Gonorrhea infection and sexual behaviors-A qualitative study of South African women

In South Africa, the incidence of gonorrhea is highest among Black women due to their high co-infection rates with HIV and other sexually transmitted infections (STIs). This is alarming because of the emergency of antibiotic-resistant forms of the disease. This study examined the psychosocial determinants of gonorrhea among Black women aged 18 – 35 in the Langa township in Cape Town, South Africa. All participants reported at least one sexual experience and one positive test for gonorrhea in the past two years. Participant recruitment was flyer distribution at Love Life, the community partner to the research study. After an initial screening call, 12 women were considered eligible and participated in the study. Interview data were gathered, transcribed, then hand-coded for emergent themes, guided by the tenets of the information-motivationbehavioral (IMB) skills conceptual framework. The study contributes to existing literature on psychosocial determinants that have a positive relationship to the etiology of gonorrhea among African Black women and to form the basis of larger quantitative studies. Findings in this study were that the access to risk reduction information with consistency and motivation to change risky behaviors are affected by a woman's sense of how much control she has in her relationship. Interpersonal factors such as sexual inequalities where the males have prevalence of sexual power and control tend to take risk-reduction information and motivation out of the hands of the women. Environmental and cultural limitations caused pressure to engage in risky behaviors that led to heightened risk of gonorrhea.