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African Journal of AIDS Research 2014, 13(4): 321–329 Printed in South Africa — All rights reserved

AJAR

ISSN 1608-5906 EISSN 1727-9445 http://dx.doi.org/10.2989/16085906.2014.961938

The influence of biological factors on students’ sexual behaviour at the University of KwaZulu-Natal, South Africa Given Mutinta1*, Kaymarlin Govender1, Gavin George1 and Jeff Gow1,2 Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, 4041, South Africa School of Commerce, University of Southern Queensland, Toowoomba, 4350, Australia *Corresponding author, email: [email protected]

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Studies in South African universities reveal that the prevalence of sexual risk behaviour is very high, putting many students at high risk of HIV infection. This study explored the biological influences on students’ sexual taking behaviour at the University of KwaZulu-Natal, South Africa. A qualitative approach was used, comprising a total of 80 in-depth interviews and 4 focus group discussions. These were conducted between late 2008 and early 2010. The research had equal representation of male and female students, different races, two campuses and different levels of study. Factors associated with students’ sexual behaviour were identified. The data were analysed using thematic analysis, and the themes identified form the basis for discussion in this paper. Students’ sexual behaviour was positively associated with the influence of a range of biological factors. Factors such as age, judgement of the health of the partner by looking at appearances, pursuit of physical beauty, sexual debut, sexual fit, and search for sexual pleasure encouraged students to engage in sexual behaviour. Most students are young and lack experience in assessing the influence of biological factors on their sexual behaviours, and need education on biological factors. This poses a big challenge to controlling students’ sexual behaviour, especially if HIV and sexually transmitted diseases prevention interventions are to be successful. Keywords: biological factors, HIV and AIDS, sex drive, sexual risk behaviour, university students

Introduction Sexual behaviour is driven by human biology of both men and women (Spector et al. 1996, Archer et al. 2003, Gonzaga et al. 2006). Human sexuality is driven by the anatomic and functional integrity of the brain’s entire limbic system (Baumeister et al. 2001). This initiates sexual desire and related sexual phenomena in both genders. The limbic system’s function activates sexual fantasies, sexual daydreams, erotic dreams, mental sexual arousal, and the initiation of the cascade of neurovascular events triggering all of the somatic and genital responses (Eagly et al. 2005). But socio-cultural factors within which particular communities operate determine how biological sexual drive is expressed (Leclerc-Madlala 2008). Culture and systems of biological conditions impose forms of expression on sexuality with females being more repressed (Gangestad et al. 2000). South African studies, for example, Hunter (2002) and Leclerc-Madlala (2008), claim that due to the cultural regulation of women’s expression of sexuality, men have been largely represented as driven by an uncontrollable biological need to have sex. This libido is seen as natural and a biological necessity and is represented as ‘unmanageable’ (Eagly et al. 2005, Gonzaga et al. 2006). In Kunda’s (2008:38) findings the sex drive or desire for sexual activity was represented by notions such as ‘fire inside’, or ‘the dog in men’. Narrative words included, ‘torment’, ‘agony’ and ‘pressure’ (Kunda 2008:54) with the underlying notion being that men’s sexual drive is impulsive

and in constant need of release (Ostovich et al. 2004, Gonzaga et al. 2006 Lippa 2007). Mulwo (2009: 198) found that young females are seen as objects that arouse and provide success to men’s sex drive while men’s drive was perceived as a “force” that once “stirred up” by a woman is “unstoppable”. Thus, it places pressure on men to engage in sex even when it means being exposed to HIV. Men who do not actively pursue females are labelled as ‘lesser men’ (Kunda 2008:69). This notion of sex drive is governed by the script that men are active hunters of women. As such, women are not expected to actively seek sexual relationships or intercourse (Mulwo 2009). Mawoyo et al. (2009) and Lippa (2007) argue that females’ motivation in engaging in intercourse is love and intimacy not lust, which is portrayed as normal for men. The triadic link between sex and sexual risk behaviour and HIV infection, in heterosexual relationships has been long established in sub-Saharan Africa. Biological factors such as age and pubertal development have been identified as factors that encourage sexual behaviour and have been linked to the spread of HIV in South Africa (Hunter 2002, Parker et al. 2007, Peltzer et al. 2009). In South African universities, there are a handful of studies on the reasons students engage in sexual behaviour. Mulwo (2009) found that students engage in sexual behaviour because they arrive at university with little funding and thus engage in transactional sex to meet their needs for food and shelter (see also HEAIDS 2010). This lack of disposable income encourages sexual

African Journal of AIDS Research is co-published by NISC (Pty) Ltd and Routledge, Taylor & Francis Group

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risk behaviour. Kunda (2008) found that desire to experiment with sex and drugs influences students’ sexual risk behaviour while Breier (2010) argues that living with parents or guardians who harbour unregulated sexual attitudes encourage students to engage in sexual risk behaviour. The prevalence of risky sexual behaviour among students was estimated at 68% of students in heterosexual relationships in South African universities (HEAIDS 2010). Behaviour that makes students engage in sex and exposes them to HIV infection is widespread and takes place across all universities (Mulwo 2009, HEAIDS 2010). Sexual risk behaviour identified includes having multiple and concurrent sexual partnership and unprotected sex. Past research shows that students’ self-reported sexual risk behaviour and HIV/AIDS are common on campuses (Pretorius et al. 2006, Mulwo 2009, HEAIDS 2010). Contributing factors to the spread of the virus are the prevalence of multiple and concurrent (a situation in which a person may have a steady partner in a long-term relationship) partnerships but also has casual partners (Green et al. 2009). These partnerships usually overlap, forming a sexual network. While condom use amongst casual partners is high, it tends to become inconsistent and eventually decreases over time with a regular partner (Parker et al. 2007, Green et al. 2009). If one of the partners within the network gets infected with HIV, the virus could spread rapidly to others, as HIV is most infectious during the first three to six weeks after infection (UNAIDS 2010). According to Parker et al. (2007), 17% of young people between the ages of 15 and 24 years reported having had concurrent partners. Breier (2010) also found that youth falling into this age group have a greater chance of being involved with multiple and concurrent partners. Multiple and concurrent partnerships may also involve the exchange of material goods and status between a man or a woman who is better off economically, and a younger partner who is not. The younger partner is expected to give sexual favours in return to the ‘sugar daddy’ or ‘sugar mommy’ (Parker et al. 2007: 10). This paper investigates students’ perceptions of sexual risk behaviour on two campuses of the University of KwaZulu-Natal (UKZN) in Durban and Pietermaritzburg, South Africa. The purpose of this paper is to provide insights into student’s insights into the biological factors that influence students’ sexual behaviour that have the potential or capability of exposing them to HIV infection. Perceptions of biological factors that instigate students’ sexual behaviour are discussed under sub-headings including student’s age, judgement of the health of the partner by looking at appearances, pursuit of physical beauty, sexual debut, sexual fit, and search for sexual pleasure. The research account in this article forms part of broader study on students’ sexual risk behaviour at UKZN (Mutinta et al. 2012). Findings from the broader study sustain the conclusion that students’ sexual risk behaviour is influenced by interrelated, interactional and transactional factors from the biological, environmental/social, behavioural and personality domains that either instigate or buffer against students’ sexual risk behaviour.

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However, this paper only presents biological factors that instigate students’ sexual risk behaviour. This does not mean that biological risk factors operate in a vacuum, as they are inextricably intertwined with environmental/social, behavioural and personality determinants of risk. The rationale of presenting biological sexual risk factors without contextualising them into the dynamics of other sexual risk factors is to show the dominant factors reported by students. Methods In-depth interviews (IDIs) and focus group discussions (FGDs) were used to engage UKZN students on their sexual behaviour. This approach is inherently crosssectional and descriptive. Group dynamics were observed to ascertain individual and group thinking and obtain the majority view of the normative behaviour of students. IDIs were conducted in quiet environments to provide a confidential atmosphere in which informants could share sensitive, personal information. FGDs were conducted in college dormitories with each session lasting about one hour. Data were transcribed immediately. FGDs were used for several reasons. FGDs use interactions between researchers and participants to generate data. Crabtree et al. (1999) suggest the dynamic nature of interaction in individual interviews or small group discussion enables the generation of insights which provide comprehension of how people view a situation. The use of FGDs helps researchers understand the social construction of sensitive issues which are characterised by taboos or silence (Higgs 2001). FGDs afford the researcher privileged access to in-group conversations which often include everyday language and home-grown terms, uncovering variety, group dynamics, and stimulating conversations and reactions (Denzin et al. 2000). Ethical clearance was obtained through the UKZN Research Ethics Committee and all procedures were followed, with particular sensitivity to issues of confidentiality and anonymity. Participants were provided with information sheets detailing the aims of the research project and the process they would participate in. Participants were given the opportunity to ask questions about the research, and were aware that they could withdraw at any time. A verbal explanation was also provided to all participants. Written consent was obtained from participants before data collection started. Confidentiality was maintained through the use of pseudonyms in the research reporting and by changing specific contextual details that could have revealed the identity of the participants. Study setting and sample size In South Africa, of 48 million people more than 5.7 million are living with HIV. Evidence shows that South Africa has the highest HIV prevalence in the world. In 2009 about 310 000 South Africans died due to HIV and AIDS related complications (Shisana et al. 2009, UNAIDS 2010). KwaZulu-Natal (KZN) is a hub of the HIV epidemic in South Africa with the prevalence percentage at 17.8% (UNAIDS 2010). In addition, this province boasts the second largest

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provincial population of 10.8 million people and is one of the poorest provinces in the country (SSA 2012). Five campuses make up UKZN: Howard College, Westville, Pietermaritzburg, Edgewood and the Nelson Mandela Medical School. Over 40 000 students are enrolled and the demographics of the campuses vary, although dominated by the largest population group, Black African. The campuses are multi-cultural, comprising Black, Indian, Coloured and White students. Students come from within South Africa, other African countries, and further afield. Some live on campus, while others live in rented houses outside the campus in neighbourhoods that are close to the campus, with at times, mixing of racial groups. Two campuses out of the five were purposively selected (Howard College in Durban and Pietermaritzburg). Next, a one-time ballot selected two faculties as follows: each of the eight faculties of the two campuses was assigned a unique serial number. These numbers were written on equal sized pieces of paper, folded and placed in one box representing all faculties. Two pieces of paper were picked from the box, one at a time without replacement. The two schools whose serial numbers corresponded with the numbers picked from the box were studied. A list of students in the selected schools was obtained from the university. Using purposive sampling, 80 students (40 male and 40 female) were selected from each of five levels of study, that is, first year, second year, third year, fourth year and all postgraduate levels for the IDIs. Each level of study was represented by eight respondents. The racial diversity of the student population was replicated in the study population. Mulwo (2009) showed that most (68%) of the students at the university were Black, 20% of were Indian, and the remaining were White (8%) and Coloured (4%). The number of White and Coloured respondents was adjusted slightly to give more meaningful results. In total, 80 IDIs and 4 FGDs consisting of 8 participants each were conducted. Data analysis All IDIs and FGDs were audio recorded. Thematic analysis was conducted on the transcripts, which were transcribed verbatim from the audio recordings. The analytical software package NVivo 8 was used to process and analyse the data. Qualitative research is concerned with making sense of human experience from within the context and perspective of human experience (Kelly 2006) and has been widely applied. The analysis involved identifying patterns or themes across the dataset (Braun et al. 2006, Ajjawi et al. 2007). The concern was with the multiplicity of HIV risk factors in students’ perceptions rather than attempting to ascertain the ‘truth’ about actual factors. Patterns of similarities and differences in participant responses were identified and catalogued into themes and sub-themes. These themes form the starting point for the following discussion. Findings and discussion This section presents common themes that emerged as biological factors that encourage students to engage in sexual behaviour. Biological factors exert their influence in the context of a complex and dynamic multi-factor system

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and they included: age; judgement of the health of a partner by looking at appearances; pursuit of physical beauty; sexual debut; sexual fit; and search for sexual pleasure. This section is a descriptive and explorative discussion of the biological factors that encourage students’ sexual risk behaviour. The general observation is that students on the campuses studied engaged with the research themes easily. This is attributed to the fact that the primary researcher was also a student; therefore participants were familiar with him and felt at ease to participate. Age The majority of students interviewed were below the age of 21. Most of the respondents reported that they were teenagers and experiencing hormonal changes and physical maturation, factors which encouraged them to have frequent opportunities to engage in sexual behaviour. Harriet, a black female undergraduate explained what made her, and other students, engage in sexual behaviour: ‘From the time I began puberty I have been prone to sexual behaviour something that has somehow taken me by surprise. It is like I am in the sexual developmental and maturation time frame and my sexual drive tends to be high. To me this experience is worsened by the fact that on campus we do not have our parents to guide us through what we are experiencing’ (Harriet, white undergraduate student, Howard College). This response suggests that students tend to engage in sexual behaviour that may have long-term consequences for their health. In addition, this is also a time when many of students are developing emotionally and socially which influences their sexual behaviour as they lack knowledge and experience of what is happening in their lives. Often students are independent for the first time and are growing up, no longer under the supervision of parents who give them ‘a warm but demanding’ way that reduces their children’s risk of becoming prematurely sexually active or engaging in sexual risk behaviour before adulthood. Respondents said that being adolescents they lack the bargaining power and skills to insist on protected sex due to a lack of experience in dealing with senior students and older partners. Most respondents explained that students use condoms at the beginning of their relationships and stop after two to three months. Evidence shows that young girls do not insist on condom use for fear of losing their so called ‘university boyfriends’: ‘One thing I have seen is that both male and female students especially those who are still adolescents, experience incredible pressure to get sexual partners once they have joined university. Some are not psychologically ready but get into sexual relationship anyhow. They also cannot withstand older partners’ opposition to abstinence and end up giving in to their partners’ demand for sex’ (Anina, postgraduate student, Pietermaritzburg). This account suggests that lack of control over condom use among students often arises from unequal power relations between senior students or older partners and young female students. Of interest is that some senior

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students explained that they do not use condoms because of societal disapproval and cultural beliefs that stigmatise condom use. Some male students reported that condom use is not ‘macho’ because ejaculation of semen into the vagina is considered to be a very important biological experience and part of the sexual act. This is supported by Mulwo’s (2009) finding that students consider sex inadequate if it does not involve ejaculation into a vagina. Findings from IDIs and FGDs indicate that half the students come to the university when they are already biologically mature. However, the communities they come from, unlike campus environments, suppress their sexual desires until wedlock, as was described by Ayanda: ‘At home I may feel my sexual drive to have sex but society still sees me as a kid therefore I am not allowed to engage in sex and this makes me live in a den of unsatisfied sexual passions. So, when I get to varsity I felt free to express my sexual drive’ (Black, female postgraduate student, Howard College). This response reveals that when some students arrive at university, some are not sexually active despite having reached biological sexual maturity. Thus, entering the university gives them freedom to engage in sex, which they cannot do at home because they have not reached adulthood, as prescribed by their local communities. Some postgraduate respondents reported that students engage in sexual behaviour because they believe that although they are adolescents they have a concrete understanding of sex as opposed to abstract thinking. However, when they have intimate sexual relationships they fail to use their ‘concrete’ knowledge to remain abstinent. Findings in this study seem to suggest that students tend to focus on the here and now and cannot appreciate the future consequences of their sexual behaviour. Students enter into tertiary education at a period in their lives where they are in search of their identities, and independence; free from parental supervision (those living away from parents) and community expectations, which by nature involves the taking of risks: ‘It is time most of us get exposed after many years of living under lock and key and we want to explore life, you know’ (Sifiso, Black male undergraduate student, Howard College). This response shows that within student culture many young men and women are not serious about their relationships, and that they do not go beyond the university ‘gates’ as girlfriends and boyfriends. Respondents explained that lack of experience of campus life makes it easy for them to be deceived by their usually older partners and engage in sexual behaviour. Respondents said that upon joining university they found that they had more ‘space’ to do what they wanted to do than they had before. The increased freedom and space accompanied by peer pressure from senior students and older partners make young students more vulnerable to engaging in casual sex encounters. Physical beauty This study found that most respondents identified ‘physical beauty’ as an underlying factor to students’ sexual behaviour. This is in agreement with Jessor (1991) who

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asserts that although it is a fallacy to place too great a value on appearances, our desire for physical beauty is so ingrained in our collective consciousness that we cannot disassociate ourselves from it when searching for a sexual partner. In agreement, Jemmott et al. (1990) state that people’s desire for physical beauty is an original human feeling like the desire for food or water. Jessor (1991) further argues that the valuing of physical beauty is a procreative and ritualistic response. In addition, Jemmott et al. (1990) elaborated that physical beauty is seen as a natural precursor to the desire for sex and procreation, which exists in every society to some extent. This explains why most respondents said that students are drawn to the beautiful girls or the handsome men they meet. Students’ responses show that many students, especially males, engage in sex because they think that physically beautiful girls make sex more enjoyable. This has the potential of encouraging students to have many sexual partners: ‘There is a huge difference in the sexual pleasure I feel with different nice looking girls. With some I experience little pleasure, and with others it is so pleasurable such that it blows off my mind (some students laughed). I used to think that tightness is the only aspect that makes sex pleasurable, but there is more to it (some students laughed). I enjoy sex when a girl is both physically attractive and makes me get the sexual thrill I need. I wonder why sex feels so different even amongst girls who are all beautiful. When I think about girls who give me good sex, the thrill I get from each girl is different. I know there must be some factors that make one better than the other, but what really amazes me is how beautiful girls feel equally fantastic but yet very different’ (Siphumelele, Black postgraduate student, Howard College). This response suggests that male students who already have sexual partners are inclined to have other partners because they increasingly become discontented with their current partners as they meet other beautiful girls. It seems campus culture has a role to play in defining how beautiful or handsome a student looks like as many students indicate this perception strongly influenced their sexual behaviour. This is supported by Mulwo’s (2009) finding that university influences the way beauty or handsomeness is understood. When students were asked about the underlying factors to their sexual behaviour, most reported physical attraction. Male and female students mentioned different physical factors that attract them to engage in sex. Most male respondents mentioned that they are attracted to engage in sexual behaviour when girls look youthful. This is because juvenile characteristics are perceived as ‘sexy’ or sexually attractive. The physical beauty of a girl’s breasts was also mentioned as a factor that encourages them to engage in sexual behaviour. They explained that they are enticed to engage in sex if a female student had breasts with a conical shape termed as ‘paraboloid of revolution’ in students’ language to mean pointed breasts. Most male students reported that they are influenced to engage in sexual behaviour by girls with nicely curved buttocks that look like a semi-circle. This explains male students’ widespread terminologies such as she has a

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‘cardioid’ or ‘booty’ buttocks. These terms were reported mainly by White and Coloured students. Black male students used terms such as ‘BBBG’ for ‘big booty black girls’. What is interesting is that some male students reported the shape of the breast and buttocks to be underlying factors to students’ sexual behaviour, with a preference for females who have these attributes. This study found that male students’ sexual attraction to engage in sex goes beyond external features to include the female genitalia. The aesthetic consensus among sexually active students stressed the roundness and largeness of the labia majora, and the proportion of the labia minora. This finding highlights a changed cultural view because observing vulval aesthetics is relatively new, as previously female genitalia were regarded as taboo in many South African cultures. The realisation to the contrary is an indication of a high speed sexual revolution taking place in South African campuses. Thus, it was common to hear on campuses discussions of the so-called ‘designer vaginas’ and ‘tight vaginas’ achieved by applying gels. Some male students reported that they are lured to engage in sex by girls with long hair. They explained that girls with long hair are sexually attractive because the ability to grow long and healthy looking hair is perceived as an indication of continuous health of an individual: ‘Sometimes we engage in sex just to experience how it feels to have sex with a girl with long hair’ (Sifiso, Black male undergraduate student, Howard College). The preferences for these effects show that there are different physical attractions that encourage students to engage in sexual behaviour. Healthy-looking skin was also considered a sexually desirable trait for one to engage in sexual behaviour. Most female students said that their sexual attraction to a man to engage in sex, was somewhat determined by the height of the man. Female students reported that men should be at least taller than them to be perceived as handsome and considered for sexual intercourse. Among females who are heterosexual, some reported that their attraction to engage in sex usually begins with the physical features of a man’s form and attire. Most female students said that men’s muscular contours attract them to engage in sex. Remarkably, most female students reported that they would like to engage in sex with men with well-defined muscles. However, some respondents argued that the issue of physical beauty that encourages students to engage in sexual behaviour is issue. For example, Tau said that: ‘The pursuit of beautiful girls or handsome men on campuses is like chasing after the wind because beauty is understood differently by different cultures, and it makes students move from one partner to another without finding this beauty they are searching for’ (male, Black undergraduate student, Pietermaritzburg Campus). These comments suggests that the pursuit of beautiful girls or handsome men is somehow encouraging serial monogamy as it results in students moving from one partner to another. Eleazar (2009: 12) argues that the search for beautiful girls is “vanity of vanities” or unattainable practice because beauty is an “inside job”; it is how one is and feels inside that matters — not the outside. This interpretation

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of beauty reinforces the findings here as well as Kunda’s (2008) findings that the search for beautiful and handsome partners is a complicated and dynamic concept without standard comprehension making it difficult to pursue. As Tau observed, the concrete meaning of physical beauty differs across cultures. However, this study suggests that certain aspects of what is sexually attractive influence students’ sexual behaviour. Sexual attraction due to visual features is seen as a normal human phenomenon. The problem is that students are not able to manage their sexual attraction such that they end up engaging in sexual behaviour. This study indicates that physical beauty is a significant factor in students’ sexual risk taking behaviour. ‘Plastics’ reduce sexual pleasure Findings from the IDIs and FGDs support the contention of Kunda (2008), Mulwo (2009) and Breier (2010) that condom use for most students is erratic and that some do not use condoms at all. Kanyile, a Black, female undergraduate student from Pietermaritzburg, explained that students engage in sex often, but rarely use condoms. More male respondents than females said that using a condom reduces sexual pleasure. This was supported by Sifiso’s experience: ‘I do not like plastics [condoms] and I rarely use them. I cannot remember when I last used it. If you use plastics always, then you do not know how cool sex is and what you are missing.’ Sifiso also reported that he has two sexual partners and does not use condoms. He explained that condom use is unnatural because it prevents the deposit of semen into the vagina, an act perceived by many students as an important aspect of sexual intercourse. Most male students reported the use of condoms hindered the intimacy experienced through ‘skin to skin’ or condomless sex. For Motsamai, having sex without a condom was like sharing his body with his sexual partner. To him, condomless sex draws a person closer to his or her sexual partner because their biological connection is uninterrupted: ‘I am encouraged to engage in sex because I am able to have condomless sex that makes me to enjoy intimacy in having sex in a natural way. Condomless sex brings the closeness that you experience in your partner, you really feel that you are sharing something with your partner and you are really one. So, we yearn for that kind of sex because it is natural and satisfying, it is the way sex is supposed to be’ (Black, male undergraduate student, Howard College). For some, like Sipho, also a Black male undergraduate student at Howard College, engage in sex because ‘condomless’ sex that is readily available on campuses gives him sexual pleasure: ‘Tell me if it is a good experience to eat your favourite lunch bar chocolate wrapped in a paper, let us be serious guys, most of us engage in sex because we know condomless sex is available that is soothing and does not distort the biological rhythm of sex, so we decide to roll the dice and take our chances.’ In other words, students engage in sex because they have access to condomless sex or ‘live sex’ which they consider

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pleasurable. Students said that if condom use was compulsory they would not engage in sex because condoms distract from their sexual rhythm (disruptive to spontaneous love-making). If condom use were compulsory some students said that they would forego sex because condoms reduce sensitivity, are uncomfortable or result in lack of sexual satisfaction. This seems to suggest that students would engage in less sexual activity if condoms had to be used all the times. This is because they believe that sex using a condom interrupts the rhythm of sex, reducing the pleasure from the act of sex. Thus, sexual pleasure seems to be given precedence over readiness to engage in sex or their health and safety. Similar views were noted in Mulwo (2009) and in Eleazar’s (2009) study where young men noted that they prefer sex that is biological, natural, uncontainable and free of reflective considerations that come from using condoms. The message underlying most of the students’ perceptions shows that sexual pleasure is given precedence over any considerations. These reports are attributed to the belief in myths regarding sexual sensitivity and pleasure. Physical health Most respondents in this study, both male and female, explained that the decision to engage in sex largely depends on their perception of the health status of their sexual partners. This is consistent with the Mulwo (2009) study that found that physical development and appearance influence young people’s sexual behaviour. A female student, Khumalo, reported that she has sexual relationships with married men. More interestingly Khumalo said that at times she judges the health of her sexual partners based on their physical appearance or their children: ‘When you look at the guy, he is loaded (rich), you are made to hold on to him. The other thing is that when you look at the guy and his wife they are producing healthy children, then you get convinced that it is safe to go out with him. It is just that evident of the fact that the man is healthy so, you have no fear especially if you like or love the guy’ (Black, female undergraduate student, Howard College). This response gives an impression that students find it easy to have sex if their partners have healthy physical appearances. From Khumalo’s account, it seems that students engage in sex by considering their partners’ healthy looks. Students said that they only get discouraged to engage in sex when the health status of the sexual partner is in serious doubt, for example, when one has sores or looks ‘abnormally’ thin. Some respondents said that they engage in sex because condoms are always available in campus dispenser boxes. In some instances, individuals are sexually aroused and know that there are condoms in dispenser boxes, and thus end up having sex. One participant explained her experience: ‘We have condom boxes in our blocks and flats and it is so easy to quickly chip in for one or two. Then you ask yourself why you should not engage in sex when condoms are always available?’ (Siyaya, Black, female undergraduate student, Howard College).

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Observations of students’ discussions, and condom supply at some students’ residences supported this participant’s claim. The researchers noted that condoms were always available on campuses, and supply was consistent: condoms were regularly at hand in residences. Sexual ‘fit’ as a driver of sexual behaviour Jessor (1991) argues that biological factors are fundamental to human sexual experience and should be taken into account when trying to understand and explain the complexities of sexual behaviour. Most respondents reported that sexual ‘fit’ is important in sexual relationships. It emerged that male students prefer females with ‘tight’ vaginas. If their partners’ vaginas were not tight enough, the male students look for more compatible partners: ‘It’s because you find that hers does not “grip” you the way you want so you go and look for the one who has a “G-clamp” [tight vagina]’ (Sadebe, Black male undergraduate student, Howard College). Both male and female students also reported that female students want men with big enough penises to sexually satisfy them. Some respondents said that they would leave their partners if they were not able to satisfy them sexually due to incompatible private parts: ‘I want someone who would make me feel complete; it can be very hard for me to live with a guy who is sexually not of my fit’ (Ayanda, Black female postgraduate student, Howard College). Therefore, among students, both male and female, the size of genitals matters in their relationships when it comes to attaining physical and psychological sexual satisfaction, what they call ‘good sex’. Sexual ‘fit’ is a tricky notion in the sense that female students think that big penises cause sexual satisfaction therefore they search for men with such. Once they find and sleep with them, it means that they will no longer have tight vaginas. However, male students seek females with tight vaginas who are not easy to find because the same men with big penises have caused females to lose the tightness of their vaginas. These perceptions among students create an unachievable search for sex and sexual partners because it is not easy to find what they are looking for. Early penetrative sex Respondents reported that engaging in early penetrative sex influences students’ sexual behaviour. They reported that those who have been sexually active for a long time find it difficult to accommodate calls for abstinence. Students argued that it is difficult to refrain from sex once one has indulged in it, as compared to when one is a virgin, because one does not know how thrilling sex is and what they are missing. Interestingly, some female students said that they find it easy to refrain from sex and would stay as first or second virgins for a longer time than male students. A first virgin is a student who has never engaged in penetrative sex while a second virgin is a student who has engaged in sex once and has decided to abstain. What was clear from respondents is that they find it difficult to abstain from sex. Sbu said: ‘I have been sexually active for more than 11 years and there are more times I have engaged in sex here on campus than when I am at home. It is difficult to abstain here on campus because

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situations that lead to sex are many and different. Some situations are so sudden and do not allow me to think of abstinence’ (Black, male undergraduate student, Howard College). These findings indicate that early penetrative sex appears to make it difficult for students to be abstinent, particularly for male students. This is partially attributed to the fact that the more students engage in sex for pleasure, the more cumbersome abstinence becomes. This finding supports Kunda’s (2009) study, which found that students who engage in early penetrative sex are more prone to engage in sex. Parker et al. (2007) argues that early coital debut sets a precedent for future behaviour that elevates sex. Thus, findings in this study associated early coital debut with increased desire among students to engage in sex. This study indicates that early sexual debut among students is part of the transition to adulthood and it is influenced by the contexts and cultures they grow up in. These contexts make students prone to engage in sex. Desire for ‘good sex’ Kotchick et al. (2001) and Jessor (1991) argue that sexual arousal is a strong biological factor that encourages young people to engage in sexual behaviour. This is consistent with this study which found that lack of ‘good sex’ in their stable relationships influences students to engage in sex with other partners. Respondents explained that male students generally do not romance their partners before sex, but rather, physically rush into sex and stop when they are satisfied. Female students suggested that their boyfriends are usually not very passionate about sex and that they simply engaged in sex upon request. However, they become frustrated when their boyfriends fail to adequately attend to their emotional and physical needs. Students’ responses showed that when female students do not consistently reach orgasm with their partners, they are easily tempted to seek other men to achieve it: ‘The thing is that most of our boyfriends do not play with us [meaning foreplay] so that we are also get there you know [one student interjected saying where?] I mean we do not get aroused so that we can begin the mulabala [game] together. Most guys do not know where to touch us but just climb on top and jump up and down like horses, finish and they leave [students laughed]. So we are left on the way and guys do not know what it means to be left on the way all the time. We all need physical and emotional sexual satisfaction’ (Liphilwe, Black, female undergraduate student, Pietermaritzburg Campus). This study found that some male and female respondents said that lack of conjugal satisfaction, especially physical and emotional, makes them look for other partners. Most female students associated good sex with physiological and psychological satisfaction. Determinants of good sex included being able to have sex slowly; taking time to create a sex feedback loop; where they touch each other gently and feel their partner’s body; and achieving vagina lubrication triggered by physiological and psychological changes. Some respondents mentioned sustained excitement as good sex, and some (especially male students)

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cited orgasm as a determinant of good sex. The findings in this study show that students have different interpretations of what ‘good sex’ is. However, one common denominator is that ‘good sex’ should involve both positive physiological and psychological experiences. Thus, the desire for ‘good sex’ encourages students to have sex. Implications of the findings for HIV prevention programmes

This paper focused on student’s perceptions of the importance of biological (natural) factors on sexual behaviour at UKZN. The findings contribute to the understanding of the bigger picture on the underlying factors to students’ sexual behaviour. Most of the students’ responses demonstrated that biological factors play a significant role in influencing their sexual taking behaviour. This study indicates that adolescence is an experimental period and students are likely to being susceptible to biological influences. In this regard, South African universities, offer an ideal location within which the biological factors of students’ sexual behaviour can be highlighted and dealt with. The study found that students’ sexual behaviour is influenced by: age, judgement of the health of the partner by looking at appearances, pursuit of physical beauty and sexual debut. Other sexual factors include students’ sexual fit and search for sexual pleasure. This study recommends that HIV prevention initiatives must include educating students on the potential risk of these biological factors. Such an approach may encourage students to protect themselves. In the same vein, prevention initiatives should have an ongoing study of students’ understanding of the factors that influence their sexual behaviour. Prevention initiatives must use comprehensive models that take into account, among other factors, the perceived biological influences and their combined effects on students’ sexual taking behaviour. HIV prevention messages that comprehensively address biological sexual factors are likely to be more effective in promoting desired sexual behaviour change on campuses. Of concern is that, if these potential risk biological factors are not dealt with through prevention initiatives then they will not be effective in reducing the level of risky sexual behaviour (Moodley 2008). The findings of this study clearly show that sex that is connected to sexual risk behaviour and the risk of HIV infection is caused by contextual factors that include biological factors impacting strongly on students’ sexual taking behaviour. HIV prevention messages such as condom promotion and abstinence must be accompanied by knowledge regarding prevailing influences of biological potential risk factors which form the context within which sexual decisions are made. Prevention initiatives must have messages that comprehensively address biological factors. Addressing these conditions is an important part of prevention. Given that HIV transmission and infection are inextricably bound to sex and several influences, it is equally essential to focus on these factors that encourage sexual taking behaviour. In addition, many biological variables found to be related to students’ sexual activity have not been studied with regard to sexual risk-taking behaviour on campuses.

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More research is needed to understand the role of these variables in promoting sexual activities and sexual risk or sexual safety. Conclusion This study aimed to draw attention to the role of biological factors that contribute to students’ sexual behaviour on two UKZN campuses. Factors found to influence students’ include their age, judgement of the health of the partner by looking at appearances, pursuit of physical beauty, sexual debut, sexual fit, and search for sexual pleasure. These findings are not exhaustive in exploring factors that shape students’ sexual behaviour. Nevertheless, the biological factors provide a good basis for understanding the key factors that encourage students’ sexual risk-taking behaviour. They can serve as a strong conceptual basis for prevention initiatives to address the factors that encourage sexual risk behaviour. The drawback of not adequately addressing these biological potential risk factors is that they make it easy for students to engage in sex and high-risk sexual behaviour on campuses. Addressing these factors may help prevention initiatives to keep pace with the dynamics of the causes of students’ sexual activities and risk behaviour and effectively reduce the HIV epidemic. The authors — Given Mutinta, PhD, works at the University of KwaZulu-Natal, Durban, South Africa. He is a research champion in the School of Management, IT and Governance. His research interests are in gender, sexuality and HIV. Kaymarlin Govender, PhD, is the Research Director of the Health Economics and HIV/AIDS Research Division (HEARD) at the University of KwaZulu-Natal. He has published in the area of young masculinities and sexualities. Gavin George, PhD, is a Senior Researcher at HEARD at the University of KwaZulu-Natal. He has published in the area of health systems and HIV. Jeff Gow, PhD, is a Professor of Economics at the University of Southern Queensland, Australia and a Research Associate at HEARD at the University of KwaZulu-Natal. He has published widely in the area of health.

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The influence of biological factors on students' sexual behaviour at the University of KwaZulu-Natal, South Africa.

Studies in South African universities reveal that the prevalence of sexual risk behaviour is very high, putting many students at high risk of HIV infe...
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