Except in a handful of countries, men have a lower life expectancy at birth and higher death rates during adulthood than women. Many of the health problems that men face could be prevented or even cured with early medical intervention or a change in lifestyle. However, boys who are brought up to believe that "real men don't get sick" may see themselves as invulnerable to illness or risk. When they actually fall ill, they may put up with the sickness or seek health care only as a last resort.
These attitudes and behaviours undermine AIDS prevention efforts. If real men do not fall ill, then it is not "manly" to worry about avoiding drug-related risks or to bother with condoms and other safer-sex precautions to prevent HIV and other sexually transmitted infections.
Over 330 million cases of sexually transmitted infection other than HIV occur every year. While women suffer the most serious complications of STIs, including infertility and cervical cancer, infection in men is an important link in the chain of HIV transmission. A person with an untreated STI may be 6-10 times more likely to pass on or acquire HIV during sex. The risk increases to ten to three hundred-fold in the presence of a genital ulcer, such as occurs in syphilis, chancroid or genital herpes. Although most STIs are easily cured with antibiotics, many men go untreated, delay treatment or use home remedies when they contract an infection. In some settings, such a disease is a taboo subject -- something that only "dirty" or "lower class" persons contract. In other places, an STI is a seen as a "badge of honour" and proof of sexual conquest.
How can men be encouraged to use health services and seek support when they need it? When asked what they want in health centres, men often cite the same things as women: high-quality services at an accessible price; privacy; confidentiality; staff who are sensitive to the needs of men, including those who have sex with men; and clinic hours that are compatible with work schedules. Some men also prefer male doctors and nurses. In countries such as Australia, the public health sector is coming up with creative approaches, such as offering men's health nights at clinics, and encouraging men to seek not just HIV counselling and testing but screening and treatment for prostate or testicular cancer. Community-based organizations have started support groups for men who were victims of sexual abuse as children.
Discussion groups for men facing stress, including those living with AIDS, can also be effective. In 1996 The AIDS Support Organisation (TASO) in Uganda created the Positive Men's Union to help men living with HIV or AIDS. While the men wanted to discuss broader issues such as unemployment and poverty, their participation also led to more health-seeking behaviour and better communication with their wives.
This article was provided by UNAIDS. It is a part of the publication Men and AIDS -- A Gendered Approach, 2000 World AIDS Campaign. Visit UNAIDS' website to find out more about their activities, publications and services.