Need to make men more sexually responsible

Botswana's efforts to curb the AIDS epidemic will be shaped by attempts to make men more sexually responsible. This emerged from a four-day national workshop on male involvement in sexual and reproductive health, organised last week in Gaborone by United Nations Population Fund (UNFPA) and the ministry of health. "Men in an all-male environment, such as the military, may be strongly influenced by a culture that reinforces risk-taking, including unsafe sex," said Dr Agathe Lawson, UNFPA representative in Botswana. According to a 1999 study on HIV/AIDS commissioned by the Community Health Services Division, men feel entitled to have multiple sex partners. The study found that there was extreme mobility of the population in Botswana and also "frequent and long-established work-related separation of spouses or partners, which in turn leads to extra-marital or extra-relationship sexual encounters". More than half the mobile workers had sexual intercourse twice or more often per week, and only one-third went home every weekend or every other weekend. Women were at special risk of HIV infection because of their lack of control over sexual practices, it emerged at the workshop. "What is less recognized, however, is that the cultural beliefs and expectations that make this the case also heighten men's own vulnerability. HIV infections and AIDS deaths in men outnumber those in women on every continent except sub-Saharan Africa," Lawson told IRIN. "Policy-makers in many countries have almost automatically assumed that men are not interested in or supportive of family planning and contraceptive use, even though recent research shows that many men are." Lawson indicated that men who were educated about reproductive health issues were more likely to support their partners in decisions on contraceptive use and family planning, which was crucial if women were to practice safe sex or avoid unwanted pregnancy. The threat posed by HIV/AIDS is taken seriously in Botswana, not only because it affects the nation's reproductive health, but because it undermines government's development agenda. "There is a direct relationship between sexual reproductive health/HIV/AIDS and development. We have seen indicators of reversal in our social development: life expectancy has dropped to pre-independence era; infant and maternal mortality and morbidity are increasing," said Major General Tebego Masire, a representative of the Botswana Defence Force. "The Prevention of Mother-to-Child Transmission programme is not doing so well, largely because men prevent their spouses and partners from enrolling in the programme," he said. "We also need to re-examine certain pieces of our legislation, which reinforce the belief that men have no responsibility for their children in certain circumstances. For example, men have no rights over children born out of wedlock, except to maintain them," said Masire. Men were regarded as important in discussions on sexual reproductive health because they tended to initiate sexual relationships; more often than not headed families; committed almost all incidents of rape; and were not actively involved in AIDS awareness initiatives. "I work for a rape crisis centre, called Botshabelo, where we see men as perpetrators and violators. We need them [men] to see women as mothers, sisters and daughters who deserve their love and nurturing," said Botho Ntswaneng, Director of Botshabelo Rehabilitation Crisis Centre. The leadership role occupied by men in most societies meant they often took decisions that affected their partners as well as their children. "They [men] also have economic power in many cases, so it is important that those resources are used for the benefit of families and children," said Dr Amani Maeni, an occupational health consultant with the ministry of health.