Gender attitudes, sexual violence, and HIV/AIDS risks among men and women in Cape Town, South Africa

Journal of Sex Research, Nov, 2005 by Seth C. Kalichman, Leickness C. Simbayi, Michelle Kaufman, Demetria Cherry Cain, Chauncey, Sean Jooste, Vuyisile Mathiti

METHOD

Participants and Setting

Participants were 415 men and 127 women receiving services from an STI clinic in Cape Town, South Africa. In terms of demographic characteristics, 47 (9%) were 20 years old or younger, 159 (30%) were between 21 and 25 years old, 276 (52%) were between 26 and 35, and the remaining 53 (10%) were over age 35. In addition, 521 (95%) participants identified as Black, and 7 (1%) were White, 2 (4%) Indian, and 11 (2%) Colored or of mixed race. Nearly half of the sample had not matriculated high school (N = 235, 43%), 42% (N = 226) were unemployed, and 16% (N = 85) indicated that they were married.

The public STI clinic that served as the site for this research treats over 1,800 patients with STIs per month. Approximately half of all patients seen at the clinic have previously received STI services. In 2003, the clinic conducted over 5,000 HIV antibody tests, of which 25% were HIV-positive.

Measures

Measures were administered in English and Xhosa (an indigenous African language), the two languages spoken by nearly all clinic patients. Measures included demographic characteristics, history of sexual violence experiences, attitudes and beliefs pertaining to gender and sexual assault, sexual behaviors and STI risks, substance use, and AIDS-related knowledge.

Demographic characteristics. Participants reported their age, race, years of formal education, employment status, and marital status.

History of sexually violent experiences. To assess participants' history of having experienced sexual violence, we adapted items from the Sexual Experiences Survey, a widely used measure of sexually coercive experiences (Koss & Gidycz, 1985; Koss, Gidycz, & Wisniewski, 1987). Participants were asked to indicate "Yes" or "No" to three questions regarding having perpetrated sexual assault: "Have you ever had sexual intercourse with a person when he or she really did not want to?"; "Have you ever threatened to use force to get a person to have sex when he or she did not want to?"; and "Have you ever forced or pressured a person to have sex when he or she did not want to?" In addition, three items measured history of having been sexually assaulted: "Have you ever had sexual intercourse against your will because a person threatened to use physical force to make you?", "Has someone ever forced you to have sex when you did not want to?", and "Has someone ever pressured you to have sex when you did not want to?". All sexual violence history questions were responded to by men and women as either "Yes" or "No."

Gender attitudes. Participants responded to seven items adapted from the Attitudes Toward Women Scale (Spence & Helmreich, 1972). The items selected and adapted for this study represented beliefs about traditional gender roles and gender relations. The items correspond with gender themes identified in qualitative research with South African men, such as defining masculinity in terms of number of sex partners, the sexual desirability of one's partners to other men, and the ability to "control" girlfriends (Wood & Jewkes, 2001). The results section presents the items, which were responded to on 4-point scales from 1 (Disagree) to 4 (Agree). Reliability analyses indicated that the scale showed slight heterogeneity among items, alpha = .63.