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“An Unchanging God in a Changing World”: Sexual Practice and Decision-Making among Christian Women in South Africa


This study explored the relationship between sexual health and religion among young, Pentecostal Christian women navigating the transition to adulthood in Khayelitsha township, in the City of Capetown, South Africa. Between February and August 2019, eleven semi-structured interviews and three focus group discussions were conducted. Thematic analysis and discourse analysis were used to analyse the data collected. The study found that the relationship between sexual health and religion was complex and multifaceted, shaped by the religious dichotomisation of “right” and “wrong”, socio-economic constraints and culture. Despite the perceived decline of religious influence on the sexual and social lives of youth, religion continues to play an instrumental role in shaping the dreams, aspirations and lifestyles of young people, especially as they transition to adulthood. We argue therefore, that religion is a significant spiritual and cultural resource that young women use to develop their sexual and social identities, although it cannot always be equated with their sexual practice or decision-making related to sexual health. In the light of this, churches should still be seen as key partners in the fight against HIV as their involvement can act as a stabilising force for young people dealing with poverty and uncertainty. Church engagement with young people should offer programmes that include but are not limited to sexual health.

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We would like to thank all the young women who participated in this study for their time and efforts and the community liaisons who provided us with venues and other resources to conduct this research in Khayelitsha. We would also like to acknowledge Associate Professor Christopher Colvin, Dr. Jennifer Githaiga and Dr. Carmen Späth for their review of this paper.


This work was supported by grants from the Fogarty International Centre (FIC) and the National Institute of Mental Health (NIMH) (#D43 TW011308), the National Research Foundation of South Africa (#118533 and Unique grant #111678) and Canon Collins Educational and Legal Assistance Trust. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the National Research Foundation or Canon Collins Educational and Legal Assistance Trust.

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Correspondence to Shehani Perera.

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The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Cape Town’s (UCT) Health Science Faculty’s Human Research and Ethics Committee (HREC) and UCT’s School of Public Health and Family Medicine (HREC REF: 288/2019).

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Informed consent was obtained from all the participants involved in this study.

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Perera, S., Swartz, A. “An Unchanging God in a Changing World”: Sexual Practice and Decision-Making among Christian Women in South Africa. J Relig Health 60, 4045–4060 (2021).

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  • Religion
  • Christianity
  • Sexual health
  • Transition to adulthood
  • South Africa