Heterosexual behaviour is a complex subject and one which is aggravated by confounding variables. Few studies have investigated the way in which one variable, namely coitus, is initiated and negotiated in stable marital relationships. As the HIV/AIDS pandemic spreads in sub-Saharan Africa, the subject of marital coitus becomes of increasing concern. This study tests a methodology of semi-structured interviews and diary-keeping techniques to investigate how the activity is initiated and negotiated. A research team monitored the study and evaluated the research techniques. The study concluded that the HIV/AIDS pandemic is affecting the initiation and negotiation of coitus between marital partners and that the partners wish to renegotiate the relationship, but the mechanisms for renegotiation are not at present available.
PIP: Qualitative research involving married couples in Kenya indicated that the acquired immunodeficiency syndrome (AIDS) pandemic in sub-Saharan Africa is having a profound effect on coitus; however, couples lack the interpersonal skills to negotiate safe sex. Study participants included 10 men and 10 women recruited from family planning, health, and social service centers in Nairobi; all were involved in stable marital relationships of at least one year's duration (average, 6.5 years). During the three-month study period, subjects participated in weekly semi-structured interviews and kept a diary of all sexual activities. Coitus occurred an average of three times a week and its timing was under the control of the husband. Condom use was rejected due to its association with infidelity. Men became increasingly willing to acknowledge extramarital sex as the study progressed and they became comfortable with the research team; many of them were concerned about the risk of AIDS associated with this behavior. The diaries indicated that the sexual negotiation process begins with recognition of a conscious need and proceeds to initiation strategies (e.g., a romantic glance, touching of partner, a gift), which is either accepted or rejected. At times, men bypass the negotiation stage and violently force their wives to have sex. Most initiating and negotiating strategies were nonverbal and acquired unconsciously, impeding open discussion of physical and emotional needs. The qualitative methodologies employed in this study served to provide participants with a vocabulary for discussing sexual matters and motivation to re-negotiate a monogamous sexual relationship.