Men Make a Difference is the title of the first year
of a two-year campaign focusing on the role of men in the AIDS epidemic.
The new Campaign aims to involve men more fully in the effort against
AIDS and to bring about a much-needed focus on men in national responses
to the epidemic.
All over the world, women find themselves at special risk of HIV infection
because of their lack of power to determine where, when and how sex
takes place. What is less recognized, however, is that the cultural
beliefs and expectations that make this the case also heighten men's
own vulnerability. HIV infections and AIDS deaths in men outnumber those
in women on every continent except sub-Saharan Africa. Young men are
more at risk than older ones: about one in four people with HIV is a
young man under the age of 25.
Part of the effort to curb the AIDS epidemic must include challenging
harmful concepts of masculinity and changing many commonly-held attitudes
and behaviours, including the way men view risk and how boys are socialized
to become men. Broadly speaking, men are expected to be physically strong,
emotionally robust, daring and virile. Some of these expectations translate
into ways of thinking and behaving that endanger the health and well-being
of men and their sex partners. Other behaviours and attitudes, on the
contrary, represent valuable potential that can be tapped by AIDS programmes.
Focusing the Campaign on men also acknowledges the fact that men are often less likely
to seek health care than women. Except in a handful of countries, men
have a lower life expectancy at birth and higher death rates during
adulthood than women. But boys who are brought up to believe that "real
men don't get sick" often see themselves as invulnerable to illness
or risk. This is reflected in the under-use of health services by men.
Greater attention must be given to the health needs of men, including
those living with HIV and AIDS.
There are sound reasons why men should become more
fully involved in the fight against AIDS.
All over the world, men tend to have more sex partners than women, including
more extramarital partners, thereby increasing their own and their primary
partners' risk of contracting HIV. More men than women inject drugs
and are therefore more likely to infect themselves and others through
the use of unsterilized equipment. And many men who have sex with other
men do not know how to protect themselves or their partners. Secrecy,
stigma and shame surrounding HIV compound the effects of all these risk
behaviours. The stigma surrounding HIV may prevent many men and women
from acknowledging that they have become infected.
A number of
special circumstances place men at particularly high
risk of contracting HIV. Men, who migrate for work and live away from
their families may pay for sex and use substances, including alcohol,
as a way to cope with the stress and loneliness of living far from home.
Men in all-male environments such as the military may be strongly influenced
by a culture that reinforces risk-taking including unsafe sex. And in
some all-male institutions such as prisons, men who normally prefer
women as sex partners may have unsafe sex with other men.
Male violence further drives the spread of HIV – through
wars and the migration they cause, as well as through forced sex. Millions
of men a year are sexually violent towards women, girls, and other men
sometimes in their own family or household. Worldwide, a recent report
states that at least one woman in three has been beaten, coerced into
sex or otherwise abused in her lifetime.
At the same time, a balance needs to be struck between recognizing how
men's behaviour contributes to the epidemic and recognizing their potential
to make a difference. As politicians, as front-line workers, as fathers,
as sons, as brothers and friends, men have much to give. Men need to
be encouraged to adopt positive behaviours, and to play a much greater
part in caring for their partners and families. Studies worldwide show
that men generally participate less than women in caring for their children.
In terms of the AIDS epidemic, which has left over 13 million children
orphaned, there is an urgency for both men and women to provide
the love and practical needs such as food, housing, clothing and education
for children who have lost their parents.
At end 1999, 34.3 million men, women and children were living with HIV
or AIDS, and 18.8 million had already died from the disease. In 1999,
there were 5.4 million new infections worldwide, of which 4 million
were in sub-Saharan Africa, and 800,000 in South and South-East Asia.
In 2000, the Campaign has
three broad objectives. The first is to raise awareness of the relationship
between men’s behaviour and HIV. The second is to encourage men
and adolescent boys to make a strong commitment to preventing the spread
of HIV and caring for those affected. And the third objective is to
promote programmes that respond to the needs of both men and women.
Objective One
To motivate men and women
to talk openly about sex, sexuality, drug use and HIV/aids
–
motivate men and women to talk openly about sex, sexuality and HIV/aids
– motivate men and women to talk openly about men who have sex
with men and HIV/aids
– motivate men and women to talk openly about alcohol, drug
use and HIV/aids.
Objective two
To encourage
men to take care of themselves, their partners and families
–
encourage men to take care of themselves
– encourage men to take more care of their partners and their
families
– provide good-quality education on sexual health, HIV/aids
and life skills for boys – and girls – in and out of schools
– educate men about their roles as perpetrators and subjects
of violence, and their responsibility to stop violence
– develop HIV/aids programmes for men at particular risk.
Objective Three
To promote
programmes which respond to the needs of men and women
–
devise messages, activities and interventions that address the needs
of men and women
– provide support and care for boys and men living with, affected
by, or orphaned by, HIV/aids
– provide employment opportunities and vocational training to
reduce the vulnerability of unemployed and disempowered men
– provide male-friendly health services, including reproductive
health and prevention of mother-to-child transmission of HIV
– advocate for social, economic and legislative changes to protect
the rights of men and women and to challenge the social norms that
increase the risk for women of HIV infection through men’s behaviour.