Men, male sexuality and HIV/AIDS: Reflections from studies in rural and urban East Africa

Abstract

Men, male sexuality and HIV/AIDS:Reflections from studies in rural and urban East Africa Margrethe Silberschmidt (bio) Introduction Empowering women to prevent HIV/AIDS has received much lip service in recent years. However the time has come for a real focus on changing male attitudes and behaviours. In the past the focus has been on the women's side and what they should be doing, but we need to focus on the other side of the gender equation and correct men's misconceptions and behaviour. At the moment male power is almost synonymous with multiple relations and power over women. (Helen Jackson, UN Population Fund Advisor to IRIN NEWS, September 3, 2002) In spite of numerous prevention activities during the past decade in sub Saharan Africa, the HIV/AIDS epidemic is still spreading (Fitzgerald and Behets 2003). Heterosexual men are often seen as the driving force behind the epidemic. The view is that gender inequalities permit men to dictate the terms of sexual intercourse and this results in unprotected sex with women being the major victims. This article offers a different view of the respective positions of men and women within the AIDS epidemic by exploring some of the less stereotyped reasons why men now seem to be driving the epidemic. It investigates the gendered effects of socio-economic change, the implications of these for male identities, masculinities and sexualities. Finally, it addresses lessons to be drawn from the research findings regarding HIV/AIDS prevention activities and campaigns. According to Caldwell (2000:126) 'Africans have been educated by AIDS programs to know that the disease is deadly and is largely spread among them by high-risk sexual activities. The epidemic cannot be defeated [End Page 42] by more education'. This sweeping (and pessimistic) claim needs to be qualified by noting that HIV/AIDS prevention campaigns that lead to behaviour change will only be successful if proper attention is given to the wider socio-economic context, and to issues of gender, gender relations and sexuality. In order to understand the role of male sexual behaviour in the AIDS epidemic the focus should fall on the social and cultural context in which sexual activity is shaped and constituted (Parker 2001; Parker and Gagnon 1995). Based on my research from rural and urban East Africa, the aim of this article is to elucidate how socio-economic changes differentially have impacted on women's and men's social roles, social value, self-esteem and perceptions of self. The focus will be on the way in which masculinity and male sexual behaviours have been affected. The research was first carried out by the author in Kisii, rural Kenya, at different periods from the mid-1980s to the mid-1990s. Research in urban Dar es Salaam took place during one year (1996-97). The Kisii research consists of both survey data (723 women and 200 men in their reproductive years) and qualitative data collection, life histories and focus group discussions with a selection of men and women from two villages included in the survey. The vast majority had not completed primary education. Most women referred to themselves as housewives and the majority of men referred to themselves as farmers. The qualitative data collection in urban Tanzania took place in three low-income squatter areas of Dar es Salaam: Mabibo, Vingunguti and Buguruni. In-depth interviews were carried out with 38 women and 53 men also at reproductive age by means of structured, semi-structured and open-ended interviews. Unlike the Kisii informants, the majority had completed a primary education. While seven out of the 53 men had attended secondary school, only one of the 38 women had been to secondary school. The vast majority of men said they were casual labourers, self-employed or involved in petty business (selling cold drinks, dried fish, etc). Women said they were housewives and at the same time involved in petty business. In addition, 13 focus group discussions were conducted with different groups of men and women of different age but with similar backgrounds. Socio-economic change and gender change in East Africa While the causes are still contested, there is no doubt that people in East Africa have...