5.5. Subjective norms influencing contraceptive use
5.5.5. Social expectations about sexual behaviour and contraceptive use
Most of the participants were of the opinion the society imposes beliefs about sexual activity which stigmatises contraceptive users. The following extracts illustrate this finding:
Where I come from, when one uses contraceptive and you are not married, like myself, so am likely to be stigmatised and tagged as a person who is promiscuous (Viola, F, 26, I, PG, IN).
Where I come from, you can't just walk to a shop and say I want contraceptives, you are considered very weird and immoral. So if I go to a shop and I want to buy something like a condom, I would have to negotiate and think about how I will approach that it is not as simple as going and buying Hedex (painkiller) and sweets (James, M, 33, I, PG, IN).
They (people) will be like so she is definitely going to have sex (Nombuso, F, 25, I, PG, SA).
The extracts suggest that issues about contraceptive use and sexual behaviours of unmarried individuals affect both national and international students. Nombuso and Viola seem to be saying that sexual behaviours of unmarried women are seen as immoral, while contraceptive use is linked
63
with promiscuity, while James seems to be saying that accessing a male condom is not an easy practice due the society’s expectations of sexual behaviours of unmarried people.
There were comments from one male participant that contraceptive use is not stigmatised but their use is an indication of sexual behaviour which in itself is considered a humiliating practice. The following extract illustrates his opinions:
I think the shame is with sex itself, not the contraceptives, the contraceptive shows a sign that you are sexually active, it is not shameful to be using pills or condoms but the fact that you are sexually active, that is the stigma (Melusi, M, 22, FGD, UG, SA).
Melusi suggests that the perceptions that sexual activity is a shameful act may not only compromise young people’s rights to contraceptive access and use but also interfere with their rational decision making processes to prevent the risk of pregnancy and/or STIs.
A few male participants were of the opinion that the motive of accessing the male condom, either to use with the wife or with other women, may determine how a person takes the judgement from others. The following extract from a male participant illustrates some of these findings:
I guess it depends on the reason why you are buying it (condom) like if you are buying to use it with your wife, it will be more acceptable in the community like if you go with your wife and buy the condom. It is more problematic like if you are alone, or with a girl that you are not in any formal relationship and you buy a condom, that will be more problematic, the community will view that as immoral and not acceptable (James, M, 33, I, PG, IN).
The opinions raised by James suggests that perceptions of others about when the male condoms should be accessed and used may impact on actual use, even if a person is motivated to protect against the risk of pregnancy and/or STIs. This relates to the argument in the theory of planned behaviour that approval or disapproval of behaviour by others may impact on behavioural outcomes (Ajzen, 1991).
There were views from a few participants that children are valued in marriage and women in some communities may be required to prove their fertility before marriage. The following extract illustrates the views of a woman from the Zulu community in South Africa:
64
There is in Zulu, like if a guy (man) has to get a woman to marry say especially in rural areas then you must make the girl pregnant before you can marry, so they want to know if she can be able to give you children (Zita, F, 23, FGD, UG, SA).
Zita’s comment suggests that women may fear using contraceptives due to the belief that contraceptives use interfere with fertility as shown in prior extracts in this chapter. Such beliefs may negatively influence young women's decision-making processes about contraceptive use.
In other contexts where women are not required to prove their fertility before marriage, they are expected to bear children a few years after getting married. The following extract illustrates the views of a male participant from Kenya:
For me it is about the side effects like when she swallows the pill it may render her infertile for the rest of her life and that woman will never get a kid and for the family to be sustained everybody needs a kid. So you will find they may be married and stay for five years without a kid, then divorce will automatically come although they are afraid of pregnancies in the premature stages of their relationships (Samuel, M, 26, I, PG, IN).
Samuel seems to be saying that marriage is complete with children and young women who use hormonal contraceptives might render them infertile, and this will make them worthless and vulnerable to divorce when they get married.
There were reports from two female participants at the undergraduate level which were against the perceptions of sexual activity and contraceptive use among the unmarried women. They argued that such perceptions should be ignored in the modern society where women engage in sex at a young age. One of them alluded that the use of hormonal contraceptives is a private practice and not easily detectable, for example, through a variety of methods which involves injections or inserting contraceptive devices into the body. This is unlike the condoms which can easily be noticed when they are being used. Her ideas are illustrated in the following extract:
Yes, it in some cultures, they do not allow women to use contraceptives, but I think women just do it because it’s a private thing nobody will know, for like injection, but condoms it can be known (Leah, F, 21, I, UG, IN).
Leah’s perceptions of contraceptive use as a private act suggest intentions to prevent the risk of pregnancy, which relates to the argument in the theory of planned behaviour that formation of intentions to perform behaviour may influence positive outcomes (Ajzen, 1991).
65
However, a favourable attitude towards contraceptive use and approval of contraceptive use by significant others alone did not influence the formation of intentions to use contraceptives.
Intentions to use contraceptives was also influenced by perceptions of control over their use.