The Role of Sexual Dissatisfaction in Driving Multiple Concurrent Partnerships

This PowerPoint presentation, presented at the 4th South African AIDS Conference in 2009, looks at the role of sexual dissatisfaction and lack of partner communication in driving multiple concurrent partnerships (MCP) in South Africa. The author argues that sexual dissatisfaction must be addressed as part of a strategy to decrease MCP.

Recent studies have shown that multiple and concurrent partnerships (MCP) are a key driver of HIV/AIDS in South Africa. MCP link people into a sexual network where having more than one partner puts all others in the network at risk. Decreasing MCP has therefore become central to HIV prevention efforts nationally. To understand the factors that lead to multiple partnerships and in order to plan prevention strategies, Soul City Institute for Health and Development Communication undertook a national qualitative study with men and women in both rural and urban areas.

The overall aim of the research was to gain insight into the audience's understanding, attitudes, and practices around sexual relationships in the context of HIV prevention. Thirty focus group interviews among female and male youths, young adults, and adults were conducted in rural, urban, and informal settlements of eight provinces in South Africa. In addition, in-depth interviews were conducted with women and men who were involved in concurrent sexual relationships. The data were analysed thematically within audience age segmentation using ATLAS.ti computer software.

The findings showed that sexual dissatisfaction (or a need for sexual satisfaction) and lack of communication were reasons for having multiple and concurrent partnerships in South Africa. The findings revealed the following:

• Both women and men experience sexual dissatisfaction.
• Men and women revealed lack of communication about sex in steady relationships such as marriage.
• Women in particular are looking for an understanding of how to have better or "great sex".
• Men spoke of their relationships with their primary partners as being stressful and said that sex with them is not exciting.
• Issues around sexuality are grounded in the broader issues of gender inequalities and cultural practices: Men are dissatisfied because they perceive women in a certain way - they feel they cannot demand sex which could be dirty or demeaning. The idea of the "purity" of the mother also plays a role, so certain sexual acts cannot be performed with the core partner. Women are also too scared to discuss the issue of sexual dissatisfaction with their partner.
• There is a lack of access to contextualised sexual information (some people taught themselves about sex through pornography).

The author argues that sexual dissatisfaction and partner communication around sex must be addressed as part of a strategy to decrease MCP. Better communication within relationships could potentially lead to better sex within core relationships and could potentially limit the need for multiple and concurrent partnerships. The presentation cites some challenges to consider in terms of programmatic responses:
- Messaging: how does one address sexual dissatisfaction in communication media – how to be explicit without being offensive?
- Language: how does one communicate complex sexual information and knowledge?

Click here to download the PowerPoint presentation.