Men and Families

Men's reluctance to acknowledge a health problem and seek help for coping carries over into HIV and AIDS. Reports from Africa, Asia and elsewhere suggest that infected men are less likely than women to support one another and look for help from their family and friends. Men who discover they are HIV-positive often cope less well than women. An exception seems to be settings in which HIV is transmitted through sex between men and where special support networks exist for HIV-positive gay men.

However, when men with HIV start to develop disease, they are the ones who are more likely to receive care from the family. In the traditional male-female division of labour, the provision of care for sick family members falls to women. This pattern has tended to prevail even in the AIDS era, although with sexual transmission in marriage both partners can be ill and require attention. Studies from the Dominican Republic and Mexico find that married women with AIDS often return to their parents' home because they are unlikely to receive adequate care from their husbands. Some studies in Africa suggest that families are more likely to seek and pay for medical treatment for a male than a female family member with AIDS.

Research worldwide also shows that men generally participate less than women in caring for children -- in part because men are more likely to be working outside the home and in part because men are not raised or encouraged to act as caregivers. Again, this has a direct bearing on the AIDS epidemic, which by the end of the year 2000 will have left thirteen million children orphaned and in need of adult help to grow up clothed, housed and educated. The vast majority of these children are left to the care of women relatives and neighbours, though some orphan groups or households are headed by boys.

But men have a major investment in the family as husbands, as respected members of the household and as fathers. A number of initiatives have been successful in getting fathers and future fathers more involved in caring for their children -- for example, in Brazil, Cameroon, Jamaica, Sweden and Uganda. Many of these have played to men's commitment to their children and their desire to protect loved ones. It is urgent to apply these sometimes innovative approaches on a far greater scale, especially in parts of the world hard-hit by the epidemic.

Fathers, and men wishing to have children, need to be more aware of their potential to transmit the virus to their partners and, through mother-to-child transmission, to their children as well. They need to bear in mind that their children will be orphaned if they and the mother die of AIDS. How might men as fathers be motivated to keep themselves safe and uninfected for their children's sake? Or, if they already suspect or know they have HIV, motivated to protect their wife and children from the virus? One way might be to encourage fathers to be more involved in their children's lives. While it is important not to oversimplify the complex factors involved in men's attitudes about sex, shining the spotlight on their important role of fatherhood is one avenue for encouraging men to reflect about the consequences of their sexual behaviour.

AIDS -- Men Make a Difference While men's behaviour currently contributes substantially to the spread and impact of HIV, and puts men themselves on the frontline of risk, such behaviour can change. Engaging men as partners in the effort against AIDS is the surest way to change the course of the epidemic. Pointing the finger or apportioning blame is unlikely to motivate men to listen or change their ways. Through the World AIDS Campaign, UNAIDS and its partners worldwide will work with both women and men, with NGOs, governments and the United Nations system to bring about a new, and much-needed, focus on men.