Sunday Times (Johannesburg) - June 12, 2005
Claire Keeton, Johannesburg

-- 'Not much is known about what goes on between the sheets or behind the school sheds' - SA needs sex survey to wage war on Aids

TO HELP in the fight against Aids in South Africa, the country needs a sex survey to provide information about what goes on between the sheets as well as a statistical database.

This is the view of the head of the Anglo American Chairman's Fund, Clem Sunter, who told the country's second Aids conference this week that the war on HIV/Aids needed a study on sexual patterns.

This is the best way to formulate a viable Aids prevention strategy, Sunter told the delegates in Durban.

The Kinsey studies on the sexual behaviour of Americans in the '40s and '50s revolutionised what the nation knew about sex. It explored everything from extramarital sex to masturbation and other topics that were taboo at the time.

Although South Africa has the highest number of people in the world living with HIV - an estimated 5.3 million - it still lacks research into the sexual habits of the nation.

So far two major surveys have been conducted into youth risk and sexual behaviour but to date, little research has been conducted on adult sexual patterns.

Health Director-General Thami Mseleku said: "We need an in-depth, qualitative understanding of what currently influences attitudes [on sex] and there has been little research. We would not dismiss any idea on the table but would have to have a conversation about what a sex survey means."

Professor Anthony Mbewu, the interim president of the Medical Research Council, said the youth studies were valuable but further research was still needed. "Not much is known about what goes on between the sheets or behind the school sheds," he said.

At a conference session on adolescents and the risk of contracting Aids, one of the presenters, Lisa Langhaug, reported how young people in rural Zimbabwe identified places or occasions of sexual risk by drawing "risk maps" of their communities.

The maps showed schools, long grass and dry river beds but also all-night prayer meetings with no supervision. Such venues were identified as places where consensual and forced sex occurred.

Researchers at the Aids conference highlighted common sexual patterns across communities that increased the risk of HIV infection including:

Youth bravado - a "tata ma chance" attitude to HIV;

Young women exchanging sex for commodities; and

Young women having sex with older partners.

Other patterns include having multiple partners and sex without condoms.

One study in a Cape Town township, with 310 participants between the ages of 11 and 19, found that many of them had unprotected sex.

Jessica Berwick, lead researcher from the Desmond Tutu HIV Centre, reported that not all the participants answered sexually sensitive questions, such as how many had had sex with a stranger.

Of the 91 who responded to this question, 11% had paired up with a stranger the last time they had sex.

Another study titled "Young Lions to Young Lovers" revealed that a culture of extreme risk-taking had developed among youth alongside the rise of a culture of consumerism. It was found that young women increasingly exchanged sex for commodities.

A survey in the Vulindlela rural community, in the Kwa-Zulu-Natal Midlands, demonstrated a clear connection between HIV infection and the age of a woman's partner.

Roughly 25% of women under the age of 20 were HIV-positive when their partners were between 20 and 24 years old. But their risk of being infected more than doubled to 56% when their partners were older than 25.

Another risky sexual activity is the pattern of having more than one partner at the same time.

"We should be talking about safe relationships instead of safe sex," said Dr Kgosi Letlape, head of the South African Medical Association.

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