Leveraging changing gender norms to address concurrency: focus group findings from South African university students

Background: This study aims to complement recent research on sexual concurrency in South Africa by providing a deeper understanding of women's roles and motivations for engaging in and accepting their partners' concurrency. Our goal is to inform the implementation of more effective interventions that embrace the powerful role that women can play in healthy sexual decision-making in consensual relationships. Methods: We conducted 12 focus groups with male and female students at the University of KwaZulu-Natal. Drawing on a subset of those focus groups, we examined the gender norms underpinning the apparently widespread acceptance of concurrent sexual partnerships. Our analysis focusses on women's attitudes and behaviours towards concurrency - from both men's and women's perspectives - with a goal of identifying opportunities to engage women as agents of change in sexual partnership patterns in their communities. Results: Our findings indicate that: (1) concurrent sexual partnerships were the norm among male students and increasingly common among female students; (2) material gain and changes in women's perceptions of their roles and power in relationships were the primary female motives for concurrency; (3) peer pressure, a perceived innate need and a fear of being alone were the primary male motives for concurrency; (4) women often know that their partners are cheating and stay with them because they believe they are the most important partner, for financial reasons, or because they worry they will not find another partner. Conclusions: HIV prevention interventions in populations where concurrency is common would benefit from emphasising women's role and power in taking greater control of their own sexual decision-making in consensual and non-violent relationships.