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[Washington, D.C., PSI], Transform PHARE, 2018 Jan. 102 p.This research was undetaken in order Identify male segments in Niger that were most likely to change their attitudes and behaviors towards FP, and provide high-level principles for the design and implementation of interventions targeting these segments. The objectives of the research were: 1) Identify and capture the factors that influence male decision-making with regards to family planning and 2) Identify segments of men in the three target regions of Maradi, Zinder, and Tillabéri that are more or less likely to change their attitudes and behaviors towards FP.
Multilevel Influences on Men's Partner Violence Justification, Control Over Family Decisions, and Partner Violence Perpetration in Bangladesh.
Psychology of Violence. 2018;Objective: Men's justification of intimate partner violence (IPV), control, and IPV perpetration persist globally. We tested feminist theories of dominant masculinity norms and gendered social learning in childhood to explain young married men's violent attitudes and behaviors. Method: The sample was ever-married-junior men (18-29 years, n = 774), senior men (30-54 years, n = 2,398), and women (15-49 years, n = 3,841)-in 307 communities from the 2007 Bangladesh Demographic and Health Survey. Two-level logistic regression models tested whether community norms of masculine dominance and childhood exposure to father-on-mother IPV were associated with higher odds of justifying IPV, controlling family decisions, and perpetrating physical IPV. Results: Compared with senior men, junior men more often justified IPV, controlled family decisions, and perpetrated physical IPV in the prior year; junior men also more often were exposed as children to father-on-mother IPV. In multilevel models, witnessing father-on-mother IPV in childhood and living amid stronger norms of masculine dominance were associated, respectively, with higher adjusted odds of justifying IPV (adjusted odds ratios [aORs] = 1.86 and 33.45), controlling family decisions (aORs = 2.03 and 25.03), and perpetrating physical IPV (aORs = 3.19 and 3.39). Conclusion: Findings support a situational, feminist social ecological model of the influences of community norms of masculine dominance and of gendered social learning on young men's violent attitudes and behavior in marriage. Promoting positive masculinities and reducing men's exposure to violence in childhood may be needed to curtail violence against women in Bangladesh and similar settings. © 2018 American Psychological Association.
Atlanta, Georgia, CARE, 2017 Sep. 16 p. (Tipping Point Social Norms Innovations Series Brief 4)This brief documents CARE’s Tipping Point project and how using tea stalls can help change social norms. It offers tips on how to replicate this approach in your own work. Personal relationships often reinforce or challenge power imbalances between men and women. Fathers and brothers hold a great deal of power in the lives of adolescent girls in Bangladesh’s Sunamganj district. For men and older boys, the tea stall is a common spot to socialise with peers. Tea stalls are a productive space to start discussions with men on gender and equity in a familiar setting.
Atlanta, Georgia, CARE, 2017 Oct. 16 p. (Tipping Point Social Norms Innovations Series Brief 3)This brief documents CARE’s Tipping Point project and how it encouraged men and boys to take up tasks that are not typical for their gender. It offers tips on how to replicate this approach in your own work. In rural communities in Bangladesh’s Sunamgank district, household chores take up much of women and girls’ days. This limits their time for themselves, their friends and community engagement. The campaign, called Amra-o-Korchi (“We are also doing” in Bangla) supported men and boys to take up tasks that are not typical for their gender. Men and boys took part in public competitions around cooking, stitching and laundry. These small competitions culminated in a large public event –which saw men and boys go head to head to test their cooking skills.
Community vulnerability and stratified risk: hegemonic masculinity, socioeconomic status, and HIV/AIDS in a sex work community in Kampala, Uganda.
Global Public Health. 2018 Jan 29; 1-12.This article examines the social patterning of health, economic uncertainty, hegemonic masculinity, and vulnerability among men who live and work in a low-income sex work community in Kampala, Uganda. This problematizes the notion that vulnerable communities are homogenous, in demographics, economic status, and risk. This article draws on ethnographic data collected in 2016, including semi-structured interviews and participant observation. This article uses a stratified risk framework to describe the central finding of this study, which is that men’s experience in Kataba is characterized by a struggle to fulfil the provider role that constitutes a core aspect of their socially ascribed gender role. In a context of economic scarcity, men’s lives are fraught with strain and this intersects with other forms of risk. Finally, by focusing on community vulnerability rather than individual risk, this work contributes to theories of gender and sex work, and informs HIV/AIDS praxis.
Understanding masculinities, results from the International Men and Gender Equality Study in the Middle East and North Africa.
Cairo, Egypt, UN Women, 2017. 292 p.StudyThe International Men and Gender Equality Survey – Middle East and North Africa (IMAGES MENA) study includes quantitative and qualitative research with men and women aged 18 to 59 in Egypt, Lebanon, Morocco, and Palestine. Local research partners are: (1) Egypt: El-Zanaty and Associates; Social Research Center, American University in Cairo (AUC); (2) Lebanon: Connecting Research to Development (CRD); ABAAD; (3) Morocco: Association Migration Internationale (AMI); Rajaa Nadifi (independent researcher); Gaëlle Gillot (independent researcher); (4) Palestine: Institute of Women’s Studies at Birzeit University.The multi-country study and its dissemination were coordinated by Promundo and UN Women, under the UN Women Regional Programme Men and Women for Gender Equality funded by the Swedish International Development Cooperation Agency (Sida), with additional support from the Arcus Foundation, the Ministry of Foreign Affairs of the Netherlands (via Prevention+), the U.S. Institute of Peace, the U.S. Department of State in partnership with Vital Voices, and the Oak Foundation.This report presents the first round of IMAGES data collection in the MENA region that was carried out from April 2016 to March 2017. Other studies in the region are currently being planned. National reports are being produced in the four countries, further elaborating on the research findings and providing country-specific recommendations.
Adolescent boys and young men: engaging them as supporters of gender equality and health and understanding their vulnerabilities.
Washington, D.C., Promundo-US, 2016 Mar. 88 p.Achieving gender equality must, and has, involved efforts to understand the vulnerabilities and risks that adolescent girls and young women face every day – but how much do we know about the realities of adolescent boys and young men? This report takes a deeper look at the daily lives of adolescent boys and young men around the world and at how they can join the movement towards improved health and gender equality. Exploring global research, the report reveals boys’ and young men’s specific risks and realities in relation to health in general, sexual and reproductive health in particular, sexuality, media violence, sexual exploitation and other vulnerabilities. It analyzes the implications of these risks and realities not only for boys, but also on the lives of women and girls. Adolescence is a key period where individuals of all gender identities form attitudes, opinions and beliefs – about themselves, about their sexuality and about their place in the world. It is a period when ideas about equality can become ingrained. The study emphasizes that a holistic approach to advancing gender equality and sexual and reproductive health must include both adolescent girls and boys. It highlights the need to engage adolescent boys and young men as allies to achieve gender equality and as supporters of women’s empowerment, as well as the importance of addressing the specific health and social development needs of boys themselves.
[Washington, D.C.], Georgetown University, Institute for Reproductive Health, . 2 p.Transforming Masculinities is an evidence-based approach to promote gender equality and positive masculinities within faith communities. It is based upon the understanding that spiritual beliefs and faith leaders are part of the structure that shapes social and gender norms, and focuses on prevention and response to sexual and gender-based violence. Known locally as Masculinité, Famille, et Foi, the intervention adapts the Transforming Masculinities approach to include reflection on normative environments and the acceptability of family planning.
Sociocultural Influences on the Transmission of HIV From Husbands to Wives in Cambodia: The Male Point of View.
American Journal of Men's Health. 2017; 11(4):845-854.The purpose of the study was to explore, within cultural and societal contexts, the factors of spousal HIV transmission as described by the experiences of HIV-positive Cambodian men. Using qualitative research methods, the researchers collected data from in-depth interviews with 15 HIV-positive Cambodian men of seroconcordant couples recruited from an HIV/AIDS clinic in Phnom Penh. Using a model of HIV transmission from husbands to wives, the questions were designed to elicit the men’s perspectives on the topics of promiscuity, masculinity, condom use in marriage, the image of the ideal Cambodian woman, and attitudes toward sex and marriage. Directed content analysis was used to analyze the interview data. The main results were as follows: (a) men involved with sex workers perceived this as a natural behavior and a necessary part of being an approved member in a male peer group, (b) married men never used condoms during sex with their wives prior to their HIV diagnosis, (c) men perceived a good wife as one who is diligent and loyal to her husband, and (4) men’s attitudes toward sex and marriage (e.g., sex perceived as a part of life pleasure) differed from those of their wives. Promoting honest spousal communication about sexuality, maintaining men’s marital fidelity, and increasing women’s comfort in the use of sexual techniques are suggested as strategies for reducing HIV transmission within marriage in Cambodia. Future interventions should focus on reshaping men’s behaviors and changing cultural norms to protect them and their spouses from HIV infection. © 2017, © The Author(s) 2017.
Community mentors as coaches: transforming gender norms through cricket among adolescent males in urban India
Gender and Development. 2015 Mar 19; 23(1):61-75.Addressing violence against women and girls (VAWG) through the medium of male team sport may be a promising strategy for addressing interpersonal violence and gender norms transformation in urban communities. Parivartan is a violence prevention programme in a large slum community in Mumbai, India, which works with men and boys to reduce violence and promote gender-equitable attitudes and beliefs via membership of a cricket team and mentoring from coaches. This article discusses findings from a recent evaluation of the programme.
Transformation by 2030: how ending gender-based violence and engaging men and boys will contribute to the world’s next development framework.
Washington, D.C., International Center for Research on Women [ICRW], 2015. 4 p.This policy brief presents findings from an expert consultation among Indian government and civil society representatives on gender equality, with a special focus on men, masculinities, and the critical role that men have to play toward the success of the post-2015 development agenda. The brief puts forward recommendations on how men and boys can help end gender-based violence and achieve gender equality in India, including working to shift gender norms at an early age, identifying male advocates of gender equality, preparing adolescent boys to tackle peer pressure, and more.
Performance, power and condom use: reconceptualised masculinities amongst Western male sex tourists to Thailand.
Culture, Health and Sexuality. 2018 Mar; 20(3):276-288.Each year large numbers of Western men travel to Thailand for sex tourism. Although many will use condoms during their sexual encounters, others will not, potentially exposing themselves to the risk of acquiring sexually transmitted infections, including HIV. Although sex tourism in Thailand has been well documented, the social drivers underpinning voluntary sexual risk-taking through the avoidance of condoms remain poorly understood. Engaging with R.W. Connell's concept of hegemonic masculinity and drawing on data collected from 1237 online discussion board posts and 14 face-to-face interviews, this study considers the ways in which understandings and performances of masculinities may inform the sexual risk-taking behaviours of Western male sex tourists. It argues that for some of these men, unprotected sex is viewed not as a reckless behaviour but, instead, as a safe and appropriate masculine practice, supported by relationships that are often framed as romantic and within a setting where HIV is still largely considered a homosexual disease. With sex workers often disempowered to request safer sexual practices, and some men's attitudes towards unprotected sex resistant to external health promotion advice, the paper concludes by considering what this might mean for policy and practice.
Male partners' views of involvement in maternal healthcare services at Makhado Municipality clinics, Limpopo Province, South Africa.
African Journal of Primary Health Care and Family Medicine. 2016 May 06; 8(2):e1-5.BACKGROUND: Male partners have a strong influence on pregnant partners' health and their access to care. Their involvement is critical in the delivery and uptake of maternal healthcare services and improving maternal and child health outcomes. AIM: The study sought to determine male partners' views on their involvement in maternal healthcare services. SETTING: The Makhado Municipality's Kutama, Madombidzha and Vleifontein clinics. METHODS: A qualitative study design, which is exploratory, descriptive and contextual in nature, was used. The population comprised 15 men whose partners had been pregnant within the last 2 years. A non-probability, purposive sampling procedure was used. Data were collected via in-depth individual interviews using a voice recorder and an interview schedule guide. Tesch's open coding method was used to analyse data. RESULTS: The findings revealed one major theme, namely that maternal health issues are viewed as a woman'sdomain; and three sub-themes: culture and participation in childbirth, male partners' employment status, and male partners' unwillingness to participate in maternal health issues. CONCLUSIONS: The involvement of male partners in maternal healthcare services, and further research in promoting this activity, should be proposed to policymakers.
Gender Norms, Gender Role Conflict/Stress and HIV Risk Behaviors Among Men in Mpumalanga, South Africa.
AIDS and Behavior. 2018 Jun; 22(6):1858-1869.Men's gender role conflict and stress (GRC/S), the psychological strain they experience around fulfilling expectations of themselves as men, has been largely unexplored in HIV prevention research. We examined associations between both men's gender norms and GRC/S and three HIV risk behaviors using data from a population-based survey of 579 18-35 year-old men in rural northeast South Africa. Prevalence of sexual partner concurrency and intimate partner violence (IPV) perpetration in the last 12 months were 38.0 and 13.4%, respectively; 19.9% abused alcohol. More inequitable gender norms and higher GRC/S were each significantly associated with an increased odds of concurrency (p = 0.01; p < 0.01, respectively), IPV perpetration (p = 0.03; p < 0.01), and alcohol abuse (p = 0.02; p < 0.001), controlling for demographic characteristics. Ancillary analyses demonstrated significant positive associations between: concurrency and the GRC/S sub-dimension subordination to women; IPV perpetration and restrictive emotionality; and alcohol abuse and success, power, competition. Programs to transform gender norms should be coupled with effective strategies to prevent and reduce men's GRC/S.
'If I go with him, I can't talk with other women': Understanding women's resistance to, and acceptance of, men's involvement in maternal and child healthcare in northern Ghana.
Social Science and Medicine. 2016 Oct; 166:195-204.Men's involvement in maternal and child healthcare especially in patriarchal societies such as Ghana is increasingly being advocated. While a number of studies have been conducted to explore men's views on their involvement, few studies have examined the perspectives of childbearing women. Based on qualitative focus group discussions that were conducted between January and August 2014 with a total of 125 adult women in seven communities in the Upper West Region of Ghana, this paper examines women's perspectives on men's involvement in maternal and child healthcare. Findings suggest that although many women recognised the benefits of men's involvement, few actually supported greater male involvement. The majority of women expressed negative attitudes and opinions on the involvement of men. These negative attitudes and opinions were framed by three broad factors: perceptions that pregnancy and child care should be a female role while men should be bread winners; women's desire to avoid negative stereotyping; and fears that men's involvement may turn hitherto secure social spaces for women into insecure ones. These narrative accounts largely challenge current programmatic efforts that seek to promote men's involvement in maternal and child healthcare, and suggest that such male involvement programmes are less likely to succeed if the views and concerns of childbearing women are not taken into account.
AIDS Care. 2016; 28 Suppl 3:74-82.Men’s poorer engagement with healthcare generally and HIV care specifically, compared to women, is well-described. Within the HIV public health domain, interest is growing in universal test and treat (UTT) strategies. UTT strategies refer to the expansion of antiretroviral therapy (ART) in order to reduce onward transmission and incidence of HIV in a population, through a “treatment as prevention” (TasP). This paper focuses on how masculinity influences engagement with HIV care in the context of an on-going TasP trial. Data were collected in January-November 2013 using 20 in-depth interviews, 10 of them repeated thrice, and 4 focus group discussions, each repeated four times. Analysis combined inductive and deductive approaches for coding and the review and consolidation of emerging themes. The accounts detailed men’s unwillingness to engage with HIV testing and care, seemingly tied to their pursuit of valued masculinity constructs such as having strength and control, being sexually competent, and earning income. Articulated through fears regarding getting an HIV-positive diagnosis, observations that men preferred traditional medicine and that primary health centres were not welcoming to men, descriptions that men used lay measures to ascertain HIV status, and insinuations by men that they were removed from HIV risk, the indisposition to HIV care contrasted markedly with an apparent readiness to test among women. Gendered tensions thus emerged which were amplified in the context where valued masculinity representations were constantly threatened. Amid the tensions, men struggled with disclosing their HIV status, and used various strategies to avoid or postpone disclosing, or disclose indirectly, while women’s ability to access care readily, use condoms, or communicate about HIV appeared similarly curtailed. UTT and TasP promotion should heed and incorporate into policy and health service delivery models the intrapersonal tensions, and the conflict, and poor and indirect communication at the micro-relational levels of couples and families. © 2016 The Author(s). Open Access.
Inequality and Changing Masculinities Among the Gende in Papua New Guinea: The ‘Good’, the ‘Bad’ and the ‘Very Bad’.
Asia Pacific Journal of Anthropology. 2016 Aug 7; 17(3-4):250-267.This article examines Gende socio-economic history from before 1932 to the present, a history marked by extreme inequality and challenges to traditional concepts of masculinity. Centuries ago, the Gende lived in New Guinea’s interior. Forced from their lands by tribal warfare, they escaped to the less populated northern Bismarck mountains (in what is now Madang Province) and re-established themselves, marrying Chimbu and Ramu neighbours and favourably positioning themselves in a north-south trade route. First encounters with Westerners (1932) and capitalist enterprises set off waves of migration to towns and plantations with recent mining developments generating return mobilities as migrants hope to cash in on jobs and royalties. ‘Big men’ who strove to hold society together by using development and other means to even out rural and urban inequalities that threatened Gende society represent Marshall Sahlins’s ‘developman’. Today, such men are contested by others more interested in personal aggrandisement than social cohesion. Women’s continuing role in shaping masculinities and society is highlighted throughout, demonstrating the limits of R.W. Connell’s ‘hegemonic masculinities’ (and similar concepts based on male dominance) in understanding intergenerational conflicts and violence against women. While the seeds of global hegemonic masculinities have been planted, the Gende case is one of active local resistance.
Women's Studies International Forum. 2016 Jul 1; 57:1-10.This study traces the relation between male violence and masculinist norms that attribute political agency exclusively to men. Through critical analysis of a recent campaign initiated as an effort to fight violence against women in Turkey by addressing men as the only agents endowed with agency to solve the problem, we explore the ways in which this discourse risks marginalizing women who seek empowerment through women's solidarity. We uncover three patterns: (1) the assumption of a "cultural particularity" in Turkey nested in the traditional family structure which should allegedly be left unquestioned; (2) glorification of values attributed to the masculine; (3) taking violence as an individual problem of "anger management." We argue that this campaign is inimical to the aim it declares because by marginalizing feminist efforts to question the social and structural patterns of male violence, it deprives women of political agency essential in the struggle against this problem.
Current Sociology. 2016 Jul 1; 64(4):535-550.With rates of rape in South Africa among the highest in the world, the significance of context has surfaced repeatedly in South African scholarship on rape. Most commonly, rape is understood as a symptom of deep and pervasive gender inequality, historical, social and economic legacies of apartheid as well as post-apartheid state discourses that have normalized rape and enabled it to be tolerated. In addition, the role of masculinities has received significant attention, linked to social and economic histories and contemporary political narratives. This article considers how scholarly discussions on rape in South Africa are evolving. Applying a critical sociological lens of enquiry to the ways in which the problem of rape is constructed, it outlines the significance of state histories in understandings of rape in South Africa today, the explicit and implicit ways in which research and writing on rape is racialized and classed, and considers the implications of this.
Male partners' involvement in prevention of mother-to-child HIV transmission in sub-Saharan Africa: A systematic review.
SAHARA J. 2015; 12:87-105.In sub-Saharan Africa (SSA), male partners are rarely present during prevention of mother-to-child transmission (PMTCT) services. This systematic review aims to synthesize, from a male perspective, male partners' perceived roles, barriers and enablers of their involvement in PMTCT, and highlights persisting gaps. We carried out a systematic search of papers published between 2002 and 2013 in English on Google Scholar and PubMed using the following terms: men, male partners, husbands, couples, involvement, participation, Antenatal Care (ANC), PMTCT, SSA countries, HIV Voluntary Counseling and Testing and disclosure. A total of 28 qualitative and quantitative original studies from 10 SSA countries were included. Men's perceived role was addressed in 28% (8/28) of the studies. Their role to provide money for ANC/PMTCT fees was stated in 62.5% (5/8) of the studies. For other men, the financial responsibilities seemed to be used as an excuse for not participating. Barriers were cited in 85.7% (24/28) of the studies and included socioeconomic factors, gender role, cultural beliefs, male unfriendly ANC/PMTCT services and providers' abusive attitudes toward men. About 64% (18/28) of the studies reported enablers such as: older age, higher education, being employed, trustful monogamous marriages and providers' politeness. In conclusion, comprehensive PMTCT policies that are socially and culturally sensitive to both women and men need to be developed.
'We go to the bush to prove that we are also men': traditional circumcision and masculinity in the accounts of men who have sex with men in township communities in South Africa.
Culture, Health and Sexuality. 2017 Mar; 19(3):279-292.In predominantly isiXhosa-speaking township communities in South Africa, men who have sex with men negotiate their identities and sexual practices alongside heteronormative cultural scripts of what it means to be a man. Such idealized notions of masculinity are predicated on the selective appropriation of cultural practices that preserve (heterosexual) male privilege and power. In this paper, we explore the identity work done by men who have sex with men, with particular reference to male circumcision as a cultural practice widely drawn on to inform and regulate normative masculinity. Through a narrative-discursive analysis of the accounts provided by men who have sex with men from township communities, we highlight how participants’ dissident sexualities are constructed as compromising their masculine identities. Participating in cultural practices such as traditional circumcision aligns participants to the idealized forms of masculinity that afford men full citizenship in their communities. Study findings suggest that sexual dissidence is less troubling to participants than deviating from gendered markers of hegemonic masculinity, and point to ways in which marginalized men might have an interest in maintaining the dominant gendered order. We conclude with implications for research and programmatic work with gay, bisexual and other men who have sex with men.
Culture, Health and Sexuality. 2016 Sep; 18(9):1025-1038.Female sex tourism has become an accepted income generator for many underemployed men in Jamaica who seek to reap economic benefits from relationships with visiting tourist women. This issue provides contexts to explore the numerous ways in which health intersects with issues of masculinity, sexuality and marginality. Based on ethnographic fieldwork in a popular Jamaican resort town, this paper examines the health implications of female sex tourism for the local population and tourist visitors. Data from this project indicate the need for improved sexually transmitted infection education and HIV outreach work towards men who are involved in transactional sex with tourist women. Due to prevalent perceptions of masculinity and gendered notions of sexuality, men who engage in sex tourism constitute a population that rarely receives the attention of local and national health authorities. Data from this qualitative study suggest that engaging this particular vulnerable population could potentially decrease the risk of STI and HIV infection in the country’s most popular resort areas. Research of this kind is urgently needed to better understand the risk factors and challenges for Caribbean populations, as well as to inform future prevention efforts in the region.
Global Health Action. 2015; 8:27860.BACKGROUND: Adherence to traditional notions of masculinity has been identified as an important driver in the perpetuation of numerous health and social problems, including gender-based violence and HIV. With the largest generalized HIV epidemic in the world and high rates of violence against women, the need for gender-transformative work in South Africa is broadly accepted in activist circles and at the national and community level. Because of the integral role men play in both of these epidemics, initiatives and strategies that engage men in promoting gender equality have emerged over the last decade and the evidence base supporting the effectiveness of masculinities-based interventions is growing. However, little research exists on men's receptivity to the messages delivered in these programs. OBJECTIVE: This article examines the current practices among a set of gender-transformation initiatives in South Africa to see what lessons can be derived from them. We look at how South African men participating in these programs responded to three thematic messages frequently found in gender-transformative work: 1) the 'costs of masculinity' men pay for adherence to harmful gender constructs; 2) multiple forms of masculinity; and 3) the human rights framework and contested rights. DESIGN: This article synthesizes qualitative findings from in-depth interviews, focus group discussions, and ethnographic research with men participating in several gender- and health-intervention programs in South Africa. The data were collected between 2007 and 2011 and synthesized using some of the basic principles of meta-ethnography. RESULTS AND CONCLUSIONS: Overall, men were receptive to the three thematic messages reviewed; they were able to see them in the context of their own lives and the messages facilitated rich dialog among participants. However, some men were more ambivalent toward shifting gender notions and some even adamantly resisted engaging in discussions over gender equality. More research is needed to gauge the long-term impact of participation in interventions that target gender and health.
Journal of Nursing Scholarship. 2016 Mar; 48(2):128-138.Purpose: This study aims to describe human immunodeficiency virus (HIV)-related knowledge and beliefs, as well as understanding attitudes towards masculinity in the context of HIV prevention, held among Chilean men. Design: This study reports the qualitative findings of a sequential qualitative-quantitative mixed methodology study: Bringing men into HIV Prevention in Chile, NIH R01 TW007674-03. Methods: Twenty in-depth interviews using a qualitative, descriptive approach to elicit information for the study were conducted among men residing in two communities of low socio-economic status in Santiago, Chile. Findings: Content analysis of interviews revealed three main themes regarding machismo and how it relates to HIV: sexuality and machismo, the changing nature of machismo, and violence against women. Conclusions: Addressing HIV and intimate partner violence through developing education programs tailored to meet the needs of Chilean men are needed to include men in HIV prevention efforts. Clinical Relevance: Specifically, incorporating ideas of what men consider healthy masculinity and working to destigmatize men who have sex with men are important steps in addressing the negative aspects of machismo.
Medical Anthropology: Cross Cultural Studies in Health and Illness. 2016 Jan 26; 1-13.Drawing from an ethnography of HIV care in Santa Cruz, Bolivia, in this article I explore how the social imaginary surrounding gender relations shapes men’s experiences of seeking care for and living with HIV. Popular understandings of gender relations, which draw heavily on the machismo concept, intersect with a global health master narrative that frames women as victims in the AIDS epidemic in a way that generates a strong sentiment of blaming machismo within local HIV/AIDS-related services. Statements such as, “it’s because of machismo” are used to explain away epidemiological trends. Participant observation in the context of HIV care, coupled with illness narrative interviews, illuminate how blaming machismo shapes men’s experiences of care and the ways that they feel excluded from various forms of support. Thus, the illness experiences of men with HIV problematize the machismo concept and how it is drawn upon in the context of care.