Shifts in traditional heterosexual sexual scripts whereby women were expected to be passive recipients of men’s sexual interest, have been observed since the early 1960s
]; yet, residual elements of these traditional scripts may persist. Our findings show that traditional gender roles were embedded in relationship expectations and experiences for women in our sample. This may help explain women’s attitudes and behaviors in their relationship dynamics, including risk-taking sexual behaviors. There may be important implications for adoption of HIV sexual risk-reduction in light of this particular finding. The literature suggests that even in situations where less traditional sexual scripts are present and increased sexual communication occurs, women may not perceive themselves to be “effective influence agents”
]. Consistent with the “Heterosexual Script” described in the literature
], our findings demonstrate that a sexual double standard exists, power dynamics favoring male initiation and decision-making are present, and perceptions that women seek commitment, while men try to avoid it are common.
The relational schema and the specific scripts (dating, communicating, negotiating, behaving sexually) guiding heterosexual sexual interaction may have a central place in perpetuating discord (real or otherwise) between what a woman wants in a relationship and what she believes the man wants. Moreover, sexual double standards in heterosexual relational schema set up expectations that sexual activity occurs within the context of a committed relationship for women and in all types of relationships for men
]. Women in our sample described relationships that emphasized being swept away by physical or emotional intents and desires. Moreover, the idea that sex is just supposed to happen was explicitly and implicitly presented by our study participants. Participants acknowledged that this “myth of sexual spontaneity”
] contributed to poor cross-gender communication and added to insecurities and uncertainties about relationship status on the woman’s part. Safe-sex strategies, which are contradictory to the myth of sexual spontaneity, may then get re-written into context-specific scripts that are generally held as improbable and consequentially less likely to become incorporated into a woman’s personal relations schema.
While participants emphasized that communication is essential in a healthy relationship, their accounts make it clear that communication is often lacking or constrained. A woman’s desire to remain blind to a partner’s past or current behavior to avoid threats to (a) the relationship either early in its initiation or later in its maintenance, and (b) her overall impression of her partner as well as her own ability to identify an appropriate partner may hamper sexual communication. Moreover, if in the social construction of heterosexual sexual relationship scripts, greater emphasis is placed on a woman using non-verbal and limited verbal communication to entice and hold onto a partner, little cultural guidance is provided on handling open discussions about sex, especially if it is assumed that sex will be initiated in most cases by the man, or dealing with men’s reticence to discuss their feelings or relationship expectations. Instead, the distancing and downward comparisons (i.e., evaluating other women as being in a worse situation) used to frame some of our participants’ HIV risk perceptions may help rationalize or compartmentalize sexual behaviors, especially those that occur within a committed relationship. One study found that steady dating couples who engaged in open sexual communication before the onset of first sexual intercourse had a lower likelihood of using condoms because they did not perceive themselves to be at risk for HIV/AIDS
While women’s relationship schemas acknowledged the likelihood that a man will cheat and that women may tolerate partner infidelity to a certain extent, low expectations for monogamy do not appear to provide sufficient rationale for using condoms. Participants provided a thread of negative consequences for women’s health (e.g., he contracts STI or HIV from his other sexual partner, which he then transmits to her) that recognized the benefit of condom use (e.g., can help prevent her from getting a disease); however, for most, this did not necessarily translate into actual condom use. In addition, scripts failed to explicitly take into account that when women decide to end relationships that do not meet their expectations, they may then have a series of transitory dyadic sexual relationships, which could also increase risk for HIV infection.
Several studies have suggested that among lower socioeconomic class couples, sexual decisions are male dominated
]. Other research has shown that women are less likely to make unpopular requests of their partners if they anticipate conflict within the relationship or fear that the relationship will end
]. On the surface our findings suggest a similar passivity as well as some difficulty in establishing open communication about sex. However, not all decisions were described as male dominated. Women were depicted as having a critical role in handling financial, parenting, and major household plans and decisions. In situations where men fail to meet gender role expectations, participants explained that women readily come forward to fulfill these roles. For some, a desire for egalitarian relationships was internalized as women being able to just do it all
. Resiliency and independence rather than martyrdom resonated in these experiences. Participants presented scripts that emphasized that in some situations the presence of sex as currency in relationship formation and endurance, especially where partner availability was limited. Women were described as making calculated decisions about how and when to use this currency. As has been suggested by others
], we found that resource acquisition and shifting partners were viewed as important for women who engaged in relationships without having long-term intentions.
A number of HIV interventions that address social and cultural factors, including the role of power in sexual negotiation, have shown time-limited effectiveness in reducing sexual risk behaviors for selected populations of women in the United States
]. Others have stressed that male involvement in safer sex negotiation is imperative to avoid reinforcing the idea that safer sex is women’s responsibility and concern
]. Moreover, there is sufficient evidence that among low-income women of color, perceptions of risk and awareness of susceptibility for acquiring HIV are low
]; however, recognition that a partner’s behavior increases a woman’s susceptibility of infection is present
]. The behavioral data for our sample suggests that engaging in unprotected vaginal and anal sex with men who may have concurrent partners may be influenced by relational schemas that make allowances for male infidelity and consequentially reduce a woman’s perceptions about her risks for HIV infection.
Our findings suggest that despite clear male role expectations, women readily assumed men’s responsibilities to ensure that things did not fail through the cracks and that nagging, threatening, or placing demands on a man (which might cause him to turn to another women) were minimized. The things that a woman took on (e.g., paying bills, upkeep of the household, rearing of the children), she did because she deemed them more important to her than to him. However, when it came to what he wanted or what she thought he wanted she acquiesced even if it was not good or healthy for her to do so (e.g. puts up with his infidelity, stays when he is violent or irresponsible). Given such, it stands to reason that condoms use has to be of greater importance to women (i.e., it is worth the trouble and even the risk of a man walking away). As long as women think or know that a man is not in favor of using condoms, then women will make allowances for men not wanting to use them. For effective uptake on condoms or other female-controlled prevention technologies to occur, emphasis needs to be on figuring out what would increase their importance for women.
Preferences for a partner who was honest, trustworthy, stable, family-oriented (i.e., desire for children, including acceptance of women’s children from another union), and willing to whole-heartedly commit to the relationship was contrasted against the potential shortage of available men and unlikelihood of men’s sexual fidelity. Men and women were depicted as holding different relationship priorities: men are typically interested in a sexual union while women are predominately interested in pursuing an emotionally committed partnership. Participants identified long-term relationships, including marriage, as increasingly rare in their communities. Monogamy was viewed as unlikely given the inability of men to remain sexually faithful. While mention was made of some women being unfaithful, insufficient information was provided regarding the extent to which women play the cheating role. Emphasis was instead placed on the sexual promiscuity of such women as seeking relationships just for sex or using sex to get money or other things from men, and the risk that they would develop a negative reputation.
Changing women’s schemas and scripts for sexual relations occurring within and outside of a committed relationship may be difficult. However, we believe that there is a difference between trying to change their scripts and expanding those scripts to incorporate context-specific information that addresses both the ideal and practical elements of heterosexual sexual interaction. Based on our findings, we recommend that future heterosexual HIV preventive strategies simultaneously address men and women’s scripts. Moreover, given the larger role that culture plays in the social construction and enactment of heterosexual women’s relationship scripts and that reinforcement of these scripts that is likely to occur within women’s social networks, we advocate gender-specific, group-level HIV interventions. Sexual scripts could be incorporated into the “recognize risk” phase of Connect: A Couples-level Intervention for Heterosexual Couples at Risk for HIV/STIs
]. Emphasis would be on identifying recurrent themes across a small number of vignettes and then examining similarities with past and current relationships. As part of the “commit to change” phase, the discussion would shift toward identifying ways that relationship scripts could be re-written to avoid recurrent patterns that increase risk for HIV and other STIs.
While our findings provide valuable insights, generalizations are neither appropriate nor possible. The process of comparing personal accounts as well as views about the motives and practices of others potentially errs toward overemphasizing similarities across our qualitative sample. Consequentially, we risk presenting African American and Hispanic women as belonging to homogenous groups rather than emphasizing that social construction of sexual relationship scripts may be influenced by other factors (e.g., economic status, education). A large number of women in our sample were of low income, resided in rural areas, and/or were foreign-born and not representative of the African-American or Hispanic to make our reference to this ethnic group consistent throughout the paper (exception would be with participant direct quotes) women residing in the southeastern United States or other parts of the country.
We recruited Hispanic women as a single subgroup rather than ensuring that our qualitative sample included a larger proportion of women representing the two largest subgroups in our survey sample, South American and Central American. We also recognize, that because the majority of the FL women were foreign-born, traditional gender roles and norms may be more pronounced in our findings than among U.S. born Hispanic women. Similarly, African-American women in our study are from rural counties from two southeastern states. Their experiences and perspective may vary from those of African-American women residing in urban regions or other rural areas in the country. We recognize that even though we present our findings by data collection sites, the potential for a comparison by race, ethnicity, culture, and geographical residence is suggested. Given that our small sample contained a number of diverse social, cultural, and historical characteristics, such a comparison would be inappropriate. Additionally, we recognize that asking participants to provide their views on what contributes to African American or Hispanic women’s risk for HIV infection does not directly tell us about personal risk perceptions. While sexual behavioral data were collected from all women in our sample as part of the epidemiological survey, the focus of this paper was not to compare women’s expectations and acceptance of partner infidelity with reported sexual behavior. Even with such an analysis, discrepancies between what a participant says and believes may not correspond with reported behaviors. Beyond findings presented here, our data does not support further examination of the disparity between women’s with men’s behavior and men’s intolerance of women’s disappointment in them. Given the gendered communication implications, future research could benefit by examining this phenomenon.
We chose to target sexually active women as opposed to focusing only on women of reproductive age. While we compared and found no notable differences for participants by age, different behavioral patterns and perspectives about relationships may exist between pre-menopausal and post-menopausal women that are not possible to explore in our data. The literature has begun to show that post-menopausal women may be at an increased risk for HIV infection given perceptions that condom use is not necessary because pregnancy is no longer an issue for them as well as the fact that biologically lower levels of estrogen can reduce the thickness of the vaginal mucosa and production of vaginal secretions which can lead to tears and abrasions
]. We did not collect data on menopausal status and even if age ≥50 was used as a crude estimate, the small number of women in the post-menopausal group could present challenges in discerning salient thematic differences compared to the presumably pre-menopausal women. Lastly, we did not collect data from heterosexual men of color and thus provide an incomplete picture as to how the social construction and enactment of relational schemes and scripts may contribute to women’s risk for HIV infection.