CSP types + free-listing potential determinants • Phase II (8 FGDs): contextualized and defined identified determinants from the literature review and the PSI framework • Stratified purposeful sampling – Gender – Age (18 to 24 years and 25 to 40 years) – Residence (urban and rural)

Research Methods Ø Data Analysis • Data were transcribed and translated into English • Data from each phase were consolidated, similar codes collapsed, and coding finalized • For each identified determinant, summary statements were developed • Utilizing the organized coded data, definitions were established for the identified psycho-social determinants

Results: Descriptions of CSPs Ø Partner types were defined in terms of: • Length of relationships (short and long-term) • Descriptors of partner attributes (age, occupation, marital status) • Transactional relationships(exchange of sex for money, goods, or services) Ø Men and women each described multiple combinations of different types of partnerships

Results: Descriptions of CSPs Ø Concurrent Partnerships for Men • Wife + CSW “Most men who have hures (commercial sex workers) find it difficult to enjoy a variety of sexual styles with their wives. But he can do such things with a hure because she accepts any style that a man might like. ” (urban male, under 25 years) • Wife + Small house “I will then have a small house where I know the welcome is great. The sexual styles she offers are way ahead of my wife; her appearance is smarter too. The small house accepts me as I am. ” (rural male, 25+ years) • Wife + Divorced/Separated Woman “(the divorced or separated woman) will do all sorts of things which are not done by your wife. You will get hot sadza (meal), you might go and watch Macheso (band), or go to a soccer match…. ” (urban male, 25+ years) • Wife + Young Girl or School Girl (Cross Gen) “Once you become broke she won’t see you. Sweet 16 follows the money. It is not a serious affair. ” (urban male, 25+ years)

Results: Descriptions of CSPs Ø Concurrent Partnerships for Women • Husband + Garden Boy or Young Boy (Cross Gen) "A woman who is married but the husband has no time for the wife. She takes advantage of the garden boy. It is us women who propose love to garden boys so that he makes me happy in bed. " (urban female, 25+ years) • Husband + Boyfriend “The boyfriend will perform much better than the husband. And with your boyfriend there is no quarrelling, only joy and laughter. ” (rural female, 25 + years) • Husband + Sugar Daddy – Women engage a ‘Sugar daddy’ for luxuries and entertainment • Husband + Driver, or Businessman, or Foreigner – Women described multiple types of relationships in which they exchanged sex for money, services (e. g. , transport), or goods

Results: Determinants of CSPs Ø 8 Main determinants/drivers of CSPs were identified • Social Norms • Locus of Control • Threat • Response Efficacy • Social Pressure • Relationship Satisfaction • Perceived Benefits • Perceived Costs

Results: Determinants of CSPs Social Pressure • Emanates from significant people - friends, family members, church elders “You have been pressurized by what your friends have been doing. This one says, ‘last night I had sex with that girl and she was super’, another one tells you the same thing. You would want to do it also. ” (rural male, 25+ years) Relationship satisfaction: • Fulfilment of expectations in sexual, financial, emotional, domestic and role aspects of one’s relationship with a main partner. “Not satisfied with the husband, some do it because they are not sexually satisfied and they think that if they go out they will get someone to satisfy them. ” (Female, urban, below 25 years) • Also linked to non-sexual aspects – beaten by spouse, feel neglected, hygiene

Results: Determinants of CSPs Perceived Benefits: Positive outcomes expected from engaging in CSPs include: • Support for survival – want groceries, cash all the time, to get job “But these days with the harsh economic environment, women are forced to look for means of survival. She will do anything to attract a man. ” (rural male, under 25 years) • Have a child (boy/girl child) • Status ‘upgrading’ and entertainment – fame, reputation Perceived costs: Negative consequences of engaging in CSP are related to physical and psychological abuse, social status, personal success.

Results: Condom Use in CSPs Ø Very low condom use is reported in many concurrent sexual partnerships. Factors which affect condom use include: • Trust • Length of relationship • Age of partner “We trust young boys. They haven’t slept with too many women so condoms aren’t used. ” (rural female, under 25 years) • Marital status of partner – condoms not normally used with the divorced /separated women

Conclusions Ø CSPs are wide-ranging and diverse with multiple socioculturally entrenched determinants • ‘Relationship Satisfaction’ is a broad determinant which covers issues around sexual satisfaction, gender roles, personal appearances, and partner violence and abuse • There are strong social and economic pressures for men and women to engage in concurrent relationships – Men are particularly pressured into these relationships by peers – Economic needs for women and young girls may override concerns and fears about HIV/AIDS • Respondents discussed benefits in relation to engaging in concurrent partnerships including economic and social (popularity) • Condoms are used on an irregular basis and multiple factors affect men’s and women’s willingness to use condoms within a relationship

Implications Ø These data will inform the development of multi-item scales for a cross-sectional survey to further knowledge about concurrent partnerships in Zimbabwe Ø Data indicate directions and challenges for future interventions in Zimbabwe • Important to promote open communication between couples regarding sexual preferences • Need to focus on discouraging cross-generational sexual relations for both men and women • Increasing individual risk perception – address ‘trusted partner myth’ • Promote consistent condom use within all sexual relationships • For some women and young men, CSP meets socioeconomic needs, that may prove more compelling than health needs

For More Information Ø Wellington Mushayi • Tel: +263 -4 -334631 • E-mail: wmushayi@psi-zim. co. zw Ø www. psi. org