The feminine ideal and transactional sex: Navigating respectability and risk in Swaziland

• Type of Material: Article
• Authors: Rebecca Fielding-Miller, University of California San Diego; Kristin L. Dunkle, South African Medical Research Council; Nwabisa Jama-Shai, South African Medical Research Council; Michael Windle, Emory University; Craig Hadley, Emory University; Hannah Cooper, Emory University
• Language: English
• Date: 2016-04-07
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Elsevier Ltd. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.socscimed.2016.04.005
• Title of Journal or Parent Work: Social Science and Medicine
• ISSN: 0277-9536
• Volume: 158
• Start Page: 24
• End Page: 33
• Grant/Funding Information: This study was supported by the Swaziland National Emergency Response Council on HIV/AIDS.; Financial and material support was provided by a US Fulbright Grant, the Health Community Capacity Collaborative, Swaziland with support from PEPFAR, and the Center for AIDS Research at Emory University (P30AI050409).; Support in preparing this manuscript was provided by NIDA grant T32DA023356.
• Keywords: INTERVENTION; Science & Technology; Transactional sex; Biomedical Social Sciences; Social Sciences, Biomedical; Social Sciences; Swaziland; Public, Environmental & Occupational Health; HIV; SOUTH-AFRICA; Cultural consensus model; TAXI QUEENS; Life Sciences & Biomedicine; Gender hegemony; Femininity; WESTERN CAPE
• Research Categories: Health Sciences, Public Health; Health Sciences, General

Abstract

Women who engage in transactional sex are not only at increased risk of HIV and intimate partner violence, but also face social risks including gossip and ostracism. These social and physical risks may be dependent on both what a woman expects and needs from her partner and how her community perceives the relationship. Gender theory suggests that some of these social risks may hinge on whether or not a woman's relationship threatens dominant masculinity. We conducted a qualitative study in Swaziland from September 2013 to October 2014 to explore transactional sex and respectable femininity through the lens of hegemonic gender theory. Using cultural consensus modeling, we identified cultural models of transactional sex and conducted 16 in-depth interviews with model key informants and 3 focus group discussions, for a total of 41 participants. We identified 4 main models of transactional relationships: One typified by marriage and high social respectability, a second in which women aspire towards marriage, a third particular to University students, and a fourth "sugar daddy" model. Women in all models expected and received significant financial support from their male partners. However, women in less respectable relationships risked social censure and stigma if they were discovered, in part because aspects of their relationship threatened hegemonic masculinity. Conversely, women who received male support in respectable relationships had to carefully select HIV risk reduction strategies that did not threaten their relationship and associated social status. Research and programming efforts typically focus only on the less socially respectable forms of transactional sex. This risks reinforcing stigma for women in relationships that are already considered socially unacceptable while ignoring the unique HIV risks faced by women in more respectable relationships.