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

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.

Introduction

Gender shapes the impact of the HIV epidemic around the world. In sub-Saharan Africa, 60% of people living with HIV are women; young women are eight times more likely to become infected than young men (UNAIDS, 2012, 2014). Transactional sex is one driver of gendered HIV vulnerability in the region. It is associated with increases in gender based violence perpetration and victimization as well as HIV risk (Dunkle et al., 2004; Dunkle et al., 2007).

International researchers and donors use the term “transactional sex” to denote economically motivated relationships or onetime sexual encounters that differ from sex work in that neither party considers the encounter to be a formal commercial exchange (Dunkle et al., 2004). Women receive a variety of items from their partners ranging from “survival” necessities such as cash, rent, or food, to fashionable clothing, electronics, or consumer goods intended to bolster social status (Masvawure, 2010; Miller et al., 2011).

Economic entanglement is expected in sexual relationships, but presents women with a complicated task of reputational management (Stoebenau et al., 2011). Women who ‘give away’ sex without receiving anything in return may be mocked for not valuing themselves or their sexuality highly enough, or face reproach from family members whom they have failed to support (Groes-Green, 2013; Wamoyi et al., 2011). However, women who do receive support or gifts from a partner risk accusations of materialism or promiscuity if their motives are perceived as mercenary rather than affectionate (Strebel et al., 2013). This may be one reason why among US women who report initiating or maintaining a relationship for economic reasons, only 10% agreed the relationship was economically motivated (Dunkle et al., 2010).

The line between acceptable and unacceptable economic dependence can be difficult to discern because in much of the world the notion of “provider masculinity” is a normative, desirable manifestation of hegemonic masculinity (Connell & Messerschmidt, 2005; Swidler & Watkins, 2007). In southern Africa, the ways in which men manifest power through financial support for their wives and girlfriends has received a good deal of attention and research (Jewkes et al., 2012; Miller et al., 2011; Potgieter et al., 2012; Swidler & Watkins, 2007; Watt et al., 2012). However, there is less empirical research on how women understand and interact with the gendered power hierarchy.

Schippers suggests that within the theoretical framework of hegemonic masculinity, women may engage in either emphasized or pariah femininities (Schippers, 2007). An emphasized femininity is a socially approved model of femininity that positions women as complementary and inferior to men. In pariah femininities, women engage in behaviors that resemble those typically attributed to hegemonic masculinity. The latter are stigmatized and penalized because they resist and threaten male power (Schippers, 2007).

Women who have multiple sexual partners, or who are perceived as sly and calculating in their relationships, are more strongly condemned by their communities than women who frame their sexual-economic relationships with romantic rhetoric or than those who express shame and attempt to conceal their more formal transactions (Stoebenau et al., 2011). Hegemonic gender theory suggests that this is the case because the former sets of behaviors mirror hegemonic masculinity (promiscuity, emotionally detached sexual relationships) and thereby challenge male dominance, while the latter reinforce the gendered power hierarchy. Because women who engage in pariah femininities risk being cut off from social and economic capital, they must manage their social identities and sexual reputations to avoid being associated with these noncompliant models of femininity (Fielding-Miller et al., 2014; Kaschula, 2011; Strebel et al., 2013).

Our study used a qualitative research design to understand how women perceive and navigate the physical and social risks of emphasized and pariah femininities within the context of transactional sex by exploring two linked research questions:

1. How do Swazi women perceive sexual-economic relationships, how do they conceptualize risk within these relationships, and what strategies do they use to mitigate risk?

2. How do hegemonic and pariah femininities in Swaziland complement or resist the male provider role inherent in transactional sex?

Methods

Setting

Data were collected in Swaziland between June 2013 and October 2014. Swaziland is an absolute monarchy in southern Africa with a population of approximately 1.2 million and an adult HIV prevalence of 31%, peaking at 54% for pregnant women age 30–34 (Bicego et al., 2013; DHS, 2007; Swaziland Ministry of Health, 2010). Poverty and food insecurity are widespread -- approximately 2/3 of Swazis live on less than $1.25 a day (African Development Bank, 2013). Unemployment is 30% overall, but 70% for women (African Development Bank, 2013). It was not until 2010 that married women could register property in their own names and their husbands must still represent them in court (Langwenya, 2010).

Study Design

This study was part of a larger mixed method project that utilized cultural consensus, qualitative, and quantitative methods to identify and understand distinct emic models of transactional sex in Swaziland (Fielding-Miller et al., 2016). Data presented in this manuscript is primarily based on in-depth interviews (IDIs) and focus group discussions (FGDs). IDIs were used to elicit women’s personal narratives of transactional sex, strategies for navigating health risks within relationships, and experiences managing social and sexual reputations. FGDs were used to understand normative community perspectives on transactional sex and femininity.

Sampling

Key informants were selected using cultural consensus modeling (CCM) and analysis. This methodology makes two main assumptions: 1) If a number of informants answer questions about their culture or community (rather than their particular preferences) in a consistent way it is because they are drawing on shared cultural knowledge – a consensus model, and 2) The degree of cultural knowledge, or competence, will vary among informants with some being more culturally competent than others (Romney et al., 1986; Weller, 2007; Weller & Romney, 1988).

We used free listing and rating to identify consensus models of transactional sex and femininity. We first asked a convenience sample of women in the urban capital city Mbabane, a peri-urban are with prominent textile and canning factories in the Manzini-Mbabane corridor, and a rural areas approximately 90 minutes from the capital city to respond to two questions:

1. What makes a Swazi woman admired in her community?

2. What items do Swazi women get, or hope to get, in exchange for sex?

We emphasized that the questions pertained to Swazi women in their communities in general, rather than their personal preferences. Answers were consolidated into two master lists of approximately 30 items each.

We approached a second convenience sample in the same way, asked them to rate the importance of each list item from 1–5, and collected demographic data. Again, we emphasized that we were interested in how important they thought each item was to Swazi women in their community in general, rather than to themselves in particular. At the conclusion participants were asked if they were interested in participating in a second, longer IDI. If they agreed we recorded their contact details.

We used this rating data to identify cultural consensus models of transactional sex and Swazi female respectability. The process is essentially a factor analysis in which participants are the variable of interest and an eigenvalue greater than 3.0 between clusters of informant answers suggests that they are drawing on a single cohesive cultural model (Weller, 2007). The process identifies a single cultural “answer key” for each cultural domain – in this case, the most correct way of rating each item – and a competence score for each informant indicating how closely their answers resembled the culturally correct answer key and thus their degree of expertise within that model (Hruschka et al., 2008). Scores can range from 0–1.00 with 1.00 reflecting perfect knowledge about a cultural model. We present full details on our methodology elsewhere (Fielding-Miller et al., 2016).

We identified one dominant model of Swazi female respectability and three cultural models of transactional sex: Younger women primarily recruited at a residential university, older women with less formal education predominantly recruited in rural areas, and unmarried, mostly urban women who had generally completed 11–12 years of formal education. Average competence scores were 0.6 (n=17), 0.5 (n=19), and 0.6 (n=12) for each model, respectively. Weller and Romney suggest is sufficient to assume informants are drawing on a shared cultural model with 95% confidence.

IDI data collection

We conducted in-depth interviews with a purposive sample of cultural experts within each cultural model. Women who had participated in the rating activity and had high cultural competence scores within a model -- implying a high degree of knowledge about what women hoped to get in exchange for sex or female respectability – and who had provided their contact details were purposively sampled from each consensus model. All informant interviews were conducted using one common field guide. Topics included participant’s opinions on the definition of Swazi femininity and female respectability, their perceptions of the gendered nature of material support within their communities, and their personal experiences and expectations of financial support in relationships. Interviews with women who were culturally competent about a model of transactional sex emphasized discussions of transactional sex. Interviews with women recruited based on respectability competence emphasized social respectability. A trained female Swazi research assistant (RA) conducted all IDIs in siSwati.

FGD data collection

FGDs were conducted at an urban clinic and a residential university using convenience sampling to recruit women who were immediately available and interested. A rural FGD was conducted with members of a pre-existing women’s social support group who had collectively agreed to participate. A female Swazi RA facilitated FGDs with assistance and occasional input from the first author. We asked FGD participants to discuss items that women hope to get in exchange for sex, what type of woman might want what type of item from her partner, and how a community would perceive that woman. Participants were asked to reflect on feminine respectability, how a woman’s sexual reputation could impact her respectability, and what the social and financial implications of this might be. FGDs were conducted in English or siSwati depending on the group’s preference.

Analysis

All FGDs and IDIs were transcribed in siSwati and translated into English except for FGDs that were directly transcribed in English. The first author checked a subset of all IDI and FGD transcripts for translation and transcription error.

Data were analyzed iteratively following Creswell’s analysis spiral and using a combination of narrative and modified grounded theory approaches (Creswell, 2013). Transcripts were coded inductively using MaxQDA software (VERBI Software, 2014), and codes were condensed into categories. We used hegemonic masculinity and femininity theory to organize categories into matrices and concept maps to clarify relationships. Narratives of transactional sex were abstracted from transcripts and compared by relationship model to identify distinctions and commonalities. We used memos throughout data collection and analysis to check saturation, track ideas, and provide a space for researcher reflexivity. A second reader reviewed all transcripts and discussed coding schemes, matrices, and concept maps. IDI and FGD data were triangulated and we used iterative member checks with RAs and local colleagues to enhance data credibility (Lincoln & Guba, 1985).

Ethical considerations

IDI participants were first contacted by phone and given a brief description of the study and interview themes. Participants who refused were thanked for their time and were not contacted again. For those who expressed interest, we arranged an interview time in a private room or office convenient to the participant. Written informed consent in siSwati or English was provided immediately prior to interview or FGD. A small snack was provided to all participants to thank them for their time but no monetary incentive was offered per SEC preferences. Pseudonyms were assigned to participants in the analysis stage to protect participant confidentiality. Preliminary study results were shared with stakeholders at the national and community level.

The Emory University Institutional Review Board and the Swaziland Scientific and Ethics Committee (SEC) approved all research activities. Traditional leadership approved study activities at the rural research site. Nurses and clinic leadership approved study activities at clinical sites.

Results

We interviewed 16 IDI respondents purposively sampled from the 77 women who rated list items and conducted 3 FGDs in 3 different geographic areas. The rural FGD consisted of 12 participants, the university FGD of 7, and the urban clinic FGD of 6. IDIs lasted between 30 and 60 minutes, FGDs were approximately one hour. In all we interviewed 41 participants. Based on demographic data and women’s narratives we labeled the three pre-identified models of transactional sex “University,” “Aspirational,” and “Inkhosikati” – a siSwati term that describes an older, respected woman. Two women with high competence scores within the Inkhosikati model were contacted and declined, as did one with high competence in the Aspirational model and one with high competence in the Respectability model. Because of high levels of cultural agreement on what makes a Swazi woman respectable, many women interviewed about transactional sex models were also culturally competent about female respectability. See table 1 for key informant sampling by cultural model and demographics.

Table 1.

Participant competence scores and demographics

ID	Age	Education	Marital status	Recruitment Site	“University”	“Aspirational”	“Inkhosikati”	Respectability
BUHLE	21	Tertiary	Single	University	0.81			0.79
J ABULILE	19	Tertiary	Single	University	0.76			0.28
KHETHIWE	21	Tertiary	Single	University	0.68			0.83
NKOSINGIPHILE	30	Tertiary	Married	University	0.67			0.51
NOKUTHULA	34	12	Single	Peri-urban	0.60			-0.45
NOMSA	36	11	Single	Rural		0.77		0.41
NOMVULA	38	Tertiary	Married	University		0.65		0.72
NOMZAMO	24	12	Single	Rural		0.60		0.61
NONHLANHLA	28	9	Married	Rural			0.78	0.84
SIHLE	50	12	Married	Urban			0.73	0.77
SIMPHIWE	19	9	Single	Rural			0.64	0.77
THANDEKA	20	12	Single	Urban				0.86
THANDILE	30	12	Married	Peri-urban				0.84
THEMBI	30	10	Single	Peri-urban				0.79
ZOBUHLE	28	8	Married	Rural				0.71
ZODWA	27	Tertiary	Single	Peri-urban				0.68
	Declined
	40	8	Married	Rural		0.74		0.61
	50	5	Married	Rural			0.86	0.67
	23	10	Single	Peri-urban			0.82	0.53
	26	10	Married	Rural				0.72

Emphasized femininity: Who is a good Swazi woman?

Informants described an emphasized femininity in which the ideal Swazi woman would be respectful, have “good behavior” (tiphatsa kahle), “good character” (similo sahle), and be humble, Christian, and kind. While “good character” and “good behavior” are vague in English, their siSwati counterparts – similo sahle and tiphatsa kahle – refer to specific feminine character traits and actions:

Respecting other people means you do listen to them and you do submit to everyone regardless of their status or age… people in your community know you, that you are a daughter in law of whatever family and not sleeping around if you are married. Also not insulting people.

-Zobuhle

Some women, typically those who were younger or had more formal education, felt that changing norms had created a place for a more independent style of feminine respectability:

In rural areas a woman cannot build a homestead without being married or being assisted by a male during the kukhonta process [in which the chief grants land access for a homestead]. Ok let’s say that this woman she managed to build her homestead without being assisted by a male, then other women they will admire her courage and that she has managed to achieve something which other women thought it was impossible to achieve.

-Buhle

Social and economic respectability were linked. Wealthy women were respected whether the source was their job, a wealthy family, or a husband with a good job.

If you are known in the community that maybe you have money, of course they [community members] will want to get closer to you, because they know that if they need help they will get it from you.

-Nonhlanhla

Wealthy married women were considered more trustworthy than single women, and sometimes more approachable than men:

Informant 1: If you seek help from married women you will definitely get help.

Interviewer: A married woman can help somebody more than an unmarried woman?

Informant 1: Oh you can say that!

Informant 2: For example financially a woman in Swaziland has her husband to take care of most of the things unlike a single woman who has all the stress of taking care of all her needs.

Informant 1: I also feel like it is easier to relate to someone who is married than someone who is single

Informant 3: Yes you think that one has experience in lots of things that you can practice now and then.

-University FGD

Financial support from men was normative and expected. Friends and family were likely to approve of a woman’s relationship if they also received gifts from her boyfriend, and some were more likely to provide short-term loans to a woman if they knew her boyfriend would shortly be able to provide her with funds to pay them back.

Sometimes when I ask for money and he says that he is too far and I need to use it at that moment I ask my friends to lend me and I pay them back when he gets back.

-Thandeka

While economic support from a male partner is expected, informants referred to women whose primary motivation was not love or marriage as “gold diggers” or “prostitutes.” A promiscuous or materialistic woman would have a bad reputation and would not receive help from her community in times of need.

Informant 1: Maybe she is dropped off by this car and picked by another one. No one can respect a person like that, no one can take that person seriously. They say, “Ah, that one.”

Informant 2: She is loose.

Informant 1: She likes material things, like you will not sleep for nothing [laughs]… but she thinks she is a hard worker because she works hard to get those things.

-University FGD

Should a woman with a poor sexual reputation fall ill, some participants thought she would be less likely to receive care than a woman with a good reputation:

Her behavior contributes in determining whether she gets the help she needs or not… Like let’s say the woman is sick, people might not help her if she was sleeping around…People will feel that you are reaping what you sow.

- Nkosingiphile

Some transactional relationships were more sympathetic and less subject to social censure. Women who were poor or obviously being taken advantage of were pitied, although their behavior was still not acceptable.

Informant 1: Just to take care of the family she is offering herself to this man. She is not entirely a bad person.

Informant 2: I think that she knows what she wants but she didn’t go to the perfect school to get where she wants to be.

Informant 1: She is doing the wrong things for the right reasons. These are important things. She is better than this [materialistic] one.

-University FGD

Relationship Models

Relationship models can be organized according to when they typically occur in a woman’s life course and the degree to which they manifest emphasized or pariah femininities. The boundaries are porous: A relationship may transition between models over time, or a woman may move through several different models within her life (figure 1). In addition to the three models that we sought out a priori, IDI participants referenced relationships they had had when younger with older men in return for gifts or cash. These are typically called “sugar daddy” relationships in Swaziland and so we too chose to use this term.

Figure 1.

Transactional relationship models by pariah and emphasized femininities across the life course

Inkhosikati

The Inkhosikati relationship model describes a woman who is slightly older, has less formal education, and spends more time in rural areas. Inkhosikati relationships most closely reflect the ideal emphasized Swazi femininity. Husbands are expected to take on a provider role and are responsible for the economic wellbeing of their family. Wives are expected to ensure their husband is sexually satisfied. Informants saw these as reciprocal gender roles rather than transactions.

The main reason [for sex] is that I want to make him happy. […] He will give me money when I ask him and cater for my needs as we are in a relationship and we are supposed to make sure that we are both happy in this relationship… I don’t have the mentality that when I have sex with him then he has to give me something afterwards.

-Sihle

Women feel pressure to marry partially to gain social status, but also to neutralize themselves as a potential threat to other women’s marriages.

We reach a point where we can do anything to get married. I think that this happens in the rural areas because the community is watching. If you are not married you will take all their husbands because you do not have your own. So that puts too much pressure.

-Nonhlanhla

The majority of women agreed that marriage was “every woman’s destiny,” and that marriage exemplified respectability and assured some degree of social and economic stability. Despite the emphasized ideal of female monogamy within marriage, informants felt that even married women were capable of engaging in extra-marital relationships for sexual pleasure.

Everyone wants to have…sexual satisfaction. You know you find that this lady she is married but since her husband doesn’t satisfy her then she will leave the man in the house and go around sleeping with men to satisfy her sexual appetite.

-Jabulile

Aspirational

In Aspirational relationships women blend pragmatic economic need with the hope of a more stable emotional and social life in the future via marriage. Many women linked gift giving to sex, but framed this within the context of love.

You develop a mentality that you’re going to get what you’re having sex for… It is what am in need of that particular time, what you have both agreed on, what he promised to give… maybe we agreed that you would buy me that airtime when we sleep together….you don’t sleep with someone you do not love; you only sleep with someone you love.

-Nomsa

The relationship can take place at any point across a woman’s life and is largely defined by an attempt to mirror or transition towards the emphasized marriage ideal. Women positioned gifts and financial support as evidence that the relationship could one day progress to marriage:

Maybe there is something big which he will do for you, like giving you pocket money so that you can buy things you need or else he surprises you and buys you things that you need. Maybe he knows that you need a new phone then he buys you one. Maybe you need clothes, maybe he notices that you need to do your hair and he takes you to the salon. Or maybe next day he marries you and you become his wife.

-Nomzamo

As in other models, Aspirational relationships may transition as partners’ feelings, motives, and social pressures change over time. One informant began a relationship with a man driven primarily by economic need. The couple developed feelings for one another in part because she viewed his ongoing financial support as a sign of both affection and his potential as a husband. As the relationship became visible his family felt she was only interested in his money and forced him to leave her:

What came in my mind was that he will help me when I needed something and I will get money and be able to help my mother. So he was able to buy me clothes and buy me food … and then I started wearing expensive clothes, and I also started using nice smelling cosmetics. So that made me to have this mentality that he will make a good husband… He bought me everything I needed because he was trying to please me when I paid him a visit …He was a good man and he was able to meet my needs … he had the intention of making me his wife…His dream was crushed by his mother … she had the mentality that I was after her son’s money, so that was her problem and we separated. My heart aches you know because he was serious with our relationship and he wanted us to get married and since now that my life is not good so I feel pain as I know that he was a caring person.

-Nomvula

University

The University model reflected an emphasized femininity for younger, more educated women attending University in their late teens and early twenties. University relationships are relatively egalitarian and accentuate female independence more than the Inkhosikati model, although women are still expected to show respect to their male partners. Women stressed that gifts were given and received as an expression of love and were not their primary relationship motivation. The lack of emphasis on gifts is partially because their partners are also students who are not capable of large economic outlays.

Since I was young I didn’t have that mentality of being dependent to other people. I have learnt to do things for myself and besides … where did I except him to get the things I needed? I do ask him for some money if I need to do my hair, I simply tell that that I need to do my hair. He knows that every month he has to give me money to do my hair and buy myself anything I need.

-Buhle

Families usually know about these relationships and approve of their daughters’ involvement with an educated man who has a strong financial future.

My family they know him and what makes them to accept him is that he is educated and employed so they are happy that we will have a good future unlike if I’m in a relationship with someone who is less educated than I am.

-Nkosingiphile

In more hidden University relationships women are clear that their motivation is primarily economic. Women may use this type of relationship to supplement tuition, support a child, or finance a fashionable lifestyle. They may appeal to the values of emphasized femininities by highlighting warm feelings for their partners or their own economic desperation.

He is someone who understands my situation and when I ask him anything he is so understanding as he can see that I’m a single parent and I am still at school… The only problem I have is that I have to have sex with him whereas I don’t love him at all. We met at a restaurant, I was having lunch and he asked to share a table with me… He made sure that I could see he has money so I told myself that I will no longer struggle financially, and he also told me that if I need anything I should call him.

-Jabulile

While there was some distinction between economically motivated and emphasized relationships, there was also a good deal of overlap. Women saw gift giving and financial support as a sign of love and affection. One relationship may contain elements of both motives:

He is a nice person… my child calls him daddy and he calls him son. So that makes me happy that he loves me and my child…. As for my family they know that he is supportive and he helps us so they just love him. At home I’m the eldest child we don’t have a mother or father so I am the one who has to take care of my sisters…You know, they tell themselves that they will get money from boys. So I have to make sure that there is always food and they don’t run out of electricity.

-Nokuthula

Sugar Daddy

Although we did not identify a “sugar daddy” model using consensus modeling, several women recruited as experts within other models reflected back on relationships that they had had with older men for financial gain when they were younger. They typically did not make any attempt to position these within emphasized femininity by framing them with affective language or mentioning a hope of future marriage. Young women were aware that gifts were being given as an inducement for sex and made a purposeful choice to engage in these relationships.

We used to meet when I was coming from school and he used to offer me a lift… He used to flash around his money and I was tempted to be in a relationship with him and my friends they also managed to convince me to do so… I freely asked him [for what I wanted] as I took advantage of the fact that I knew that he was going to give me anything I asked for because I knew that it was his way of drawing me closer to him in order for me to have sex with him.

-Nkosingiphile

The man tended to be older and was often married. Girls were usually school age, presumably secondary school, and could gain social status in certain circles from dating a high status man.

He was someone who is well known like I said and he liked women a lot and most girls in my area they wanted to go out with him as is someone who flashes his money. Well, we will get tempted and also to be known that you are dating so-and-so.

-Thandile

Girls almost always sought to hide these relationships from most of their community. When relationships did become visible they were primarily policed by female community members. If a girl’s family – or her partner’s wife – found out about the relationship then the girl was likely to be the one contacted and told to end the relationship.

One lady called me and she told me that she was going to tell my mother of my behavior, that I was in a relationship with someone who is married. That is one reason I decided to end things…I didn’t want my parents to be disappointed in me.

-Nkosingiphile

Managing health risks

Women’s strategies for managing HIV risk varied by relationship model (table 2). Although we did not ask about HIV explicitly, women in every relationship model worried about HIV and knew the importance of monogamy, consistent condom use, and frequent HIV tests. They weighed the tradeoff between potential health risks and the respectability and socio-economic stability provided by an emphasized relationship:

I didn’t eat in this fancy restaurant -- who can tell what food I eat every day? No one. So why should I put myself at risk of contracting HIV for something which is useless? It would be fine if I sleep with a man and then he builds me a house. If I die I will leave my children with property.

-Nokuthula

Table 2.

Influence of relationship norms and financial considerations on condom use and monogamy

		Relationship norms and expectations	Financial considerations
Sugar Daddy	Condoms	More likely. Low trust and short term on both parts. He may be married and wants to avoid a pregnancy	More or less likely Difficult to demand if he is her only source of income Negotiation possible if she is ‘just playing.’
	Monogamy	More or less likely Monogamy not normative: He is married, she is ‘just playing’ More likely if she hopes the relatio ship will become serious.	More likely More likely from her if he is her only source of income
University	Condoms	More likely Emphasized: Condom negotiation normative Emphasized: She may end relationship if he refuses	More or less likely Emphasized: Gifts demonstrate love and may not affect condom use. Economically motivated: Difficult to demand if he is her only source of income
	Monogamy	More or less likely Egalitarian: Monogamy is normative but she worries about him. Egalitarian: May end relationship if he is not monogamous Egalitarian: Uses sex to prove her faithfulness and ensure his monogamy Economically motivated: Monogamy less normative for both partners	Less likely Egalitarian: Friends or family may pressure her to stay with educated or financially stable partner despite cheating. Economically motivated: She cannot demand monogamy from him. She is more likely to have second partner
Aspirational	Condoms	Less likely Use declines as relationship continues.	Not discussed
	Monogamy	More or less likely Cheating suspicions normative Less likely to end relationship over cheating as relationship continues.	Unclear. Possibly less likely to demand monogamy as partner takes on male provider role.
Inkhosikati	Condoms	Less likely. Children cement and sanction marriage May provoke a fight or accusations of cheating.	Not discussed
	Monogamy	More likely Monogamy normative Cultural expectations to provide sex on demand -- uses sex to prove her faithfulness and ensure his monogamy Less likely to end relationship over cheating	Not discussed

Many felt that according to both Swazi culture and local interpretation of biblical tenets husbands were entitled to conjugal rights and married woman could not decline their husbands’ sexual advances or negotiate condom use.

Maybe they should educate [married women] more about their right when it comes to sex in marriage, because most women they find themselves obligated to have sex with men without using protection, whereas men sleep with other women and don’t use condoms…We have lost many women because … she has to sleep with her husband without using condoms as she is afraid of the husband and knowing very well that there are other women he sleeps with outside their marriage.

-Thandeka

Inkhosikati women’s main strategy to protect their health and relationship was ensuring their partner’s sexual satisfaction. One woman explained that being consistently receptive to sex would prevent cheating that could introduce HIV into her relationship:

If I do satisfy him, he won’t need to go out and bring home what may be a risk, like these diseases. It is what is very expected from a wife. Because when you get married, they do say that, “the cake is eaten anytime.”

-Nonhlanhla

Similarly, women in both emphasized and hidden University relationships worried about cheating and felt that having sex whenever their boyfriend requested it could both “prove” their own fidelity and prevent their partner from straying.

“I think it was peer pressure from my friends…I kept complaining that he is cheating and they asked me what I was expecting because I was not sleeping with him.

-Khethiwe

Aspirational relationships are less socially regulated than marriage and less egalitarian than the University model. Because of this, women tended to worry more about cheating but were reluctant to end a relationship over infidelity.

It’s pointless to ask him that what problem is because he will never tell me. Because maybe … the problem is in me and he will not tell me because he is shy …or maybe you find out that there is someone else he is dating that is why he gets annoyed but he usually does ignore me….I do love him…I can be patient with his mistakes.

-Nomzamo

Because they are often predicated on the hope of future marriage, women in Aspirational relationships were less likely to use condoms, particularly as relationships progressed over time.

At first we [used condoms], but we got used to each other and forgot all about that…

-Nomsa

In contrast, the utilitarian nature of hidden Aspirational relationships made condom negotiation more viable than in relationships that had the potential for marriage:

Interviewer: So is there many an instance whereby maybe you found yourself that you had sex and you didn’t use condoms?

Informant: Eish. It has never happened I think the reason is that he is married and he is extra careful that I don’t get pregnant and I am extra careful.

-Thembi

In Sugar Daddy relationships condom use was more likely if a woman’s partner was married and didn’t want her to get pregnant. However if the woman had few economic alternatives outside of the relationship she was less able to negotiate condom use.

You know it becomes a challenge when you try to insist that he should use [condoms] and he refuses and you will end up giving in because you need his money.

-Jabulile

Discussion

We found and described four relationship models based on what Swazi women get or hope to get in exchange when they have sex. These are often labeled with the etic term “transactional sex,” although this phrase has little emic meaning. Each relationship model we examined contained a blend of sexual and economic obligations. IDI participants in Inkhosikati and the more visible University and Aspirational models described their relationships using rhetoric that aligned with emphasized femininities: They were respectful and sexually available to their partner and in return their partner provided them with financial support, social respectability, and stability. Those models which most closely aligned with traditional notions of ‘transactional’ or ‘commercial’ sex – “Sugar Daddy,” and certain manifestations of University and Aspirational models – were distinctive not because women were more reliant on male financial support, but because they did so in a way that was not socially acceptable. IDI informants in these pariah relationships tended to hide their relationships from their community. In interviews they used language designed to appeal to the listener’s sympathy. Normative data from IDIs and FGDs suggests that this is because women whose relationships do not align with emphasized femininity are likely to be stigmatized and cut off from social and material support. While there are many useful theoretical lenses to understand transactional sex, the notions of pariah and emphasized femininity can offer particular insight into why some forms of economic dependence are culturally acceptable, while others are locally vilified and internationally problematized.

Previous research suggests that risk in transactional relationships stems predominantly from women’s economic dependence in a relationship, however we found that social pressures are also important. Women whose relationships manifest emphasized femininities use health protection strategies that do not jeopardize their relationship so as to maintain their social and economic stability. In contrast, women in pariah model relationships may be less able to negotiate condom use or sexual encounters if they are financially dependent on their partners. However, they may also be more willing and able to leave a partner or to demand condom use.

As with all qualitative studies our results are meant to describe emic perceptions and experiences rather than make generalizable claims about prevalence and risk correlates (Creswell, 2013). For example, while our data describes four culturally salient models of transactional sex, we cannot know how prevalent these models are within Swaziland, nor do we claim that all relationships fall into one of these four models. While distinct differences between relationship models emerged, it is possible that some salient themes did not reach saturation due to the relatively small number of key informants from each model. However, data triangulation between IDIs and FGDs and member checking with RAs, clinicians, and local Swazi social scientists improves our data’ credibility and our confidence that we did reach saturation on those themes that we report here (Lincoln & Guba, 1985). While our IDI sample size was relatively small, and we cannot rule out the possibility that these models emerged by chance, purposively recruiting cultural experts within each domain based on their cultural competence score – women whom we knew to be experts within each relationship model a priori -- increases our confidence in the themes we did identify within the data (Hruschka & Maupin, 2013; Hruschka et al., 2008).

Our findings reflect cross sections of the different relationship models which a woman may engage in over her life course, echoing previous research in Swaziland that describes men and women’s shifting priorities over time (Ruark et al., 2014). The main difference between the relationship models we identified is not the degree of economic dependence or sexual obligation --some degree of both appears to be the rule, rather than the exception – but the social acceptability of this tradeoff within a woman’s community. Women in emphasized model relationships viewed this tradeoff as reciprocal gender roles rather than economic transactions. In emphasized relationships women receive both financial support and high social status accompanied by the tacit promise of material support from the community in times of need. Marriage – the Inkhosikati model – is the highest manifestation of this relation type.

Hegemonic gender theory suggests that women who engage in relationships that invoke pariah femininities are stigmatized and condemned by community members because they threaten male dominance (Connell, 1987; Connell & Messerschmidt, 2005; Schippers, 2007). In the “Sugar Daddy” and hidden Aspirational and University relationships, women do not link their sexual relationship to love, expect to marry their partner, or maintain an aura of monogamy. According to this gender theory, because these attitudes simultaneously mirror hegemonic masculinity and subvert male dominance these women are condemned and less likely to receive help from their communities in times of crisis, including if they fall ill. Community members are less likely to express sympathy for women in these relationships than for the woman who is “doing the wrong thing for the right reasons.” The latter woman’s motives are clearly material, and she may be engaged in multiple partnerships, but her economic need reinforces her dependence on men. Her actions do not threaten hegemonic masculinity so her behavior is discouraged but less stigmatized.

Women whose relationships most closely resemble the Inkhosikati, Aspirational, or University models also expect to receive financial support from their partners. However these models demand that in return for economic support they must be humble, submissive, and sexually well behaved – monogamous and sexually available. These relationships are socially acceptable because they do not threaten the gendered power structures. Women in relationships that align with emphasized femininity carefully weigh their socio-economic benefits with potential health risks. They may choose not to leave a cheating partner because to do so would be to sacrifice social status and access to social and financial support. They may be less willing or able to negotiate condom use, either because having children is an important element of a marriage or because they don’t want to accuse their partner of cheating or face accusations that they themselves haven’t been monogamous. Many use constant sexual availability to ensure a relationship remains intact and a partner does not cheat. In addition to increasing her risk of HIV, this strategy would also likely decrease a woman’s sexual pleasure with her partner. Women in pariah model relationships faced difficulty negotiating condom use and enforcing their partner’s monogamy as well. However, because their relationships are considered socially unacceptable they also face additional social risks and may have difficulty accessing social or material resources in times of crisis.

Interventions designed to reduce the risks of transactional sex may have greater impact if they focus on the power dynamics created by hegemonic gender norms rather than on the exchange of gifts or money within a relationship. Those that do not may risk pathologizing certain relationship types and increasing vulnerability by adding to the stigma of pariah femininities.

Women’s high unemployment and low access to financial resources reinforces dependence on male breadwinners. Microfinance programs have shown promise as a way to decrease women’s reliance on men and promote economic empowerment. While unconditional cash transfers may be a more efficient or lower cost short term intervention choice, programs that emphasize vocational skill building and long-term economic empowerment may have a better chance of allowing women to resist harmful hegemonic expectations in the long run (Dunbar et al., 2014; Jewkes et al., 2014). For married women, policy changes can mitigate the effects of economic dependence and legally sanctioned male sexual entitlement by addressing women’s property rights and outlawing marital rape. As in other structural intervention strategies, legal reforms to address property rights and marital rape would work best within a package designed to influence traditional leadership structures and social norms while bolstering community based enforcement mechanisms (Dworkin et al., 2014; Kim et al., 2007).

Conclusion

While the etic concept of transactional sex as “the exchange of sex for gifts or money” seems initially straightforward, it does not often match women’s complex emic experiences of intertwined financial, sexual, and romantic obligation. Using cultural consensus modeling, we identified four distinct models of “what Swazi women hope to get in exchange for sex.” We found that a woman’s social reputation hinged not on the degree of economic support provided by a sexual partner, but instead on how closely her relationship conformed to notions of female respectability.

Research highlights.

• Multiple models of transactional sex exist in Swaziland

• Transactional relationships may either support or subvert hegemonic masculinity

• Social risk and respectability depend on relationship to hegemonic masculinity

• Women know about HIV risks; reduction strategies depend on their relationship model