I care . . . Do you?"I care . . . Do you?" is the slogan for the second year of a two-year campaign intended to create a sustained focus on the role of men in the AIDS epidemic.
A man's self-worth is enhanced, not compromised, by actively caring for his partner's and children's well-being.
- Men should respect women.
- Men can care for their partners and families by not bringing HIV into the household. They can do so by:
- not having sexual relations with others or by always using condoms for sexual acts outside of the relationship; and
- not injecting drugs or, if they do so, by not sharing injecting equipment and by only using clean needles and syringes.
- Men should educate their children about sexuality, personal responsibility and HIV.
- Men should initiate a dialogue with their partners about sexuality, contraception and HIV.
- Men should provide support for partners and children who are ill.
- Research suggests that when fathers and other male family members are positive role models, boys develop a more sensitive vision of manhood and are more respectful in their relationships with women.
- Men, in general, spend less time than women at home and in looking after and being with their children. A review of research in 186 societies found that only in 2% of these societies did fathers have "regular, close relationships" with their children during infancy.
- In most societies, men are expected to provide for their female partners and children.
- When the man -- the breadwinner -- is HIV-infected, a higher percentage of the family's budget is spent on his health than on other members of the family who may be infected. Often, by the time of his death, the family's savings have been spent, leaving the wife and children without money and without a source of income.
- Male violence against women is prevalent in many societies.
Traditional models of masculinity can have a negative impact on boys. For example, mothers often reinforce traditional ideas about masculinity by showing that they do not expect sons to help around the home, and fathers may set a bad example through their own lack of involvement in the care of, and in their behavior towards, women. Such models may encourage boys to consider themselves as somehow exempt from responsibility for household work and care.
Men need to protect their children from the risk of contracting HIV. Many men do not actively participate in the education -- including sexual education -- of their children. Yet, men can participate in raising their children, discussing relationships, offering advice on how to respond to sexual advances, and acting as positive role models.
Among young children, mother-to-child transmission is by far the most common cause of HIV infection. Raising awareness of father-to-mother-to-child transmission of HIV can help in protecting men, their partners and their future children.
In many families, if the breadwinner dies, then the children (particularly the elder ones) may no longer be able to attend school and may, instead, have to find work. For example, in Malawi, where about 15% of the adult population is HIV-positive, child labor is becoming common, as many orphans have been forced to leave school in order to work. These children's lack of education is putting them at risk of HIV infection, since many will not have access to HIV prevention information. Also, some may become involved in sex work as a result of economic hardship.
When an adult -- particularly the breadwinner -- falls ill and dies in a rural area, there is a significant reduction in a family's economic output. Households are forced to plant less labor-intensive crops, which reduces the family income. For example, in Zimbabwe, there has been a 61% reduction in the rural production of maize (a labor-intensive crop), partly due to the increasing number of people dying from AIDS.
Men inflict violence on women -- violence that is sometimes sexual and that may result in HIV infection. Thirty-five studies from a variety of countries in Africa, Asia, Europe, Latin America and North America found that 25-50% of the women reported having been physically abused by a current or former partner. Sexually aggressive young men were themselves more likely to 1) have been sexually abused; 2) have witnessed abuse of a family member; 3) have a sexually transmitted infection; and 4) have used drugs or alcohol.
Many women who test positive for HIV face the twin prospects of coping with their diagnosis and finding a way of informing their husband or male partner. In such situations, men and other family members may accuse the woman of bringing HIV into the household, even though it is much more likely that the man has done so. In extreme cases, women with HIV may be evicted from their home by their husband, or by their husband's family after his death.
Ideas for Action
- Encourage men to act as positive role models for their sons and daughters, and to talk to their children about HIV/AIDS prevention, suggesting ways of responding to sexual advances, and discussing love, relationships and substance abuse.
- Encourage men to provide support for partners and children who are ill by ensuring a steady income, whenever possible; by encouraging sick partners to rest and taking on the tasks that they would otherwise perform (such as fetching water or cooking meals); and by providing love and affection.
- Encourage men who have contracted HIV to plan for the future. In developing countries, most HIV-positive people are already poor. This, combined with social and cultural practices, nearly always results in the assets of a family being used to cover the costs of care in the last years of life or to substitute for lost income. Even so, some men are in a position to make provisions; they can provide housing and education, and write a clear will, leaving savings or income (from land or other sources) to their family.
- Establish programs that encourage young, unmarried men to understand their roles as future parents and prepare them to be actively involved in parenthood, promoting planned fatherhood as a masculine ideal.
- Arrange counselling for couples who are considering having children and/or are worried about their HIV status.
- Educate men on their potential role in, and responsibility for, HIV transmission to their children, prior to and during their partner's pregnancy.
- Bring men together to talk about their concerns regarding care for their families and help them develop the skills to talk and listen to their partners and children.
- Work with writers for radio and TV soap operas, encouraging them to incorporate examples of caring men into their story lines.
- Encourage male celebrities and sportsmen to talk about their caring relationships with their partners and children.
- Promote peer education as well as support and counselling among men living with HIV.
- Assist HIV-positive men, or those affected by HIV, in planning for the future care of their children.
- Encourage men with HIV to communicate their HIV status to their partners and children.