What about the men?

Reproductive and sexual health services have always focused on women and girls, but little effort has gone into working with men, especially young men. The critical challenge is to curb the further spread of HIV/AIDS and sexually transmitted infections (STIs) by getting men to support their female partners' needs, choices and rights in sexual and reproductive health, a report by the UN Population Fund (UNFPA) said. Interventions involving men would also improve "understanding of men's own identity behaviour and sexual health needs", the report noted. The benefits to young men were particularly significant. Access to relevant information about HIV/AIDS and STIs, as well as exposure to positive role models, would provide opportunities to allow them to discuss their concerns. Working with men between the ages of 10 and 24 was a priority, as this stage in their development was "critical for gender-role formation", and the period when awareness of such issues was shaped. "Boys are being socialised to produce, achieve and perform, without being made aware of their own health needs," the report found. Moreover, increased access to condoms meant men would need to be able to negotiate, rather than impose, decisions on women regarding contraceptive use. The report recommended that fathers be included in the prevention of mother-to-child transmission of HIV campaigns, to ensure a "lighter burden" for HIV-positive pregnant women. Religious leaders were also capable of mobilising and empowering communities to seek these services. For instance, in Senegal, UNFPA helped create a network of religious leaders who interpreted the Koran and its precepts regarding sexuality, family planning and reproductive health. As a result, imams address family planning in their Friday sermons, providing men previously left out of such discussions with information and a greater level of awareness. Although it was usually men who decided on sexual relationships, the timing and frequency of sexual activity and use of prevention methods, "the proportion of contraceptive use attributed to men has been falling in recent years," the report found. Men, however, felt uncomfortable in health settings and were often not welcomed in family health clinics. The report called for more research to determine the constraints on men who sought to change their behaviours. Existing mass media campaigns should not reinforce stereotypical gender roles when trying to reach men, the report warned. This was one of the lessons learned from a campaign to promote men's use of family planning in Zimbabwe. Many of the campaign messages - which relied on prominent sports players to tell men about the importance of family planning - used sports to emphasise teamwork between couples. Other messages however, might have reinforced men's willingness to take sole control, such as "Play the game right; once you're in control it's easy to be a winner". "As an unintended consequence, some men exposed to the campaign were more likely to believe that they alone should make family planning decisions," the study said. But involving men could not be done without the support of women themselves. "A primary consideration ... is to meet women's reproductive and sexual health needs and to assure that women are given the choice as to whether or not they want to include their respective partners in service settings," the report concluded. To view the report: www.unfpa.org