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Africa and HIV/Aids: men at work

Patricia Daniel
9 April 2007

After my openDemocracy article "Is another world possible without the women's perspective?" was published (18 January 2007), Gray posted a comment which included these words: "in discussing changes in women's roles and expectations, we are also talking about changes in men's roles and expectations, and there needs to be specific consideration of what this means."

Nowhere could this observation be more relevant than in strategies to address HIV/Aids, which is one of the priorities in development assistance to Africa. It is also an issue that is high on Germany's official G8 agenda leading up to the summit in Heiligendamm on 6-8 June 2007, and a key concern for Germany's non-governmental sector in collaboration with African NGOs.

The focus of current plans is achieving universal access to appropriate health services - not just for treatment but also for prevention, care and support - to reverse the spread of HIV by 2010. But, as a publication from the World AIDS Campaign in December 2006 points out, the pervasive stigma faced by people living with HIV is a barrier to them accessing services even when these are available.

The degree and impact of stigma is even more acute for women and girls, because HIV is linked to sexual activity. This means an infected woman is considered promiscuous, which of course is not socially acceptable. Promiscuity is reserved for men!

In fact, traditional concepts of masculinity and "normal" (accepted and expected) male sexual behaviour are a key factor in Africa's HIV epidemic. The "custom" of having several concurrent sex partners - wives, girlfriends, prostitutes; the hospitable practice of "wife-sharing" with visitors; men taking on their brother's widow as well as his property when he dies - all contribute to the spread of the disease. Men simply put it about. So continues the "feminisation" of HIV (more women than men are now infected).

Also in openDemocracy's "HIV/Aids: what policy for life?" debate:

Donna M Hughes, "The 'ABC approach' to global HIV/Aids: good for women and girls"
(12 August 2004)

Tim France, "The United Nations and Aids: learning from failure" (30 May 2006)

Roger Tatoud, "Gendering the fight against Aids"
(21 August 2006)

Alex de Waal, "The global Aids campaign: a generation's struggle" (22 August 2006)

Alex de Waal, "HIV/Aids: the next twenty-five years"
(1 December 2006)

Beyond conformity

Women's lack of (economic) empowerment makes it more difficult to refuse sex or insist on the use of a condom - and violent sex increases the risk of infection. So the promotion of gender equality was one of the solutions proposed at the most recent international Aids conference in Toronto, in August 2006. Yet as soon as this concept is raised, commentators suggest it is unworkable because women's empowerment necessarily implies "male disempowerment".

Men with HIV in Africa often suffer alone - because that's more manly. The big problem is that everybody is afraid to talk, about HIV specifically or gender relations in general. Breaking the silence is the first step in the long road to self-awareness and social change. This means men and women, young and old, communities and public-health workers, village chiefs, religious leaders, market traders, long-distance truckers, sex workers, sitting down together to exchange views and experiences, then identify for themselves what needs to be done. This approach is increasingly being used by local groups and development agencies including German technical cooperation (GTZ).

When people begin to make explicit the link between their own behaviour and the HIV epidemic, a revelation can occur, as reported by the United Nations Development Programme (UNDP) in Ethiopia: "In the night, Ana Dentamo wakes up in excitement, he's had a sudden insight: 'I am the medicine', he keeps repeating to himself. 'The disease does not jump up and attack me unless I myself give way for it to attack.' From now on he knows how he can protect himself and his family from infection" (from "Transforming the response to HIV/Aids", UNDP Ethiopia 2002 - not online).

Once men start talking, they find it difficult to stop. Thus I've learned it's a mistake to assume that African men are automatically any happier than women with the current state of gender relations. Workshop discussions provide the first opportunity to break the taboo and put into words some of their concerns. "I wish my wife had never been circumcised, she can't enjoy sex." "I'd like my wife to initiate lovemaking from time to time." "My family is trying to arrange a second (polygamous) marriage for me, but I love my wife and don't want to hurt her."

Both women and men in Africa are subject to intense social pressure to conform. Yet what's real masculinity? Is it behaving like the other guys or doing what you think is right? After all, what kind of a man is he whose sense of identity depends on holding on to power over women - especially when he has the power to stop the spread of HIV/AIDS?

Patricia Daniel is a senior lecturer in social development at the University of Wolverhampton, England. She is involved in a collaborative study on gender, peace and stability in Mali. Her website is here.

Patricia Daniel blogged the World Social Forum in Nairobi for openDemocracy – see "Women at the World Social Forum".

Also by Patricia Daniel in openDemocracy:

" Mali: everyone’s favourite destination" (11 May 2006)

" Africa: ask the women" (3 August 2006)

“Women, violence and empowerment: the world we live in”
(23 February 2007)

"Justice, not globalisation: Lebohang Pheko's voice"
(13 March 2007)

New role models

In Mali I've worked with two trained technicians involved in development projects with the pastoralist Fulbe community.

While his wife is busy at home with their new baby, Baba Maiga goes to market and brings home the groceries, in broad daylight, in a basket on his moped. This is extremely unconventional behaviour, as noted with amusement by his colleagues. Normal practice would be for Aminata to go on foot, carrying the baby and the basket with her.

Amadou Diakité, Baba Maiga's boss, not only refused to let his three daughters go through circumcision (a practice which, among other health problems, brings increased risk of HIV infection) but also withstood family pressure to "try for a son" - saying that three children, girls or boys, was enough. Unheard of.

Such men can help to promote gender equality in the workplace. Another example is Eugène who told me: "I was the one member of the recruitment committee who argued for appointing a woman to the new education post in a case where we had a male and female candidate with similar profiles."

Strong female role models - from policy level down to the grassroots - are essential in the process of changing attitudes and behaviour but the part played by male advocates is also invaluable.

Working with a national NGO in Nigeria - a country with the largest and most conservative Anglican church in Africa - I've seen male trainers raise gender issues at civil-society workshops and church meetings. In his presentation, Dan links equal opportunities for women at work to how he would like his own wife and daughter to be treated: "I'm proud of their achievements and I'm angry when they experience discrimination."

By speaking of his own feelings, Dan gives other men the courage to voice their opinions even in the face of more reactionary views. The capacity of men to deliberately confront convention while retaining their dignity provides a new role model. And in publicly demonstrating genuine respect and affection for the women in their lives, these men also reveal real self-respect.

In the words of Michael Onyango, founder of the movement of men against Aids in Kenya (MMAAK):

"This is what we call positive masculinity. It is the belief that all men can show, express and utilise their masculinity to support positive change both within and without themselves. It is about men reaching out for help however strong and courageous they may be. It is also about men not being threatened by the empowerment of women but taking a lead in supporting their role in development."

So, one answer to reducing HIV and increasing gender equality is a different kind of male empowerment. As Ana Dentamo intuited, you can be part of the disease or part of the cure. To men who take the second choice: the respect is mutual.

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