Mediators of sexual decision-making among young South African and Zimbabwean migrant heterosexual men: a study conducted in Johannesburg, South Africa

Abstract

Background: The global goal of improving sexual and reproductive health (SRH) for young people and achieving Universal Health Coverage (UHC), as outlined in the Sustainable Development Goals (SDGs) Agenda 2030, faces a significant knowledge gap regarding migrant men’s SRH. Current research on migrant SRH primarily focuses on women and children, emphasising risks and challenges rather than protective behaviours and sexual decision-making. While a universally accepted definition of “sexual decision-making mediators” is lacking, some literature identifies it as situational factors that influence sexual encounters (Davis et al., 2010). These mediators, including individual attitudes, beliefs, intentions, and preferences regarding sexual engagement, impact choices. However, migration, and challenges as well as opportunities around it, is rarely considered as one of the mediators of young men’s sexual decision-making. Aim: This qualitative study explores the mediators of sexual decision-making for heterosexual young economic migrant men, offering a unique contribution by conceptualising “migration as a mediator of sexual decision-making.” The study demonstrates how migration-related factors significantly influence the sexual decisions of young men in urban contexts, filling a notable gap in both SRH and migration research. Methodology: The study was conducted in Johannesburg inner city and involved 22 young migrant men (11 Zimbabwean and 11 South African) aged 23-30. All participants had resided in the inner city for at least six months, with the longest stay being 14 years. Data was collected through semi-structured, one-on-one in-depth interviews and analysed using a six-step thematic analysis method (Braun & Clarke, 2006). Findings: The study identifies micro-, meso-, and macro-level sexual decision-making mediators that shape the SRH of heterosexual young migrant men. These mediators are categorised into two main themes: socio-cultural and economic-related. Chapter 4 explores socio-cultural mediators, focusing on cultural differences between the Johannesburg inner city and participants’ home countries, their evolving sense of belonging, the interplay between cultural norms and personal agency in shaping sexual decisions, and the factors influencing their access to and choices about sex. Chapter 5 examines economic-related mediators, including the role of family planning, access to SRH services, and how participants’ perceptions of Johannesburg’s physical and social landscape influence their sexual decisions. Mediators of sexual decision-making among young South African and Zimbabwean migrant heterosexual men: a study conducted in Johannesburg, South Africa vii These findings contribute to both SRH and migration scholarship by offering empirical insights into the complex interplay of migration, culture, and economic factors in sexual decision- making. Conclusion: This study introduces a novel conceptual framework that sheds light on the interconnectedness of economic migrant young men, their sexual decision-making, and the mediating role of migration. In addition to highlighting the urgent need for further research on the SRH of young economic migrant men, the study makes a significant contribution to knowledge by advancing the understanding of how migration shapes SRH decision-making. Methodologically, it reveals the importance of exploring migration as a dynamic factor in SRH research. Theoretically, it builds on migration and SRH literature by positioning migration as a critical mediator of sexual decision-making and, therefore, sexual behaviours. Empirically, it provides fresh focused insights into the strategies young migrant men employ to protect their SRH, despite limited access to services, peer pressure, and substance abuse. Further research is necessary to deepen the understanding of heterosexual young migrant men’s sexual behaviours and to develop strategies that support and improve their SRH. By incorporating methodological, theoretical, and empirical contributions, this study not only fills an important research gap but also sets the foundation for well-designed interventions that can positively impact the SRH of men globally, contributing to the Agenda 2030 goal of achieving UHC.