All over the world, women find themselves at special risk of HIV because of their lack of power to determine where, when and whether sex takes place. What is perhaps less often recognized is that cultural beliefs and expectations also heighten men's vulnerability. Men are less likely to seek health care than women, and are much more likely to engage in behaviours -- such as drinking, using illegal substances or driving recklessly -- that put their health at risk. Men are also less likely to pay attention to their sexual health and safety, and are more likely to inject drugs, risking infection from needles and syringes contaminated with HIV.
All over the world, and on average, men have more sex partners than women. Moreover, HIV is more easily transmitted sexually from men to women than vice versa. In addition, HIV-positive injection drug users -- who are mostly male -- can transmit the virus to both their drug partners and sex partners. There are sound reasons, therefore, why men should be fully involved in the fight against AIDS. As politicians, as frontline workers, as fathers, as sons, as brothers and as friends, they have much to give. The time is ripe to start seeing men not as some kind of problem, but as part of the solution.
That said, we need to strike a careful balance between recognizing how some men's behaviour contributes to the epidemic and pointing the finger at all men and their actions. Blaming individuals or groups has never been a successful way of encouraging greater involvement in HIV prevention and care. Instead, efforts should be made to encourage positive behaviours and responses. We should aim to build upon successful work and include as many men as possible in the global struggle against AIDS.
Too often in the past, it has been assumed that, if only they wanted to, men would change their behaviour. Far too frequently, some men's apparent unwillingness to offer care and support has been viewed as evidence that all men make no real investment in their own or their families' future. Yet men's actions, like those of women, are constrained by traditional beliefs and expectations and influenced by divisive cultural beliefs and social norms.
This is not to excuse men or some of their behaviours. The actions of men who rape, who commit acts of violence, and who will not take into account others' points of view, cannot be excused. It is, however, necessary to recognize the power of existing gender relations, which affect both women and men, and the fact that collective as well as individual effort is needed to achieve greater equity and a proper balance of responsibility for AIDS prevention and care.
Risk-reduction measures tailored for men exist in some communities. In parts of Africa, Central America and Asia, for example, long-distance truck drivers have been encouraged to reduce the number of sexual partners and more consistently practise safer sex. In Thailand, there have been successful programmes for prevention among army recruits. In many countries, including the U.S., college students are beginning to delay the onset of sex and are more consistently using condoms.
Given the urgency of curbing HIV rates, these activities need to be scaled up dramatically. Far greater attention must be given to the needs of the millions of men now living with HIV, including support in preventing transmission to others. Men need also to be encouraged and helped to play a much greater part in caring for orphans and sick family members. Finally, even though the outcomes may take years to materialize, it is important to challenge harmful concepts of masculinity, including the way adult men look on risk and sexuality and how boys are socialized to become men.
All this does not mean an end to prevention programmes for women and girls. Rather, the aim is to complement these by work which more directly involves men. Everyone at risk of infection, whatever their gender, status or sexuality, has the right to protection from HIV. That is why, working with governments and non-governmental organizations (NGOs), men and women across the world, the UNAIDS-sponsored World AIDS Campaign will focus on HIV/AIDS and men. When it comes to HIV and AIDS, men can make a difference. Involving men really matters, and this involvement is central to any balanced national or local response.
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.