‘If you know the person, there are no risks’: ‘in-between’ strategies for reducing HIV sexual risk among young sub-Saharan migrants living in Switzerland

Abstract

In the past decade, theoretical essays have criticised the dichotomy of rational and irrational strategies for managing risk as neglecting an entire range of strategies that individuals mobilise in everyday life. Neither completely rational nor irrational, ‘in-between’ strategies rely on the use of knowledge and previous experiences, as well as trust, intuition, and emotion. Drawing on data from a multidisciplinary (sociology and sociolinguistics) and multimethod (in-depth interviews and focus-group discussions) qualitative research conducted in 2016–2018 among young sub-Saharan migrants living in Switzerland, this article explores the potential of, and provides empirical relevance for, the concept of in-between strategies in HIV/AIDS research. We argue that strategies for managing HIV sexual risk may not be fully rational, because individuals mobilise them in their social interactions. Indeed, from a sociological perspective sexual activity is a social experience that involve attitudes, practices, intimate relationships, and emotions. Strategies for managing HIV sexual risk depend on power relations between partners, as well as on the social competences and resources of each partner. We found that young sub-Saharan migrants use in-between strategies, which involve rationalisation, knowledge, experience, feelings, and emotions. Our findings highlighted five types of HIV sexual risk-reduction strategies: consistent condom use, HIV testing before discontinuing condom use, selection of partners and investigation of their sexual history, the feeling of familiarity with a partner, and commitment and trust in intimate relationships. Our analysis showed that the in-between strategies concept is particularly useful for capturing the complexity of social processes involved in individuals’ HIV sexual risk management.