Africa's men meet challenge of fighting HIV/AIDS
By Mercedes Sayages
13 Jun 2003

Two of the participants in the RAISA/VSO conference in February enjoy
a moment of relaxation.
Photo by MERCEDES SAYAGES
PRETORIA (AlertNet) - "Iraq does not harbour weapons of mass
destruction. Africa does, and it is called HIV," says popular South
African comedian Pieter-Dirk Uys. "What's killing us is the secret,
not talking about AIDS. Silence kills."

Nodding vigorously among the audience is Believe Dhliwayo, a
Zimbabwean in his early thirties. "I'm HIV positive because my
parents never talked to me about sex," he said. "It's high time we
change the aspects of our culture that spread the disease."

Uys performs his hilarious AIDS awareness skits free of charge at
schools throughout South Africa. Dhliwayo works at The Centre, a
group that provides counselling and support for people with AIDS and
their families in Zimbabwe's capital Harare.

Noticing that men die earlier than women after diagnosis, The Centre
concluded that men succumbed to opportunistic infections as a result
of low self-esteem. "Our male identity says we can deal with all
problems but we can't deal with HIV infection," Dhliwayo said.

Both Dhliwayo and Uys are part of a wave of fresh thinking about men
and AIDS in southern Africa. It moves beyond "men drive the pandemic"
to "how can men be more engaged in containing AIDS than in spreading
it?"

According to the U.N.'s joint programme on HIV/AIDS (UNAIDS),
national adult HIV prevalence has risen "higher than thought
possible" in the region: Botswana 38.8 percent, Lesotho 31 percent,
and Zimbabwe 33.7 percent. Namibia follows with 22.5 percent, Zambia
21.5 percent, Malawi 15 percent and South Africa 13 percent.

A variety of male-driven efforts were showcased at a conference on
men and AIDS organised in Pretoria, South Africa, in February by the
Regional AIDS Initiative of Southern Africa of Voluntary Services
Overseas (RAISA/VSO).

A common thread was the pervasive silence surrounding male sexuality.
Parents do not talk about sex with their children. Husbands do not
talk with their wives. Men generally feel uncomfortable discussing
intimate matters.

At the National Association for People Living with HIV/AIDS in Malawi
(NAPHAM), nine out of 10 male members felt unable to disclose their
HIV status to their wives.

Keeping it secret brought stress, risk of infection through
unprotected sex and inability to change lifestyle. However, when
NAPHAM started support groups for couples, 65 pecent of men brought
their wives. Male membership increased. "The groups enabled men to
talk," said Napham's Mark Kumbukani Black.

NON-THREATENING ENVIRONMENTS

A regional survey by Southern Africa AIDS Information and
Dissemination Service (SAFAIDS) concluded: "Men need opportunities to
explore and talk about their sexuality in non-threatening
environments."

On a balmy summer evening, Regis Mtutu can be found at a beer hall in
Bulawayo, Zimbabwe's second largest city, telling a bunch of young
men that masturbation is harmless and manly.

Mtutu is an activist with the Men's Forum Padare/Enkudleni. The forum
seeks to change stereotypes about manhood. Padare members go where
men hang out, at bars and sports clubs, and to schools and
churches. "We talk, talk and talk until we feel comfortable," says
Mtutu.

In rural settings, they discuss inheritance and traditional beliefs.
In towns, sugar daddies and domestic violence. Everywhere, they show
there are alternatives to the dominant macho identity.

Research throughout the region shows that men are socialised into a
notion of masculinity as sexual prowess, risk-taking behaviour and
male dominance and superiority over women.

At the same time, men perceive their privileged space in society is
under threat from a variety of factors, ranging from rural migration,
Western culture seeping through mass media and growing recognition of
women's rights.

"Many men are feeling a bit hopeless, like there's no place for them
in the world," says Professor Graham Lindegge, of the School of
Psychology at South Africa's Natal University.

In a study of how masculinity is constructed in schools in KwaZulu
Natal, Lindegger found that the conflict between traditional and
contemporary gender roles generates a sense of displacement and
futility among boys and men.

The sense of loss undermines men's motivation for safe sex. "What
point would there be in preserving oneself and others for a society
in which one has no place in the future?" Lindegger asked.

Similar findings occurred in a survey of risk-taking behaviour among
youths in Soweto, South Africa's largest township, where nearly half
of young men are unemployed.

"If you have no job and no future, life becomes cheap, and sex a
dangerous entertainment fuelled by boredom, alcohol and poverty,"
said Barbara Fisher, an academic with the University of
Witwatersrand.

HEALERS, CHIEFS AND PRIESTS

From the other end of the social spectrum, a survey among traditional
healers, chiefs and Zionist priests in nine provinces by the
Promotion of Traditional Medicine Association of South Africa
(PROMETRA) found that men felt socially disoriented through loss of
leadership position in the family and community.

"Men have become spectators, irresponsible and indifferent,"
according to social scientist Douglas Kabanda, who led the research.

To change this, PROMETRA taps into the traditional notion of men
being responsible for their families.

Cultural and traditional customs are maintained albeit in "safe and
best practice." Male circumcision, wife inheritance, scarification
(decorative scarring) and polygamy can be managed responsibly if
people know about HIV infection risks.

"Traditional practices make up male identity; to attack them is self-
defeating. We need to find viable ways of keeping tradition while
getting men involved against AIDS," Kabanda said.

Dry sex, where women put herbs and potions in the vagina to make it
hot, tight and dry, provokes lesions that make HIV infection easier.

Dry sex is prized by men. A wet vagina is not. The reason, according
to Kabanda, is ignorance about the female body. "When we explain what
causes wetness, their eyes open. We discourage dry sex," he said.

The wall of silence around Africa's ultimate taboo topics -- male
rape and male-to-male sex -- is crumbling.

Ivan Louw, a 26-year-old businessman, was hijacked, raped and
tortured by three men near Pretoria in 2001. At the hospital
emergency ward, he couldn't tell the nurses he had been raped.

"Rape doesn't happen to a white, Christian, married, rugby-playing
Afrikaaner man, right?" he said.

He refused to accept the stigma, went public with his story and
founded Men United, a support group for male rape survivors and their
families.

THREAT OF IMPRISONMENT

Namibia's President Sam Nujoma has denounced gay men and women as un-
African and threatened them with imprisonment and deportation.

However, ethnographic research in the 19th century documents sex
between men among the Himba, Herero and Ovambo peoples.

"Politically constructed homophobia has a negative impact on public
health because it excludes homosexuals from prevention and awareness
campaigns, making them vulnerable to HIV infection," said
anthropologist Robert Lorway.

In field research among black gay and bisexual men in Katutura
township, Lorway found they experienced regular verbal, physical and
sexual forms of assault and discrimination from hospital staff,
police, and army and church officials. Finding barriers in
employment, they turn to commercial sex work.

Because sodomy is a criminal offence in Namibia, condoms cannot be
distributed to prisoners, in spite of HIV prevalence of 27-30 percent
in the country's 13 crowded prisons. "It could be seen as encouraging
criminal behaviour," explained Pride Simana, an AIDS counsellor with
the Prisons and Correctional Services.

New is men's involvement in home-based care, although nursing the
sick has traditionally been a female preserve.

"If I fall sick, I can only think of women who would help me, no
men," says Believe Dhliwayo. "We need men's support groups."

Out of 520 volunteers with Tovwirane AIDS organisation in 52 villages
in northern Malawi, 40 percent are men. Kara Counselling in southern
Zambia also has growing numbers of male caregivers.

Chiefs and church leaders help identify possible volunteers who are
provided with training, bicycles and team support.

After 20 years of rampant spread, AIDS is forcing changes in male
behaviour in southern Africa.

"Organisations are taking the bull by the horns and engaging men with
some success," says RAISA/VSO coordinator Terina Stibbard.