AIDS: MEN MAKE A DIFFERENCE
New Delhi, 6 March 2000
Men Can Change Course of AIDS Epidemic,
New UNAIDS Campaign Report Says
Men can change the course of the AIDS epidemic, according to a report released here today by the Joint United Nations Programme on HIV/AIDS (UNAIDS) for the launch of the year 2000 World AIDS Campaign. The new Campaign aims to involve men more fully in the effort against AIDS and to bring about a new, 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.
"The time is ripe to start seeing men not as some kind of problem, but as part of the solution", said Peter Piot, Executive Director of UNAIDS. "Working with men to change some of their attitudes and behaviours has enormous potential to slow down the epidemic and to improve the lives of men themselves, their families and their partners."
The UNAIDS report challenges harmful concepts of masculinity and contends that changing many commonly-held attitudes and behaviours, including the way adult men look on risk and sexuality and how boys are socialized to become men, must be part of the effort to curb the AIDS epidemic.
Broadly speaking, men are expected to be physically strong, emotionally robust, daring and virile, the report says. Some of these expectations translate into attitudes and behaviours that endanger the health and well-being of men and their sexual partners with the advent of AIDS. Other behaviours and attitudes, on the contrary, represent valuable potential that can be tapped by AIDS programmes.
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, there by increasing their own and their primary partners' risk of contracting HIV, a risk compounded by the secrecy, stigma and shame surrounding HIV. This stigma may keep men and women from acknowledging that they have become infected. Focusing the campaign on men also acknowledges the fact that men are often less likely to seek health care than women.
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; in some institutions such as prisons, men who normally prefer women as sex partners may have 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 and girls, sometimes in their own family or household. Worldwide, a recent report says that at least one woman in three has been beaten, coerced into sex or otherwise abused in her lifetime.
At the same time, a careful balance needs to be struck between recognizing how men's behaviour contributes to the epidemic and 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, for example to play a much greater part in caring for their partners and families. Numerous studies worldwide show that men generally participate less than women in caring for their children. This has a direct bearing on the AIDS epidemic, which has now left over 11 million children orphaned and in need of adult help to grow up clothed, housed and educated.
The report also notes that greater attention must be given to the needs of millions of men, in particular those living with HIV/AIDS. 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.
"Too often, it is seen as 'unmanly' to worry about avoiding drug-related risks, or to bother with condoms", said Dr Piot. "These attitudes seriously undermine AIDS prevention efforts." It has already been demonstrated that men's behaviour can change, and that such change in turn alters the epidemic. For example, in parts of Africa, Central America and Asia, long distance truck drivers have been encouraged to reduce their number of sexual partners and more consistently practise safe sex. In Thailand, there have been successful programmes for prevention among army recruits. In many countries, including the United States, college students are beginning to delay the onset of sex and are using condoms more consistently.
All this does not mean an end to prevention programmes for women and girls. Rather, the Campaign aims to complement such programmes. Work which enhances gender awareness and sensitivity should focus on the needs of both women and men. At end 1999, 33.6 million men, women and children were living with HIV or AIDS, and 16.3 million had already died from the disease. In 1999, there were 5.6 million new infections worldwide, of which 3.8 million were in sub-Saharan Africa, and 1.3 million in South and Southeast Asia.
Source: Joint United Nations Programme on HIV/AIDS (UNAIDS) Year 2000 World AIDS CampaignDate published: 12/1/00
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