Socio demographic characteristics of participants
Although all of the older women in the sample self-identified as “gogos”, only two of the ten women were biological grandmothers and the others were aunts, great aunts, foster mothers, an adoptive mother and a caring older woman from the community. They cared for a combination of biological grandchildren, biologically-related children and other third generation children. The average age of the women who participated in the study was 60.3 years, with a range from 52-77 years (Table 1). The average number of children being cared for by each gogo was three. There were 18 male and 18 female children being cared for by the gogos in the study. The average age of the child dependents in their care was 13.5 years with a range from 2 to 21 years, although the SRH communication focused on children between 10 and 18 years. None of the gogos were formally employed. Their sources of income were mainly from grants and a few had some form of self-generated income. This self-generated income took the form of home baking and selling, rentals and charitable support.
Experiences of the gogos talking about sex, sexuality and HIV and AIDS with their grandchildren
Various themes emerged regarding the gogos’ feelings and perceptions regarding talking about sex, sexuality and HIV and AIDS with their grandchildren. These included personal, contextual and structural barriers. On a personal level, barriers between gogos and grandchildren about talking about sex, sexuality and HIV and AIDS included the difficulties experienced by gogos due to past experiences with talking about sex, a lack of skills and knowledge of how to have these conversations, and a fear that talking about sex would encourage sexual behaviour. Contextual and structural barriers housed in cultural beliefs, gender and generational differences also affected the feelings and experiences of these gogos related to talking about sex, sexuality and HIV and AIDS.
Personal barriers experienced by gogos in talking to grandchildren about sex:
Difficulty talking about sex, sexuality and HIV and AIDS
All of the participants expressed negative feelings regarding talking about sex, sexuality and HIV and AIDS and commented on the difficulty of speaking to their grandchildren about these issues:
"Hey lady…, that’s going to be difficult. That is going to be really difficult." – Sindi (59, caregiver of four children)
Although all the participants found talking about sex difficult, there was an acceptance or understanding amongst the participants that “how things are today is nothing like they used to be” (Bongi) and that there is now a need to talk to children about SRH. Lerato talked about trying to discuss issues that were not spoken about to her when she was growing up and how difficult this made talking about HIV and AIDS, and sex and sexuality.
A number of gogos spoke about their lack of experience, knowledge and skills on this topic:
“The problem is that… I would not know what to say.” – Bongi (60, caregiver of two children).
Some participants felt that, despite the fact that today’s generation is far better informed than they were, knowing, for example, that babies come from the “stomach”, and that the topic of sex does get covered at school, sex was still a very difficult topic for them to discuss. Reasons for this included cultural taboos, lack of SRH communication experiences in their own adolescence and general lack of information.
“Now you must discuss issues [that] weren’t discussed with you and therefore aren’t open about is a bit difficult … When the time to discuss it all of these topics … you feel overwhelmed and somewhat defeated.” ‒ Lerato (59, caregiver of two children)
Past experiences of talking about sex, sexuality, HIV and AIDS
A number of participants mentioned feelings of fear and experiences of corporal punishment at the hands of their parents linked to their own sexual experiences growing up. Florence described the way her parents used fear and threats when speaking about sex when she was growing up. She was also told falsehoods about where babies came from: “in suitcases delivered by nurses”. Shame was also mention as a reason to not talk about SRH:
“We are still ashamed to discuss certain issues. Sex this and that… It is difficult finding ways to tackling these issues as we never had such conversations nor was it ever taught to us at school.” ‒ Sindi (59, caregiver of four children)
Fear of talking about sex, sexuality, HIV and AIDS
Another source of anxiety raised by one gogo was based on the belief that they had grown up with that talking about sex sexuality, HIV and AIDS would encourage sexual activity.
“You see in our times, our parents felt if you taught a child about sex you were promoting the idea.” ‒ Sindi (59, caregiver of four children)
Sindi (59) recounted that although she had spoken to her own children about sex in the past, she voiced her frustration at the fact that her children had had unplanned pregnancies in spite of the fact that she had spoken to them. She now regarded these past conversations about SRH as unsuccessful as it “failed us, because now we have these children [grandchildren] in the yard”. She expressed disappointment that her children had had babies in spite of her attempts to prevent this by speaking to them and “warning” them.
Contextual and structural barriers to talking about sex, sexuality and HIV and AIDS encountered by gogos
Contextual and structural barriers played a significant role in how effective gogos were in their communication with their grandchildren about sex and HIV and AIDS. Although contextual and structural, these barriers were informed and defined by the personal experiences of the participants and through their perceptions of culture, gender, age and the generation gap.
Cultural barriers
A number of gogos brought up cultural issues as a barrier to talking about sex, sexuality and HIV and AIDS with their grandchildren. Communication about sex was not something participants had experienced during their own adolescence, due to the belief that parents discussing sex with their children would encourage or enable sexual activity and the idea that HIV and AIDS did not exist in their youth.
Although Sindi explained “in our culture, we are not used to that” and “it was not easy when it came to my children”, she felt very strongly that cultural beliefs restricting the sharing of open and factual information on SRH needed to be rejected and that gogos needed to move beyond cultural norms and address these issues with their grandchildren in order to save lives.
“There isn’t a culture that I’m committed to, to the point where I would say, I don’t do this, I don’t do that, because of my culture. Knowledge I do seek because culture doesn’t work anymore … It doesn’t work, death comes.” ‒ Sindi (59, caregiver of four children).
Gender
Participants raised the issue of gender norms when speaking to grandchildren about sex, sexuality and HIV and AIDS. Not only did these gender norms apply to the gogos and who they spoke to, they also related to the gogos’ understanding of adolescent sexuality. Sindi explained how “[they] are used to boy children being spoken to by a man”, while one participant described how, when she tried to bring up the subject, her grandson got “uncomfortable” and tried to close down the conversation as soon as possible. In addition, these gogos felt that their already limited knowledge was particularly lacking when it came to speaking to their grandsons about issues pertaining to males. Sindi claimed boys would “puzzle” her, as she had no experience with them: “honestly I don’t know what I would say to a boy,” she said. Boys were advised to go for HIV testing which was a strategy for gogos to facilitate them getting information and advice from a trusted source.
It is important to check, as you [a boy in her care] may not always know what the girl gets up to… so you should go and check [get tested] frequently.” ‒ Bongi (60, caregiver of two children).
When talking to girls, gogos frequently counselled them to avoid boys as much as possible in order to protect themselves. Gogos regarded boys as being a threat to girls. The majority of gogos perceived boys as having only one agenda with regards to girls and that was to have sex. Sex with boys was communicated to girls as something that would result in sexually transmitted infections and pregnancy.
“I need you to take good care of yourself and keep clear of boys when you play. When you play, play with girls.” ‒ Thoko (63, caregiver of one child).
Generation barrier
A number of gogos spoke about the generation gap between themselves and their grandchildren and the need for increased understanding between them.
“There is a gap between us that needs to be bridged. They need to learn how to speak to us so we can understand one another.” ‒ Patience (58, caregiver of three children)
Respect for the older generation, and the fear of this generation losing respect, were themes that emerged during the interviews. Agnes explained that she feared she would lose the respect of her grandchildren if she spoke to them about sex, sexuality and HIV and AIDS and, having lost respect for her, her grandchildren would be more likely to participate in sexual activity.
“If I speak to them about such issues… they will end up taking you for granted. Isn't it ‘Gogo can speak to me about this so…’ they’ll overstep their boundary” ‒ Agnes (58, caregiver of three children)
Sindi suspected some of her grandchildren’s responses, which included laughter, could have been due to the fact she was “gogo” and that they were possibly embarrassed by this: “Since it came with gogo, they would laugh when they see some of the things.” Sindi also mentioned that the issue of age and the generation gap as a possible reason for difficulty talking about sex, sexuality and HIV and AIDS with her grandchildren. She explained that her grandchild (aged 9) was not as close to her as he would have been to his mother.
“That is going to be really difficult, especially when they are not your [biological child]. There is no way of going beyond the fact that I’m not his mother.” ‒ Sindi (59, caregiver of four children)
Sindi and Lerato both spoke about the difficulties of trying to get their grandchildren to not only listen to their advice but also to subsequently follow this advice, rather than being influenced by other factors such as the behaviour of their peers.
“For me, it is not difficult to talk to my kids, but our kids do not want to listen. You can tell him or her something here in the house but when he is going outside to the friends, they teach their way of living.” – Sindi (59, caregiver of four children)