Introduction

South Africa has the highest number of people living with HIV in the world, with approximately 20.4% of the adult population (15–49 years) reported as being HIV-positive (UNAIDS, 2018). The extent of the HIV epidemic has meant that various spheres of South African society have had to be involved in prevention and sexual health promotion efforts since the 2000s, when HIV prevention and treatment became a national priority (Hunter, 2010; Katz et al., 2019). In subsequent years, these collaborative efforts occurred against a backdrop of socio-political reconfiguration and AIDS denialism, leading to the all- encompassing but confusing response to the epidemic (Hunter, 2010). Many of these collaborative efforts involved partnerships between public health and faith-based organisations (FBOs) which, although contributing positively to a large extent, have also brought ideological conflicts to the surface (Taliep et al., 2016). These conflicts relate to tensions between the progressive nature of South African legislation and religious conservatism which have led to rifts between ‘secular’ public health approaches and faith-based modes of response to the epidemic (Olivier & Smith, 2016).

To some extent, these conflicting messages have created an environment in which young people who identify as Christian have to consider seemingly incompatible sexual health messages as they navigate religious values on one hand and public health messages on the other (Casale et al., 2010). The relationship between sexual health and religion therefore, requires investigation, particularly because we do not fully understand how young people deal with these conflicts against the backdrop of pervasive inequality of South African society in which many young people attempt to make meaning in contexts fraught with multiple and often confusing tropes of what it means to be “successful” (Swartz et al., 2012).

Additionally, despite the challenge of conflicting ideologies, FBOs and churches specifically, are recognised as being able to deliver high-quality health services. To make their response more effective however, further examination of how their assets can be leveraged in this context is required. This calls for greater exploration of the intersection between local needs and culturally appropriate strategies that could be helpful in facilitating the tensions faced by young people.

Based on individual interviews and focus group discussions, we explored the relationship between sexual health and religion among young Pentecostal Christian women between the ages of 18 and 24 living in Khayelitsha township as they navigated socio-economic uncertainties and the transition to adulthood. We explore how they negotiate the various tensions between keeping religious commitments and coming to terms with who they are sexually and socially as they transition to adulthood within this context of socio-economic deprivation. By doing this, we bring to light how socio-economic circumstances, religion and culture influence sexual practice and decision-making related to sexual health among young Christian women living in an impoverished setting.

Methods

Study Design and Study Site

This study was part of a broader ethnographic study exploring uncertainty, sexual partnerships and the transition to adulthood among young people living in Khayelitsha. A qualitative, exploratory study design was used to gain an in-depth understanding of the relationship between sexual health and religion during this period (De Vos et al., 2011). The study site of this research project was limited to Khayelitsha, an informal settlement in Cape Town, South Africa. Khayelitsha is one of South Africa’s largest townships and was established as a result of apartheid racist geographical design in the 1980s (Ngxiza, 2012). It is situated nearly 30 km away from the city centre. Although it is difficult to estimate Khayelitsha’s population due to increased mobility, it is reported to have a population exceeding over 500,000 inhabitants (Ngxiza, 2012; Stats, 2012; Stinson et al., 2017). Since Khayelitsha’s establishment, there have been persistent, interconnected challenges linked to socio-economic deprivation, high unemployment rates, inadequate infrastructure and a lack of economic opportunity, most of which continue post-apartheid (Ngxiza, 2012). Many people live in informal shacks made out of corrugated iron and have to walk outside, sometimes for hundreds of metres, to use communal taps or public toilets. More recently, brick houses have been erected, and a number of clinics, schools, libraries and social development initiatives have been established for public use.

Study Population

According to the 2011 Census Survey, 64% of Khayelitsha youth between the ages of 15 and 24 are unemployed and only 36% aged 20–24 have finished high school (Stats, 2012). Young women in Khayelitsha represent 70% of this unemployment rate, and only 22% had completed high school. Additionally, 72% of females were reported to live in income-poor households (Stats, 2012). While the 2011 Census Survey is an outdated dataset, it is the only available dataset disaggregated to represent youth statistics in Khayelitsha. The more recent 2016 Community Survey does not include income and unemployment, nor Khayelitsha-specific data. However, these statistics show that women are at a socio-economic disadvantage in this community (De Lannoy et al., 2018; Stats, 2016). For the purposes of this study, young women between the ages of 18 and 25 were selected for their social position as emerging adults navigating the transition to adulthood in this context of socio-economic deprivation.

Many were unemployed and lived with their immediate caregivers, while a few were still at school or lived alone. At the time of interview, three of the participants had children, and one was pregnant. All of the women were also religiously affiliated with Pentecostal Christianity; a movement emphasising the Holy Spirit and the direct experience of God (Meyer, 2010). Table 1 below provides relevant demographic information for participants in individual interviews and focus group discussions.

Table 1 Individual interviews and focus group discussion participant demographics
Full size table

Recruitment and Sampling

Participants were recruited from two different networks. The first was through the second author’s existing networks created through ongoing ethnographic research with young people living in Khayelitsha. These women were approached, given information about the study and asked whether they would be willing to participate. The second network through which participants were recruited was a Khayelitsha-based psycho-social project teaching business, self-development and entrepreneurial skills to young women. All prospective members were provided with information about the research project and asked if they would be willing to participate. Subsequently, purposive and snowballing methods were used to recruit more participants. The sample for this study consisted of 11 participants for individual interviews and three focus group discussions (FGDs) of six participants each, some of whom also participated in individual interviews.

Data Collection

Data for the study were collected between February and August 2019. Fieldnotes were written during the first initial visits in order to ensure credibility through the triangulation of field notes, FGDs and individual interviews. FGDs were based on the ‘River of Life’ activity which seeks to explore life histories from birth into 5 years into the future and were conducted as a first exercise to gain insight into how the women positioned themselves in relation to social systems such as FBOs, schools, their families and the community’s health system (Pienaar et al., 2011). Eleven semi-structured interviews were later conducted focusing on the role of religion in influencing the formation of romantic relationships and sexual partnerships, sexual health issues related to marriage, fertility and motherhood, sexual practice and behaviour, as well as issues of contemporary youth culture in Khayelitsha. This paper is based primarily on data from these interviews.

Data Analysis

Braun and Clarke’s (2006) six-step framework for thematic analysis was used to guide the analysis of the data collected. Thematic analysis is “the process of identifying patterns of themes within qualitative data” (Maguire & Delahunt, 2017, p. 3352). Data were first transcribed and uploaded onto DEDOOSE software. An audit trail was kept throughout data analysis to detail the process of coding the transcripts several times, grouping similar codes into themes and iteratively revising them between the authors.

Simultaneously, discourse analysis was conducted on the data set. Where useful, easy and clear examples of phenomena and broader patterns of the data were available, they were subjected to a rigorous, iterative analytical process to ensure that their inclusion in the ‘Findings’ section was relevant and provided a deeper understanding of the overarching themes.

Findings

In the sections that follow, we explore how young women grapple with the tensions that emerge between their desires to be religiously committed and materially comfortable while they simultaneously attempt to find meaningful ways to be sexually and socially fulfilled.

‘Party girls’ and ‘church ladies’: The Religious Dichotomization of “right” and “wrong”

When asked about whether they perceived religion to be important among youth in Khayelitsha, most of the women were quick to respond saying that, “There are not a lot of youth that go to church” (Interview 5, age 21), and that they perceived religion’s influence on sexual matters to be diminishing among their peers. For example, one woman said:

Nowadays, people don’t really worry about religion. If you have a boyfriend, you have a boyfriend, it’s got nothing to do with religion. It’s not important anymore. We don’t see it as a factor that’s going to stand between us and having boyfriends, it’s not. (Interview 11, age 19)

There seemed to be a perception that older generations were somehow different by being more religious or morally superior, and the assertion is quite clear, that religion, for their generation, is something that no longer stands “as a factor” inhibiting their abilities to fulfil sexual and romantic desires. However, as the conversations continued, some made explicit references to two female archetypes—“party girls” and “church ladies”, both of which were founded upon the religious dichotomisation of ‘right’ and ‘wrong’, revealing that religion continues to play an important role in shaping young people’s sexual and social lives. When asked about what she meant when she called herself a “church lady”, one participant said:

As a church lady, we don't go out partying, don't do certain stuff. If you’re a girl, you’re expected to be at home. You must be cleaning the house. You’re expected to do woman stuff, like cleaning the house, cooking for everybody, making sure things are in order, you don't go out partying. By doing that they say that you will get the right husband for you. By going out, you won't get the right husband. (Interview 4, age 20).

The excerpt reveals the powerful influence religious values in their families and communities have on shaping young women’s ideas about female sexuality and their social acceptability, despite the perception that religious influence is seen to be declining. “Party girls” were, as in this quote, nearly always associated with “going out” referring to an aspect of contemporary youth culture in Khayelitsha: the vibrant nightlife consisting of parties and the consumption of alcohol and marihuana which was perceived as “bad” or “wrong” by almost all participants. One participant said, “We’re all about partying and going out. You know, you only live once! There is hardly any time to talk about God” (interview 10, age 20). “Church ladies” on the other hand, were linked to words that indexed domesticity such as “home”, “house”, and “cooking” and were seen as being “good”. The performance of these ‘wifely’ duties could, as noted by this participant’s assertion, “get (you) the right husband” if executed as “expected” and reveals both internal and external expectations placed on her sense of womanhood. She refers to her list of domestic responsibilities as “making sure things are in order”, which may also reveal an aspiration towards an ideal of what it means to be socially acceptable and a good Christian woman.

While most of the women spoke of their sexuality and religiosity through the ‘right’ or ‘wrong’ binary, others employed the ‘success’ or ‘failure’ binary when they felt that they had failed to achieve religious ideals. For example, one woman said she had “failed” by “getting pregnant and having sex before marriage” (Interview 11, age 19) and another said “when you play two characters that’s when you are not going to see where you are failing as an individual” (Interview 2, age 21). This binary seemed to refer to either failing to hide one’s sins from others, failing to become a better person or failure to do both. Playing “two characters” seemed to enable the ability to hold contradictory values but was also acknowledged as disabling one’s ability to see where one could improve and become a better person.

Despite the perceived boundary between “church ladies” and “party girls”, some of the young women had experiences of participating in both realms and found that contravening religious rules did not always lead to the imagined judgement or persecution of their “failures”. Some women said they were “leading a double life” (Interview 5, age 21) and “breaking the rules” (Interview 4, age 20) which made them feel as though they had transgressed the perceived boundary. However, many noted that once their wrongdoings were out in the open, that they actually felt less judged. For instance, one woman said, “I already have a child so people aren’t going to judge me anymore” (Interview 11, age 19). This does not necessarily mean that religious judgement itself is imaginary. In fact, many women claimed that it was a reason why “most people don’t want to go to church, because in church, that is where you get judged” (Interview 2, age 21) but rather, that the perceived boundary between the “party girl” and “church lady” can be seen as a form of psychological compartmentalization of values and behaviours, which is further compounded by the fear of religious judgement. As this fear shapes how some young women practice sex and make decisions related to their sexual health, the section below presents how they attempted to participate in both the “party girl” and “church lady” realms.

Negotiating Tensions: Taking Part in Both Realms

When discussing sexual health matters such as marriage, fertility and the formation of sexual partnerships and romantic relationships, many of the women said religion was an important factor, despite perceiving the influence of religion to have diminished among youth in Khayelitsha. This made it seem as though they perceived others’ religious engagement to be waning, although it was seen to be a strong influence in their own lives. The contradictory perception may have arisen from their experiences with having to negotiate the tensions emerging between their faith, personal aspirations, socio-economic conditions and social pressures, which affected their ability to adhere to religious ideals such as getting married first before having children. In order to deal with these tensions, two strategies were used by some women. The first, was the flexible and situational use of religious reasoning to guide decision-making. For example, one woman used a religious framework to help her decide whether or not to take up employment at a shebeen, a local tavern, because she was likely to have to sell alcohol to young customers:

Last year, I was at home all year. Some people saw me and said “we have this job (an offer to work at a shebeen)”. I believe that if I wasn’t a Christian, maybe I would have taken that job. But because I am a Christian and I know that God doesn’t want me to be in a place that supports wrong doings…then if I work in a shebeen, selling alcohol to young people, then I'm destroying them. So it has impacted me on job offers because I know I won’t do something that is going to make God turn on me. (Interview 7, age 20).

The excerpt reveals that depending on the context and particular needs the participant wanted met, religious standards could be used to give reasoning to her decision. Here, the participant used the religious dichotomisation of “right” and “wrong” to make decisions about employment by applying the dichotomy to the type of employment being considered. This kind of fluidity in reasoning enabled her to practically integrate religious standards in her daily life. Similarly, the situational use of religious reasoning was revealed through the use of social media which could be used to play a different “character” as well as go unseen by the religious community and older caregivers who may judge women for their “immoral” actions. One woman said:

Facebook and Instagram. They also play a role in the youth’s lives because for instance, on Facebook, people fake themselves. People want to meet the standard of living, the standard of living that they can’t afford, you see? So on Facebook, they pretend to be a person they are not because they want to be seen as slay queens. (Interview 3, age 23)

Here, we see that social media could be used by young women to portray themselves according to their own ideas of success, ambition and beauty away from the eyes of the church. However, even in this example, the influence of religious reasoning was evident. For example, when discussing “slay queens”, a colloquial term used to refer to young women who engage in transactional sexual relationships with older men and receive financial and material benefits in return, many women also used the word “blessed” to explain the sense of material security and comfort these relationships promise (Masenya, 2017 as cited in Ligaga, 2020). Being a “slay queen”, by way of being materially provided for, can be seen as tangible evidence of being “blessed”, not just by a ‘blesser’, but by God, even though it may entail engaging in ‘immoral’ activities that contravene traditional religious ideals of female behaviour. The use of social media and engaging in a virtual reality, allowed for young women to act in these ways in a realm that could quickly be turned off by going ‘offline’, unlike in real life where one cannot simply ‘delete’ church or community judgement and ostracisation. Slay queens were seen to be “sinful” but “blessed” revealing the idea that some women can embrace multiple, contradictory values. This type of fluidity of character and flexible use of religious reasoning was an important aspect of the participants’ experience as young people navigating multiple tensions. It may also reveal an alternative way for women to express their “agentive nature”; a point Haddad (2018, p. 8) makes in her reflections on “blesser-blessee” relationships.

Another way in which young women negotiated the tensions that emerged in wanting to be both religiously committed but also live the “party girl” lifestyle was through the use of the creative reconciling strategy. This was revealed through their perceptions of engaging in sexual partnerships and relationships. The lack of socio-economic opportunities in Khayelitsha has meant that many young people are unable to find gainful employment. For young men who desire to marry, this may lead to their inability to pay lobola [a form of local bride price]. For young women, the deprivation of opportunities may mean an engagement in multiple and concurrent relationships. Many of the women spoke about having one main boyfriend whom they loved and wanted to marry someday but also having other sexual partners who provided them with financial and material resources. For example, one woman said:

But then you also get people who have multiple boyfriends where you get one that pays for your clothing, gives you money for your food and for your hair, and then you have your own boyfriend, the one that you love. But he doesn't give you money because you know he doesn’t get money. Like me, I have a boyfriend, he's my age and he goes to school so I don't expect him to pay anything for me. (Interview 11, age 19).

Having multiple boyfriends enabled some young women to creatively reconcile between their desire to uphold their religious commitment on one hand and have their immediate needs met on the other, as they could meet the ideals of love and marriage as conceptualised by the church through one primary “love” relationship but also meet their socio-economic needs through other partnerships. Thus, the sense of having “broken the rules” and engaging in pre-marital sex was somewhat mitigated by the feeling that they were at least aspiring, in one key relationship at least, to live in accordance with the standards of love, honesty and faithfulness, all of which are values emphasised in Pentecostal Christianity, through one primary relationship.

The ‘pastoral’ Role of Churches: The Desire for More Nuanced Engagement

Although many of the participants considered themselves believers and had adopted at least some Pentecostal Christian values, they also felt a great deal of social pressure to adhere strictly to religious standards and did not always agree with their pastors. Despite this, many expressed a desire for their churches to be more open to discussing sexual matters with them, notwithstanding the difficulties inherent in doing so, as demonstrated in the following excerpts which represent views shared by several women: “It’s difficult for black pastors to talk about [sex]” (Interview 7, age 20) and “pastors can’t say anything about sex” because “they are reserved and want to be respected” (Interview 6, age 20). Others noted the issue of mixed messages saying “you can’t teach two things at the same place” (Interview 4, age 20) referring to churches handing out condoms but preaching abstinence at the same time and “It’s the mothers. They want to protect their kids but they’re not willing to talk about sexual health” (Interview 7, age 20) identifying issues around intergenerational communication on sexual matters.

These challenges reveal that it is not religious norms alone that present as barriers to sexual health communication in church but rather, that it is a constellation of factors related to pastors being seen as ‘upstanding’ religious leaders, traditional gendered and cultural norms, socio-economic challenges as well as intergenerational silences on sexual matters that compound these difficulties. Nevertheless, the young women expressed their wishes for churches to be more open with youth about sexual issues. One woman said, “Churches have to talk and be open about those things in order to not judge people” (Interview 6, age 20). When asked about how they envisioned this support given the challenges, the most common suggestion was for religious leaders to share their storeys of personal and spiritual triumph and give ‘testimonials’ of their faith. One woman said:

I think if they had talks with the young kids. Tell them about how they grew up. Because not all pastors grow up wanting to be pastors, some of them didn’t even know. So if they shared their experience like maybe one man grew up a gangster and then he says “Religion got me out of jail, now I am out of jail and God called me.” If they shared their storeys, I think that would be better. (Interview 7, age 20).

The excerpt reveals that for young people growing up in difficult circumstances, these real life testimonies can offer much needed psychological strength, hope and help facilitate a sense of resilience.

The notion was further emphasised by the perception that God was a disciplinary and paternal force revealed through comments such as “my religion disciplines me” (Interview 7, age 20) and “religion plays a big role in my life. I don’t have a dad so it’s like having a parent when I communicate with God. He’s more like a father, and I believe he exists.” (Interview 6, age 20). Due to these types of beliefs and because of the perception that “God never changes” (Interview 2, age 21), the church can be a stabilising force for young people navigating the transition to adulthood in contexts where they simultaneously grapple with socio-economic deprivation and a lack of opportunities.

Another very common suggestion was for churches to provide other forms of support ranging from psycho-social, material and financial support instead of having a sole focus on religion and faith. This was borne out of the perception that there was a lack of state, parental and community support for young people, prompting many of the women to say that churches were best suited to fill the gap. For example, one woman said:

If pastors offered support to kids that parents don’t offer them, that would also be fine. And if they donated more, it can be anything… clothes [and food]… anything that will make the young people feel good. (Interview 7, age 20)

Here we see that the values of charity and generosity have been assigned to the church as a social institution that may be more accommodating and sensitive to young people’s needs than other organisations in their community. The desire for churches to provide both food and clothing also reveals the extent to which the young women feel that their community is left destitute and impoverished by a lack of social support services, to the extent that such basic needs are not adequately being met. In these circumstances, the church may be seen as more than just a partner in public health efforts or a faith community, but instead, charitable agents that can provide much needed services. Churches then, do not only provide spiritual guidance for these young women, but they also seem to be the most suitable space to discuss sexual matters, hear their pastor’s testimonies in dealing with uncertainty, poverty or other social issues, be disciplined, protected and guided, and be taken care of materially and emotionally.

Discussion

Our findings suggest that despite the perceived decline of religious influence on sexual matters, religion, as well as other factors such as socio-economic circumstances and culture, continue to play an instrumental role in shaping sexual practice, dreams, aspirations and lifestyles of young people, especially as they transition to adulthood. For many of the young women who participated in this study, this was experienced as both a psychological/internal process as well as a social force. The findings propose that young women living in Khayelitsha perceive there to be a boundary between different values and behaviours which is founded upon the religious dichotomization of “right” and “wrong”. The study also found that young women employed two key strategies: (1) the situational use of religious reasoning and (2) the creative reconciliation of values and behaviours to negotiate the tensions that emerged between upholding religious commitments and having their immediate socio-economic needs met. Lastly, the study found that despite the challenges of churches being involved in sexual health matters, young women desired more complex, layered engagement with their churches. They did not only want spiritual guidance from their churches but also wished for them to be safe spaces to discuss sexual matters, hear their pastors’ testimonies in dealing with hardship and uncertainty, receive protection, guidance and discipline, as well as material and emotional support. We argue therefore, that religion can be a significant spiritual and cultural resource that women use to form their identities, develop moral stances and base their personal narratives, although it cannot always be equated with their sexual practice.

These findings are important as they highlight the complexities of the lives of youth in Khayelitsha, an informal settlement in Cape Town, South Africa faced with a high prevalence of HIV/AIDS and a lack of socio-economic opportunities (Swartz et al., 2016; Stats, 2012). These complexities may affect how sexual health messages (and public health ones more generally) are understood and adopted among this population. Interventions that are based on the critical evaluation of how various factors such as religion, culture and the socio-economic context influence sexual practice among youth are more likely to be tailored to suit the particular needs of its target population, rather than interventions that focus solely on improving sexual health-related issues faced by the community.

The finding that religion (as well as other factors) exerts a considerable influence on the sexual and social lives of young women, despite its perceived decline, is similar to findings in other studies (Burchardt, 2011; Challa et al., 2018; Haddad, 2018; Mampane, 2018). Challa et al. (2018) found that a host of interpersonal, community-level and macro-social factors influenced the decisions of young people, and that religion was a primary cause of internal conflict. This study confirms these findings but adds yet another factor, the psychological compartmentalization of values and behaviours based on the religious dichotomy of “right” and “wrong”, which influenced sexual practice among youth. Decisions are made not only through interactions with peers, partners, community members or religious communities but also through attempts to internally reconcile between personal desires and aspiration and religious beliefs. While Challa et al. (2018) have noted a similar finding, this study goes further to suggest two emergent strategies that the participants used to negotiate the various tensions that emerged: (1) the situational use of religious reasoning and (2) the creative reconciliation of values and behaviours.

These strategies are based on findings similar to those in Mampane’s (2018) study which explored the “blesser-blessee phenomenon” among young women in South Africa. The study found that young women engaged in multiple concurrent relationships as they felt it offered them the possibility of getting married in the future as well as acquiring financial and material resources (Mampane, 2018). Similarly, in this study, young women were found to be engaging in multiple concurrent relationships as well as in one primary relationship in order to reconcile between acquiring their immediate socio-economic needs and upholding their religious commitments. These relationships are an inevitable risk factor for HIV-acquisition, however, the findings suggest that they could be understood as more than just ‘casual’, ‘transactional’ relationships. Instead, these types of partnerships and relationships may hold great value for young women attempting to negotiate multiple tensions arising between their personal desires, socio-economic realities and religious and cultural standards and enable them to express their “agentive nature” more fully (Haddad, 2018, p. 8). Hunter (2010, p. 180) also highlights how these relationships might not be based on the commodification of impersonal sex but rather, “enmeshed in new forms of emotion and reciprocity” binding together sex, love and survival. As such, interventions that encourage the prevention of these types of relationships may not be the most effective solution to addressing sexual health problems in this community.

The finding that young women desired more layered engagement with their churches echoes the findings of Moodley’s (2017) study among college students in Cape Town, South Africa. This study confirmed Moodley’s (2017) findings that young people wanted religious institutions to be more open about sexual health matters, that rigid and judgmental attitudes towards female sexuality persist, and that religious leaders are seen as role models by youth (Moodley, 2017). However, unlike Moodley’s (2017) study which found that students were in agreement that religion had no influence in their daily life decisions and sexual behaviours, this study found evidence to the contrary—religious influence was only perceived to be declining but in actuality, was still a very powerful force that shaped young people’s sexual and social lives. Garner’s (2000, p. 49) early work in KwaZulu-Natal points to similar findings with reference to the term “socialisation” which refers, in part, to the social control and surveillance of certain aspects of social life (such as the function of sex and marriage and the use of time and money) through the implementation of church discipline. Especially for youth in Khayelitsha, where the ability to become independent as per conventional standards such as obtaining educational qualifications, employment, getting married and having children is severely inhibited due to the interlinked challenges of socio-economic deprivation and a lack of opportunities, religious affiliation and sexual and romantic matters can act as playing fields in which young people exercise their agency (Honwana, 2014; Juárez and Gayet, 2014; Swartz et al., 2016). As this also occurs against a backdrop in which young people living in Khayelitsha perceive a lack of state, parental and community support, sexual practice and decision-making related to sexual health become much more than matters of personal faith, religious conviction and the fulfilment of sexual desires. Instead, they take on meanings of being safe and protected and feeling guided by religious doctrine in their everyday lives through hardship and uncertainty.

Despite the evidence that these findings are based on, there may be alternative explanations to understanding the data collected. For example, the use of social media to play “two characters” and go unseen by church and community members, may be seen instead as a way of escaping one’s socio- economic reality by appearing to be part of a different social class. Or, as in the case of Kenya, where the politics of respectability are linked to religion as well as colonial attitudes towards Black African sexuality, social media may enable young people to experiment with different behaviours and personalities on virtual platforms leaving their actual, real life selves untouched by judgement (Tamale, 2011; Nzegwu, 2011 as cited in Ligaga, 2020). The perceived decline of religion’s influence on young people’s lives may also be explained by the process of secularisation rather than due to the interaction of multiple factors that could influence decision-making (Moodley, 2017). Similarly, the desire for churches to be more open about sexual health matters may not be a desire for more layered engagement with churches themselves, but rather, a call to other sectors such as public health or social development to meet sexual health, material and financial needs more adequately so that churches do not have to fill in the gaps.

Although these alternative explanations exist, the findings presented in this paper can be used to contribute to the improvement of public health efforts attempting to address sexual health-related diseases such as HIV/AIDS, especially among young women transitioning to adulthood and living in similar contexts to Khayelitsha township. In other cases, HIV/AIDS has also served as a call for compassion and an opportunity for personal and spiritual transformation (Derose & Kanouse, 2011). The finding that churches could offer more layered engagement with these women could be used to conceptualise more holistic forms of guidance and support. To these ends, the church could play a greater role in allocating some of their resources to basic needs such as food and clothing in order to indirectly facilitate young people’s ability to make decisions related to their sexual and social lives. Having this foundation may allow young women to feel more in control over their lives and decision-making abilities. The finding that young people use strategies such as the creative reconciliation of values and discourses to negotiate the tensions that arise, may allow us to understand their sexual practice in a different light.

Ultimately, what may be required to fully improve public health and faith-based efforts attempting to address sexual health issues among youth going forward is a re-thinking of how churches, and other FBOs can best be involved. Currently, churches and FBOs tend to typically fill in the gaps wherever they emerge, providing single service programmes or interventions on prevention or care (Olivier & Smith, 2016). However, these singular prevention and promotion interventions neglect other psycho-social, material and spiritual needs that are just as pressing as sexual health concerns. The findings of this study support an emerging argument in the literature that it may be the right time for churches and FBOs to align themselves with the global shift towards more “integrated” and “holistic” approaches to HIV- prevention and other sexual health-related efforts that take young people’s sexual and social lives into consideration (Burchardt, 2015; Casale et al., 2010; Olivier & Smith, 2016; Olowu, 2015).

Additionally, the difficulties in current implementation, are in part, also caused by the fragmentation of health promotion, prevention and treatment by all the different types of FBOs that exist in the HIV-prevention ecosystem which further inhibits the transition to more integrated, synergistic approaches (Casale et al., 2010; Olivier & Smith, 2016). Further research is therefore required to understand how best to synchronise the HIV-response in its partnership with public health but also within the sphere of religion itself. As a starting point, this paper makes the modest suggestion that churches take on a more pastoral role in their communities by shifting their attention to the provision of psycho-social, material, financial and spiritual needs of young people. This may also lead to churches being more open to and acknowledging of young people’s sexuality, contemporary youth culture and the particular difficulties they face during the transition to adulthood within impoverished contexts.

Limitations

This study may have been limited by the language and cultural barriers between SP and participants. Interviews were conducted in English which was not the primary language of participants and might have influenced how they translated their perceptions. Another limitation is that many of the participants were involved in a community-programme and thus, their views might not be representative of other young women living in Khayelitsha who are uninvolved in similar activities. Given the similarities in the “sexual discourses” of some religions, findings may be applicable in similar contexts. However, some of the nuances pertaining to the relationship between sexual health, religious values and contemporary youth culture as described in this article, are unique to Khayelitsha, and thus, might not be generalisable. Additionally, questions posed to participants were specifically related to religion. Had there been more time for longer ethnographic observation and an exploration of questions related to other variables, the study may have yielded very different results.

Conclusion

This study sought to explore sexual health in relation to religion, culture and socio-economic circumstances among young, Pentecostal Christian women living in an impoverished township settlement in South Africa as they navigate the transition to adulthood. We argue that religion is a significant spiritual and cultural resource that women can use to form their identities, develop moral stances and base their personal narratives, although it cannot always be equated with their sexual practice or decision-making related to sexual health. Findings suggest that despite the perception that religious influence on young people’s sexual and social lives was diminishing, that it continued to play an instrumental role in shaping their sexual health and personal aspirations. Although many of the young women found it challenging to deal with the multiple tensions arising from conflicting values, some found innovative strategies to negotiate these tensions such as the situational use of religious reasoning and the creative reconciliation of values and discourses. More layered engagement with their churches was also desired. This may require a shift towards more integrated and holistic approaches rather than interventions/programmes that are solely sexual health oriented. As churches and FBOs are already perceived to play a stabilising force amidst a background of uncertainty and poverty in the lives of youth, they are well-suited to play a pastoral community-role and address the psycho-social, material and spiritual needs of young women as they navigate both the transition to adulthood and make decisions related to their sexual lives.