School Health Education to Prevent AIDS and STD A Resource Package for Curriculum Planners
AIDS MEN MAKE A DIFFERENCE
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.
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
To encourage men to take care of themselves, their partners and families
- encourage men to take care of themselves
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
All this does not mean an end to prevention programmes for women and girls. Rather, the Campaign aims to complement such programmes. Work that enhances gender awareness and sensitivity should focus on the needs of both sexes. The Campaign is designed to provide material for national and local organizations to create their own campaign based on Men Make a Difference but responding to local priorities.
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