Girls cannot be trusted: young men's perspectives on contraceptive decision making and sexual relationships in Bolgatanga, Ghana.

BACKGROUND: There is extensive research on African girls sexual experiences, but much less is known about boys thoughts and actions. There is a need to understand the male perspective in order to develop sexuality education programmes that address the high rates of teenage pregnancy and sexually transmitted infections in sub-Saharan Africa.

METHODS: For this qualitative, phenomenological study we spoke to 20 boys from Bolgatanga, Ghana and explored their sexual decision making, using semi-structured interviews designed to highlight psychosocial and environmental factors. Content analysis was used to construct categories and later the themes.

RESULTS: Boys often had negative perceptions about sexual relationships. They believed that girls could not be trusted and mostly embarked on sexual relationships for material gain. The boys reported engaging in multiple sexual partnerships to secure their masculine status; however, they expected girls to be 'faithful'. We found that accurate knowledge of safe sex was lacking, boys were under peer pressure to conform to beliefs about masculinity and communication about sex mainly took place within peer groups.

CONCLUSIONS: There is a need to emphasise condom use in established relationships. There should also be more discussion of issues surrounding fidelity and gender equality, as part of sexuality programmes aimed at boys in Ghana and in similar cultures.