Brothers are doing it for themselves

In the context of sub-Saharan Africa's HIV/AIDS epidemic, women have often been characterized as the victims and men as the perpetrators incapable of sticking to one partner or taking responsibility for their sexual health.

But what if men were victims of the social norms that define masculinity as much as women? And what if they were willing to change, and persuade other men to do the same?

Speakers at the MenEngage Africa Symposium in Johannesburg, South Africa, this week have been debating ways to help men achieve this and to become part of the solution to the continent's twin epidemics of gender-based violence and HIV.

"When we talk about a feminized epidemic, we make the mistake of leaving men out of interventions," commented Mandla Ndlovu, programme officer of the recently launched "Brothers for Life" campaign.

The initiative by Johns Hopkins Health and Education in South Africa (JHHESA), USAID and the Sonke Gender Justice Network aims to spark a movement of "good" men to encourage their peers to take more responsibility for their health and that of their partners.

One presentation indicated that there may be more good men out there than we think. In a recent study on multiple partners in four locations across South Africa, 74 percent of men reported having had only one sexual partner in the past year.

"While the prevalence of men having multiple partners is quite high, it's not as normative as has been suggested," said Sarah Laurence of Health & Development Africa (HDA), a health consultancy that conducted the research on behalf of JHHESA.

Although men are less affected by HIV than women in high-prevalence countries like South Africa, they are far from invulnerable: 24 percent of South African men aged 25 to 49 are living with the virus.

Because men are far less likely than women to seek out HIV testing, treatment and support, they experience worse outcomes from HIV and other chronic illnesses, according to Dr Francois Venter, director of the Southern African HIV Clinicians Society.

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Venter urged delegates not simply to blame men for their poor health-seeking behaviour, but to consider some of the reasons for it. Some presenters focused on the fact that men were socialized to consider illness a sign of weakness, and tended to perceive an HIV-positive diagnosis as a humiliating blow to the ideal of masculine strength, but Venter suggested that South African public healthcare facilities were also to blame for not responding to men's specific needs, and not prioritizing interventions such as male circumcision, which could reduce their HIV risk. "How can we expect men to change their behaviours if we're failing them on a public health level?" he asked.

The "One Man Can" campaign by Sonke Gender Justice - launched in late 2006 with the goal of supporting men and boys to become advocates for gender equality and active participants in HIV/AIDS responses - has already demonstrated that men are capable of changing their behaviour and attitudes.

Dr Chris Colvin presented an evaluation of the campaign's impact, based on interviews with 265 participating men, which found that 75 percent had increased their use of condoms, 23 percent had gone for voluntary counselling and HIV testing, and 83 percent of those who had witnessed gender-based violence had reported it.

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