Sex, tensions and pills Young people’s use of contemporary reproductive and sexual health technologies in Addis Ababa, Ethiopia

This study sheds light on why some young men and women from diverse backgrounds in Addis Ababa use emergency contraceptive pills (ECs) and sildenafil citrate (Viagra) repeatedly, sometimes in a routinized manner. It unravels the reasons behind the frequent yet secretive purchasing of these two pharmaceuticals, which were not developed for repeated (and in the case of sildenafil citrate non-prescription) use. It shows that these pills reflect young people’s sexual concerns and aspirations. They are used to manage tensions that arise from pressures young people experience due to changing gender relations and notions of sex. Young men feel pressure to be ‘strong’ lovers – partially because of the emerging importance of pornography in modelling new ideals of masculinity and sexual performance – and use sildenafil citrate to mask sexual insecurity. Young women try to balance the competing notions of being a ‘proper’ woman and a ‘modern woman’. ECs make it possible to pursue sexual relationships with greater freedom, while seemingly adhering to longstanding norms regarding pre-marital sexual abstinence. While these two pills often provide young men and women with a sense of control by protecting, boosting, or strengthening their sexual reputations vis-à-vis peers, lovers, or society, this can easily shift to loss of control when they experience unwanted bodily symptoms with ECs or psychological dependency with sildenafil citrate. The important role of gendered sexual reputations in young people’s encounters with reproductive and sexual health technologies are too often ignored by programmes targeting their sexual and reproductive health and rights.