The South African Centre for Epidemiological Modeling and Analysis or SACEMA, did an in depth study of the sexual behavior of 878 citizens of several South African Countries. These include Wallacedene, Delft-South and Khayelitsha. In total, the participants in the study reported in being in 1130 relationships in the past year, with a quarter of these relationships overlapping with others for extended periods of time. The evidence has shown the researchers that the proportion of men and women having simultaneous relationships is higher that previously thought.
One of the questions the researchers sought to answer through the findings of the study included why HIV infection was higher in black communities than in communities of similar socioeconomic backgrounds of their colored counterparts. They found that, on average, colored communities had less condom use than black communities, suggesting that condom use was not an effective preventative against HIV unless used consistently. Without this consistent use, HIV levels will not drop in these communities.
Additionally, the study provided evidence that South African respondents reported larger numbers in the age gap between them and their sexual partners as compared to colored participants. It was found that two-thirds of black men, 45 years of age ad older were in relationships with women at least five years younger; nearly half of women ageds 24 and older were in relationships with men who were at least five years older than they were. When interviewing the women in the study, it was found that many find security in having an older man as a partner because there will be a lower risk of abuse - physical and verbal, and older men were more calm, understanding and supportive. While HIV campaigns warn about the age diparity in sexual relationships among the black population in African countries, a 2014 Africa Centre Study showed no correlation among women with older partners and an increased risk for HIV, when compared to women who were dating men their own age.
Overall, the study has shown that people do not make relationship decisions based on their risk for HIV, but instead, that sexual relationships are "complex phenomenon with many dimensions." Therefore, if HIV interventions are designed with all of these aspects in mind, it is likely to be much more effective.
Finally, there is a study that has proven that by incorporating the culture of the people into their intervention plans, it will make prevention and recovery efforts more effective. I think that by addressing the different aspects of African culture, which includes polygamy, and the right to have mulitple sexual partners, intervention efforts can be made more specific to the population. As I have studied in my cultural studies class for nurisng school, African culture values fertility in a woman, and it is very important that she have many children in order to keep her husband. Similarly, the man's family name is passed on by his sons, and the children that the man has will help expand his tribe, so it is very important that he father many children to carry on his legacy. Often times, this means that a man will leave his wife once she can no longer bear children, in search of a younger partner who is fertile, and whom he can continue to have children with. Also, many women seek out older men, or "sugar daddies," because, in such an impoverished country, their sexual relations with a man will get the woman and her children dinner for a night, or a week, or even simply point her in the direction of the resources she needs. By addressing all of the above issues and more, intervention plans can be made that will be more specific to this population and this culture. We will no longer be simply telling these poeple "you can't have unprotected sex," because clearly, it is getting us no where. By approaching them at a cultural level, and taking the time to understand why the African people engage in so many relations, I think they will be more receptive to treatment, and we will be more effective in providing it.