Condom use: a less travelled route among minibus taxi drivers and their taxi queens in KwaZulu-Natal, South Africa.

Gugu G Mchunu,Joanne R Naidoo,Busisiwe P Ncama

doi:10.4314/ahs.v20i2.15

Abstract

Despite significant gains in the HIV epidemic in South Africa, with reduction in mortality and elimination of vertical transmission, national HIV prevalence remains high, with women rather than men continuing to bear higher burden of the disease. Population subgroups, through ignorance, disbelief or recklessness, continue to engage in risky sexual behaviour. A substantial proportion of minibus taxi drivers engage in risky sex, seldom seeing themselves at risk for STIs or HIV/AIDS. These taxi drivers have been linked with so-called taxi queens, with whom they engage in transactional and intergenerational relationships. The study explored condom use and condom negotiation strategies among taxi drivers and taxi queens in Kwa- Zulu-Natal, South Africa. Applying explorative qualitative design, we conducted focus group discussion and individual interviews among participants who were purposively recruited in KwaZulu-Natal. Qualitative data analysis revealed that condom use and negotiation are sources of conflict for the participants. In addition, the strategies employed by participants to ensure condom usage are not always sustainable and are likely to be problematic due to a variety of complex factors. Our study concludes by recommending a nested public health response that takes cognizance of factors that promote sustainable condom use strategies among this population subgroup.

Highlights

Despite significant gains in the HIV epidemic in South Africa, with reduction in mortality and elimination of vertical transmission, national HIV prevalence remains high, with women rather than men continuing to bear higher burden of the disease
Minibus taxi drivers belong to an occupation in which the prevailing lifestyle has been identified as making them highly susceptible while on duty because they travel throughout the city, encounter many different people, receive money, and sometimes find themselves pursued by women who hope to have money spent on them by the drivers.[6]
Relevant research findings have indicated that a substantial proportion of minibus taxi drivers engage in risky sex but seldom considered themselves to be at risk of sexually transmitted infections (STIs) or HIV/AIDS.[6,7,8]

Summary

Introduction

Despite significant gains in the HIV epidemic in South Africa, with reduction in mortality and elimination of vertical transmission, national HIV prevalence remains high, with women rather than men continuing to bear higher burden of the disease. A substantial proportion of minibus taxi drivers engage in risky sex, seldom seeing themselves at risk for STIs or HIV/AIDS. Cultural norms and gender inequality are noted as consistent determinants in risk of HIV for women.[4] Despite the threat posed by the rapid spread of HIV, many subgroups of the population continue to engage in risky sexual behaviour, possibly due to ignorance, disbelief or recklessness.[5] Minibus taxi drivers belong to an occupation in which the prevailing lifestyle has been identified as making them highly susceptible while on duty because they travel throughout the city, encounter many different people, receive money, and sometimes find themselves pursued by women who hope to have money spent on them by the drivers.[6]. Relevant research findings have indicated that a substantial proportion of minibus taxi drivers engage in risky sex but seldom considered themselves to be at risk of STIs or HIV/AIDS.[6,7,8] With such risky sexual behaviours, links have been made between minibus taxi

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