The role of sexual dissatisfaction in driving Multiple Concurrent Partnerships:

1. The role of sexual dissatisfaction in driving Multiple Concurrent Partnerships: Rayhana Rassool Presented @ 4th SA AIDS Conference 1 April 2009

2. Soul City: IHDC – Who are we? • An independent Non Governmental Organisation created in 1992 to promote health and development to South Africans. • Began working with local partners in 8 SADC countries in 2002. • Specific programmes targeted at various groups (children & adults). • Edutainment approach – intergrates education and entertainment into popular drama programmes. • Uses Massmedia – TV, Radio & Print • All products and interventions informed by formative research

3. Model of Social Change • Socio-economic + political national environment • Healthy public policy Mass media, Social Mobilisation, Advocacy • Individual • Knowledge • Attitudes/Beliefs/ • /Risk perception • Skills • Self-efficacy • Support for policy action • Subjective norms • Link to services • Community • Dialogue/debate • Social norms • Community efficacy • Community action • Social networks • Social cohesion

4. ONE LOVE Campaign- A focus on Multiple Concurrent Partnerships • ONE LOVE campaign is a 10 country partnership initiative focusing on MCP. • Soul City: IHDC is the South African partner in this initiative • A response to SADC Think Tank, Maseru, May 2006 Multiple and concurrent partnerships with low consistent condom use, in the context of low levels of male circumcision are key drivers of the HIV pandemic in Southern Africa.

5. Define: Multiple Concurrent Partnerships • What is: Multiple and concurrent partners “The term MCP is used to define a situation where partnerships overlap in time, either where two more partnerships continue over the same time period, or where one partnership begins before the other terminates. A sexual partnership is considered to be concurrent in surveys if a person reports having two or more sexual partners in a month.”

6. Research Objectives: • Gain insight into target audience understanding, attitudes and practices around sexual relationships in the context of HIV prevention. • Explore audience views and opinions on relationships relating to MCP • Explore audience attitudes towards MC • Explore audience practices and motivations around relationships including MCP

7. FOCUS GROUP INTERVIEWS

8. In-depth Interviews

9. Sexual dissatisfaction (or a need for sexual satisfaction) and lack of communication emerged as one of the reasons for having multiple and concurrent partnerships.

10. Emerging evidence around Sexual dissatisfaction: Various perceptions, attitudes and practices around relationships were both common to men and women across a wide range of ages “Sometimes when we are unfaithful is because at home between me and my wife we don’t discuss sex issues (such as) which positions I like.” (males, 28-35, Urban, Mpumalanga) “As we told you that if this other one does not satisfy you (sexually), you then get satisfaction from the other one (females 16 -20, Informal Settlement, North West)

11. One theme that emerged prominently: People need/want Sex and ‘sex is essential in one’s life “I learnt that sex is an important function of the body. It is possible to die if you don’t engage in it” (Female 28-40, Urban, Gauteng) “… this girl I do not love her but she can perform, she does everything right, you put her on the grass she does everything right, blow jobs, looking this way and that everything. And you need that.” (Male 28-40, Urban, Gauteng)

12. Men spoke of their relationships with their primary partners as being stressful and said that sex with them is not exciting. The men discussed many reasons why they strayed from these relationships in order to enjoy themselves: “If I marry my wife, that is the woman that I will experience all my sex fantasies. If I get married and she tells me after a few years that no, we can’t do that anymore, then you’ve got to finish up there.” (Male 21-28, Urban, Western Cape) “So with people who are involved in full time either with a girlfriend or wife. You end up using sex as a sleeping therapy when you want to sleep. If I can get one round I will be fine, and sleep.” (Male 28-40, KZN, Urban)

13. Young women: they need to have sex with their boyfriends because sex strengthens relationships and is a sign of love: “… it is because you love the person even though the person may not love you. So you do it out of love and you tell yourself that so and so loves me because that’s what he has told me.” (Female group 18-20, Gauteng, Informal Settlement)

14. Men asserted that their sexual desire was beyond their control “Right in the home, she can refuse to sleep with you. And now, you have to understand that men are built a certain way: a woman can always say no, but when she does, you know it can only turn out this way – we go out there and find what we are looking for, because there is no way of stopping yourself when you want it.” (Male, 21-28, rural, Eastern Cape) “There are times when you think you do not want it, but if she comes and sits there enticing you, you can’t help it and you end up falling again. Desires overpower us, especially sexual” (Males, 21-28, Urban, Free State)

15. The need for sexual satisfaction was one of the reasons participants gave as their reason for having concurrent partnerships “You just pretend as if he satisfies you and even scream like Eeeh! Eeeh! Pretending that you are enjoying and yet feel nothing … you then meet someone on the road and you start imaging that he might be better than your husband in sex, you then discover that actually he is better than your husband and you can both satisfy each other” (Gauteng Female 21-28, urban)

16. Women and men both experience sexual dissatisfaction: “Its because now we are discerning – we know the difference between good sex and bad sex. Like you know if someone is boring in the bedroom and you know when you have met someone who hits the spot. You carry on with the other one if he gives you other things but you know that he just doesn’t do it for you sexually.” (Female group 25 – 35, Rural Kwa-Zulu Natal) “Sometimes when you sleep with a person you find that his thing is small and when you go elsewhere you find a prettier one that struggles when it goes in, that is the one that we want!” (female group, Rural Mpumalanga, 21-28)

17. Men and women revealed lack of communication about sex in steady relationships such as marriage. “So you see there are no forums to discuss issues about sex if there were forums to talk openly about sex and desires that would limit men from cheating because we can explore our sexual needs without being judged that is why we prefer going to inyatsi (secret lover) to try new positions because she won’t judge you, she is willing to try new things” (Male group 28-35 years, Urban, Mpumalanga) “It is definitely difficult to say let’s try something new. The reason is that your husband will say ‘we have been married for so many years without you saying let us do something new. Where did you get it from?” (female 28-40 years, Informal Settlement, Western Cape)

18. Summary of Sexual dissatisfaction research • The research found that many people are engaging in MCP. • Sexual dissatisfaction and a lack of lack of effective communication between partners. • We know that this is grounded in the broader issues of Gender inequalities and cultural practices. But broadly we need to explore further: • Men dissatisfied because of their identifying women in a certain way - They feel they cannot demand sex which could be dirty or demeaning. The idea of ‘purity’ of the mother – so certain sexual acts cannot be performed with the core partner • Women are just to scared – could not bring up sex dissatisfaction • Some people taught themselves about sex through pornography –a lack of access to contextualised sexual information

19. Conclusion:Implications for a programmatic response: Challenges • Messaging – how do you address sexual dissatisfaction in media – how do you be explicit without being offesive • Language: how do you communicate complex sexual information and knowledge? Media/community intervention

20. I would like to acknowledge all the researchers that worked on the research project THANK YOU! rayhana@soulcity.org.za www.onelovesouthernafrica.co.za Soul City Distribution Centre 0860 11 5000