Men, Culture and HIV/AIDS
IssuesSocially constructed images of masculinity can encourage high-risk behavior such as violence, sexual risk-taking, excessive drinking or drug use. These "macho" attitudes, which are encouraged in many cultures and make women more vulnerable to HIV infection because of the imbalances in decision-making power, mean that many women cannot negotiate condom use and are often forced to have unwanted sexual relations. These attitudes also make men vulnerable to HIV infection since they often emphasize sexual prowess, encourage men to have multiple sexual partners and prompt them to exercise their authority over women.
For many men and women, it is often difficult to talk about sex and to reveal one's HIV status. Advocating abstinence, faithfulness or condom use can be difficult for many couples. In the community, openly discussing sexually transmitted infections can often mean breaking local taboos, resulting in a loss of prestige. Many men are afraid of revealing a HIV-positive diagnosis because they fear losing their jobs and being rejected by their social group, or because they feel guilty towards their regular partner.
Community leaders -- including traditional healers or medicine men -- have a critical role to play in HIV/AIDS prevention and care because they are often highly respected medical, social and psychological advisers in their community. Their position enables them to either promote or hinder behavioral change as well as HIV prevention and care in general. Therefore, their involvement in a community's response to HIV is vital.
Many cultures and religions give more freedom to men than to women. For example, in many cultures it is considered normal -- and sometimes encouraged -- for young men to experiment sexually before marriage. Also, in many cultures, it is considered acceptable for men -- even married men -- to have sex with sex workers. These cultural attitudes towards sex are leading to HIV infections in both men and women -- often the men's wives.
Because men are traditionally seen as the providers, and they believe that they must fulfill this role, many of them react negatively if they cannot find work or if they are unable to provide for their family. Men's sense of anger or disempowerment may lead to alcohol or drug abuse, or violent behavior, increasing both their own and their partner's risk of HIV infection. Employment opportunities for men may restore self-esteem and reduce their tendency to engage in such risky behavior. However, employment may also mean that couples have to live apart, since men must sometimes migrate or be mobile for work, as is the case for long-distance truck drivers. Due to loneliness and the availability of money, these men may have unprotected sex with other women or men and become HIV-infected. These HIV-positive men may, in turn, infect their wives and other sexual partners.
Some beliefs can result in increased risk of HIV infection. One especially dangerous myth, which is found in some cultures around the world, is that having sex with a virgin will cure HIV. While this is obviously untrue, increasing numbers of young girls are infected as a result of this practice.
In many societies, there are very negative attitudes towards men who have sex with other men. Nonetheless, in every society, no matter how strong the taboos, some men have sex with other men. They do so for many reasons -- for pleasure, for economic reasons, under compulsion, due to a lack of availability of women, or for a combination of the above reasons. Many men who have sex with men also have sex with women -- for pleasure, out of a sense of duty, due to self-denial or in order to hide their desires from others. Therefore, it is important to encourage broader discussion of male-to-male sex, since it is one of the ways in which HIV is transmitted.
Ideas for Action
This article was provided by UNAIDS. It is a part of the publication World AIDS Campaign 2001. Visit UNAIDS' website to find out more about their activities, publications and services.