The recent focus on fidelity – or its opposite, concurrency – is driven by interest in mathematical models showing that the HIV epidemic could be halted through decreases in exposure during the acute phase in early infection. Exposure during this period is more common when a greater percent of the population maintains multiple sexual relationships. However, given this quantitative focus on fidelity, little is known about how young adults understand fidelity and what they perceive to be the barriers to fidelity. Data from in-depth interviews with 48 participants aged 15–24 in Dar es Salaam, Tanzania, show that participants hold fidelity as the ideal in relationships, yet many struggled achieving this ideal. Young adults often discussed mutual expectations of fidelity with partners. However, constructions of masculinity that emphasize men’s sexuality were the main reason participants felt young men struggled with fidelity. Young women’s structural disadvantages, needs, and desires were described as barriers to their fidelity. Both sexes struggled with fidelity when their emotional and sexual needs were not met. Fidelity as a method of AIDS prevention permeates discussions between couples, yet young adults identify social and structural factors as key barriers to individuals’ execution of fidelity for HIV prevention.
Use of Withdrawal (Coitus Interruptus) for Both Pregnancy and HIV Prevention among Young Adults in Rakai, Uganda