110 Table 5.5: Percentage of respondents who reported a moderate or high risk of HIV infection, by selected background characteristics. 136 Table 6.5: Percentage of respondents who reported partner communication about condoms with their most recent partner.
INTRODUCTION
- Background to the Study
- Why focus on Men?
- Statement of the Research Problem
- Aim of the Study
- Conceptual Framework
- Organization of the Thesis
Male deaths due to violence are approximately twice as high as female deaths (Peacock et al., 2009). There is no doubt that some sub-groups of the population are likely to be more vulnerable to HIV infection than others (Ghys et al., 2004).
LITERATURE REVIEW
Introduction
Socialization
This is most clearly captured by Silberschmidt, who notes that while "sexual potency confers social power, value, and self-esteem on men, sexual modesty confers social value on women—but certainly not on men," and "particularly with regard to sexuality, it that gives social value to the man does not give social value to the woman". They are heroes because they suffered the ordeal with dignity". In addition, Morrell and Swart (2004) note that in Uganda, after circumcision, men are expected to marry and create their own family and take responsibility for dependents.
Sexual Experience
Barker and Ricardo (2005) report stories and experiences of young men who underwent circumcision without anesthesia and sometimes put salt and/or pepper on their wounds. In their review, Barker and Ricardo (2005) note that in many cultures, young people experience pressure to be sexually active and have multiple sexual partners.
Multiple Sexual Partners
The study found that men reported more sexual partners in the past 12 months than women. A significant proportion of young men aged 15 to 24 reported a decrease in the number of sexual partners.
Condoms
Rural men and women were less likely to report consistent condom use than urban men and women. Several studies have found that education level is associated with higher levels of condom use within non-marital partnerships.
Barriers to Condom Use
The study found that condom use was infrequent and inconsistent, and the majority of women lacked the skills to negotiate condom use. Eritrean men reported the lowest levels of condom use (1 percent), and Cameroonian men reported the highest levels of condom use in conjugal partnerships (22 percent).
Summary
CONTEXT AND METHODOLOGY
- Introduction
- The Context: Mozambique
- Study Sites
- Methodology
- Process of Data Collection
- Focus Group Discussions
- Household Survey
- In-depth Interviews
- Ethical Considerations
- Data processing and analysis
- Limitations of the Study
- Summary
On the other hand, one of the most visible consequences of HIV/AIDS is the increase in the number of sick people. The primary purpose of the survey was to collect detailed information about the sexual behavior of men and women, including the number of sex partners, type of sex partners (such as regular, non-regular, commercial), frequency of specific behaviors (such as vaginal, oral and anal sex), as well as the conditions under which sexual activity takes place (such as intercourse under duress or due to economic need). During the survey, respondents in the household were informed about the purpose of the study and then asked if they were willing to participate in the study.
Some of the respondents were not comfortable signing the consent form, but they gave their verbal consent to participate in the study.
NOTIONS OF MASCULINITY IN THE ERA OF HIV/AIDS
Introduction
The notion of ‘Manhood’
This quote highlights the awareness of the respondent of the criteria needed to be perceived as a 'real' man. It expresses the idea that the man is seen as the most important member of the family. For most women, the man is the primary breadwinner and head of the family and these are the most important and defining characteristics of true masculinity.
It is notable that respondents viewed children's formal education as part of male responsibility.
Do men conform to Traditional notions of Masculinity?
It should be noted here that the notion of 'men in the past' is relative and must be understood in the context of the research. Male infidelity (or perceptions thereof) was considered the most important characteristic that distinguishes men today from men in the past. As described earlier, many men in the study sites complained of a lack of job opportunities.
Women are seen as more sexually relaxed and less committed to their relationships than in the past.
Harsh Living Conditions impacting notions of Masculinity
Some respondents see the harsh living conditions (including the high levels of unemployment and poverty) as increasing vulnerability to risky behaviour, including sexual risk-taking. Indeed, when the respondents say "poverty leads 'us' women to look for other ways to make a living such as sex", this suggests that women are forced into transactional sex in order to survive. Meanwhile, the prevailing socio-economic and living conditions in the study areas are considered to have a different impact on men and women.
The problem of unemployment and poverty in this area does not have the same burden for men and women.
Summary
While the current, harsh socio-economic context reflected in high levels of poverty, unemployment and lack of opportunities appears to have a direct impact on men's sense of masculinity, women have however observed significant changes in men's character itself. For example, the erosion of men's self-esteem due to socio-economic problems has been the object of extensive investigation in sub-Saharan Africa in recent years. With the majority of men reduced to 'figureheads' in households, men's authority was threatened and so was their identity and self-esteem (Silberschmidt.
They are aware that peer pressure and men's fear of being perceived by their peers as dominated by women are among the main factors for men's risky sexual behavior.
PERCEPTION OF RISK OF HIV INFECTION
Introduction
Awareness of HIV/AIDS
HIV/AIDS?”; "What can a person do to avoid HIV/AIDS?" The first question is to assess general awareness about HIV/AIDS infection. In fact, almost all respondents (99.5%) of both sexes reported that they had ever heard of HIV/AIDS. The respondents who reported that there were measures that could be taken to prevent contracting HIV/AIDS were then asked about specific measures to reduce the risk of HIV infection.
Similarly, women were less likely than men to agree that someone can become infected with HIV/AIDS through the use of sterilized needles, with about 15 percent of women agreeing.
Perceived Severity of HIV/AIDS in the Community
However, we young people, sometimes when we are having fun, we don't care about condoms, but people are aware of HIV/AIDS". In this regard, women were more likely than men to report knowing someone who was currently infected with HIV/AIDS. In my block there are six people infected with HIV/AIDS and only one seems to be receiving treatment.”
This quote can serve as a clear example of the impact of HIV/AIDS on families and communities.
Perceived Personal Risk of HIV Infection
But men were more likely than women to report themselves at high or moderate risk of HIV infection. The level of education has a strong effect on the perception of the risk of HIV infection among women. The other variables do not have a statistically significant unadjusted effect on the perception of the risk of HIV infection.
Women fear that they are at risk of HIV infection because of the sexual behavior of their partners.
Summary
The results of this study on perception of risk for HIV infection appear to be mixed and somewhat contradictory. For men, the demographic and socioeconomic characteristics had no relationship with perception of risk of HIV infection. First, a significant proportion of women did not consider the risk of HIV infection - an unexpected result.
These findings are consistent with what other studies have found regarding the perception of personal risk of HIV infection among women (Maharaj, 2004; Sheppard et al., 2001).
CONDOM KNOWLEDGE, ATTITUDE AND USE
Introduction
Awareness of Condoms
In this regard, the results in Table 6.1 indicate that the majority of respondents of both sexes reported that they knew a place where they could get a condom if they needed it. Nevertheless, men were more likely than women to report that they knew a place where they could get a condom if they needed one. In addition, 23 percent of men reported being somewhat unsure of how to use a condom correctly and effectively, compared to 14 percent of women.
Notably, a significant number of women, 35 percent, reported that they were unsure how to use a condom correctly and effectively.
Beliefs about Condoms Efficacy
However, men were more likely than women to report high levels of positive beliefs about the effectiveness of condoms. In an in-depth interview, a male respondent explained why it is so difficult to use condoms in relationships. In this quote, some of the dilemmas surrounding the use of condoms in relationships are evident.
But more importantly, precisely because of their poor sexual self-concept, such people are more likely to think that suggesting the use of condoms is immoral or offensive to their partners.
Attitudes towards Condoms
Women (48 percent) were more likely than men (39 percent) to agree that it is acceptable for a married woman to ask her husband to use a condom. Therefore, while almost 92 percent of men thought it was acceptable to use a condom at the start of a relationship, fewer women (83 percent) thought it was acceptable. They argued that only in relationships where there was a lack of trust was the use of condoms justifiable.
I think it's not acceptable for married people to use a condom if they don't trust each other.
Communication about Condoms
Studies have shown that lack of partner communication about condoms is a major barrier to use (Bauni and Jarabi, 2003; Muhwava, 2004; Chimbiri, 2007). Similarly, women living in urban areas were more likely than women in rural areas to report ever discussing condom use or not with their partners. In this regard, young men and women aged 20 to 29 were more likely than men and women in other age groups to report ever discussing with their partners whether or not to use a condom.
Both men and women with secondary or higher education report more often than respondents with less education that they have ever discussed condom use or not with their partners.
Condoms Use
- Ever Use
- Current Use
In this regard, urban men and women more often reported using a condom at their last intercourse compared to rural men and women. Both men and women of higher socioeconomic status were more likely than men and women of lower socioeconomic status to report having used a condom during their last intercourse. Men who perceived themselves to be at higher risk of HIV infection were less likely to report using a condom at their last intercourse.
Urban women were significantly more likely than rural women to report condom use at last sex.
Consistency of Condoms Use
Similarly, neither married nor cohabiting men were ten times more likely to report consistent condom use than men in married and cohabiting unions (odds ratio = 10.40). Conversely, men with a lower medium API were less likely than men with a low API to report consistent condom use (odds ratio = 0.71). Furthermore, women who were neither married nor cohabiting were almost five times more likely to report consistent condom use than women in married and cohabiting unions (odds ratio = 4.89).
Women who were not yet married or cohabiting reported consistent condom use almost four times more often than women in a marital or cohabiting relationship (odds ratios = 3.71).
Summary
Furthermore, the results of bivariate analysis also indicate that consistent condom use among men and women is very low. Men with higher levels of education are therefore ten times more likely to report consistent condom use than men with less education. Similarly, married or cohabiting women are more likely to report consistent condom use than men in married and cohabiting unions.
However, women with a higher level of education reported consistent condom use five times more often than women with lower education.
SEXUAL BEHAVIOUR
- Introduction
- Sexual Behaviour
- Concurrent and Serial Multiple Partnerships
- Number of Sexual Partners in the last 12 months
- Partner Type and Characteristics
- Relationships Duration and Change
- Summary
Almost two-thirds of men (66 percent), compared to 11 percent of women, reported having five or more lifetime sex partners. Finally, the marital status of men (as well as education) appears to play a marginal role in determining lifetime number of sex partners. Lifetime number of sexual partners is not significantly associated with the socio-economic household status of men.
In contrast, marital status appears to play a significant role in women's lifespan for the number of sexual partners.
STRATEGIES OF BEHAVIOURAL CHANGE
Introduction
Awareness of the Risk of HIV/AIDS
Obstacles to Behaviour Change
- Personal and Interpersonal Obstacles for Behaviour Change
- Context-dependent and Structural Obstacles
SEXUAL DECISION-MAKING AND NEGOTIATION OF SEX
Introduction
Communication about Sex
Sexual norms and Beliefs
Negotiation of Sex
Negotiating Sex: Level of Agreement and Disagreement between Partners
Summary
DISCUSSION AND CONCLUSIONS
Introduction
Discussion
Conclusion
