Male sexual behaviour and protective practices in the context of a generalized HIV/AIDS epidemic : a case study of an urban and rural area in Mozambique.

Abstract

This study investigates male sexual behaviour and protective practices in the context of a generalized HIV/AIDS epidemic in Mozambique. It focus on how gender norms, particularly notions of masculinity influence sexual behaviour and the ability of men (and women) to protect themselves against HIV infection. A combination of qualitative and quantitative methods is used in this study. The qualitative data comes from 16 focus group discussions and 20 in-depth interviews and the quantitative data comes from a survey conducted with 209 men and 217 women. This methodological approach has proven useful in exploring complex and sensitive matters such as sexual behaviour. In this study, where it was possible, the findings from the survey were supported by quotes from focus groups discussions and in-depth interviews. The findings of this study reveal that traditional gender norms, particularly rigid notions of masculinity are still prevalent in the study settings. The existing notions of manhood are mostly associated with traditional views of men as providers and main breadwinners. In contrast, women are seen as the family caregivers. Practices which bring social prestige both in the community and in the society at large are highly valued for men. Meanwhile, traditional notions of masculinity face enormous challenges in the existing socio-economic context which is characterized by a lack of employment and widespread poverty. This has negative consequences for male self-esteem including their sense of manhood. The study shows that some men believe that having multiple sexual partners is part of male identity and is supported by culture. Similarly, some women also believe that a man cannot be satisfied with one partner or stay long without having sex. These beliefs have important implications in a country with a high prevalence of HIV/AIDS. The study found that traditional notions of manhood prevent men from accessing correct health information thereby perpetuating the cycle of harmful practices for themselves and their females partners. The findings of this study suggest that despite a universal awareness of HIV infection and protective strategies, multiple sexual partnerships and unprotected sex among heterosexual men and women are the driving force sustaining the HIV/AIDS pandemic in the study settings. This is worsened by the widespread negative meanings attached to condoms. The study shows that the level of condom use (31 percent among men and 20 percent among women) is encouraging but not sufficient to curb the level of HIV infections. Consistent condom use remains a major challenge as much fewer men and women report using condoms in all their sexual encounters.