IRIN Briefing on men and HIV/AIDS

Engaging men as partners in fighting HIV/AIDS is one of the surest ways to change the course of the epidemic, UNAIDS has said in a new report, and this year has chosen ‘Men Make a Difference’ as the title of its global campaign. Why men? HIV/AIDS affects both men and women. Worldwide, there are more men than women living with HIV/AIDS. However, women are being infected at a faster rate than men and in sub-Saharan Africa, where the majority of people living with HIV/AIDS are, women already comprise an estimated 55 percent of the 22 million adults in the region who are HIV-positive. By the end of 1999, 10 million African men were living with HIV/AIDS, as compared with 7.5 million infected men in the rest of the world combined. Globally, it is recognised that women find themselves at special risk of HIV because of their lack of power to determine where, when and how sex takes place. According to UNAIDS, what is less recognised is that cultural beliefs and expectations also heighten men’s own vulnerability. “Part of the effort to curb the AIDS pandemic must include challenging harmful concepts of masculinity and changing many commonly-held attitudes and behaviours, including the way men view risk and how boys are socialised to become men,” UNAIDS said in its report titled ‘Men and AIDS - a gendered approach’. “Broadly speaking men are expected to be physically strong, emotionally robust, daring and virile. Some of these expectations translate into ways of thinking and behaving that endanger the health and well-being of men and their sex-partners.” The report said that in some settings men were less likely to pay attention to their sexual health and safety than women. Men were also more likely than women to use alcohol ad other substances that lead to unsafe sex and increase the risk of HIV transmission. Neither men or women can or should be blamed for HIV/AIDS, the report cautioned. People of both sexes should lead lives that pose no danger to themselves or others. What is the impact on women? The report said that women were more susceptible to HIV/AIDS because they were biologically more vulnerable than men and because of men’s behaviour. On average men have more sexual partners than women and therefore more opportunity to contract and transmit HIV. Men have traditionally had more control over whether or not safe sex is practiced. “Unfortunately many consider their masculinity compromised by the very behaviours that limit the spread of HIV, namely having fewer sexual partners, using condoms or being sensitive to safer sex preferences of their partners,” said the report. Women have been made more vulnerable by men’s greater economic and social power and by unequal gender relations. Many women are often expected to and sometimes forced to be sexually faithful to a husband or a male partner, while he is permitted and in some cases even encouraged to have sex with other women. This increases a woman’s risk of contracting the disease from her partner. A study conducted in Rwanda showed that about 45 percent of women contracted the virus from their husbands. Sex between men? Most sex between men is hidden. The report noted that surveys across the world found that up to a sixth of all men reported having sex with another man. Many of these men surveyed also said that they had sex with women. In Botswana, for example between six and 16 percent of men and boys said they had sex with another man or boy. However, the social stigma and discrimination has prevented many men from admitting this placing them at greater risk of contracting HIV and has prevented the development of HIV prevention campaigns that are directed at these men. The secrecy and the stigmatism has also placed women at a higher risk of contracting the disease. Are there other links between men and HIV? Yes. Male violence, the report noted, was one of the driving factors behind the spread of HIV/AIDS. Millions of men a year are sexually violent towards women and girls, sometimes in their own homes and families. However men are also sexually violent towards each other, particularly in prisons, but also in many other settings where an older man or boy has power over a younger or weaker one. According to the report violence helps spread HIV/AIDS because it deters discussions about preventing HIV and other sexually transmitted diseases. “Women and men who have been the victims of sexual violence, particularly when they are young, are less likely to believe that they can negotiate safer sex practices with a partner,” said the report. More information on the ‘Men Make a Difference’ campaign can be found at: http://www.unaids.org/wac/2000/wad00/presskit_wad.html