Behaviour in Latin American men: implications for HIV/AIDS interventions.

Abstract

The single most deeply rooted feature of sexual culture in Latin America is the culture of machismo. Machismo is a complex ideological system that organizes gender relations hierarchically which establishes relations of power and domination between men and women. Same-sex relations between men are conceptualized within the framework of male-female relations. In Latin America the penetrating partner in same-sex interactions may maintain a sense of a fundamentally male identity. Thus he may not distinguish himself from other macho males. The receiving or effeminate partner faces the severest stigma in Latin America. Regardless of the type of sexual relations sexual practices are socially and culturally constructed within the context of sexual scripts. The broader conceptual frameworks of most HIV/AIDS prevention programs and interventions focus on psychologically grounded theories of individual behavior change rather than on more sociologically grounded approaches to community development and mobilization. Projects in Latin America have revealed many important insights that guide decision makers to reevaluate some elements of models that appear to contribute to the guidance of past HIV/AIDS behavioral interventions. Perhaps the concept of a behavioral intervention may be somewhat a misnomer because most AIDS prevention programs do not directly intervene at the level of behavior. Instead they tend to intervene at the level of social and cultural representations--the level of the subjective and intersubjective meanings held by people about their behaviors. The possibilities of behavior changes are conditioned by a range of social cultural economic and political factors or forces. These conditions may actually be beyond the possibility of any HIV/AIDS prevention program to effectively influence behavior. Nevertheless HIV/AIDS prevention programs should try to integrate as much as possible a concern with these factors into the design and implementation of prevention programs.