Exploring constructions of masculinities and their influence on sexual practice, HIV risk and health-seeking behaviours of men in Malukazi/Malagazi informal settlement in Durban.

Abstract

Introduction: This study explores the role masculinity plays in shaping HIV-related risks and the health-seeking behaviours of young men residing in Malukazi, an informal settlement located in Durban, South Africa. Traditional notions of masculinity often influence health behaviours, including perceptions of HIV-related risk and healthcare utilisation. Understanding the intersection between masculinity and HIV-related risks and health-seeking behaviours is crucial for the development of targeted context-specific interventions meant to address the HIV epidemic among young men in informal settlements of South Africa. Methods: The study adopted a qualitative approach, which involved in-depth interviews faceto-face and focus-group discussions with 23 young men aged 15-25 from Malukazi. Three focus group discussions (FGD) and 17 individual interviews (IDI) were conducted. Thematic analysis was employed to analyse, interpret and present the data. Findings: The findings indicate that masculine attributes are associated with being ‘umjita’, a tsotsitaal concept meaning a young man and ‘amajita’, meaning a group of young men that significantly shaped young men's health-seeking behaviours in Malukazi. Risky sexual behaviours, such as engaging in MSR/MSP and inconsistent condom use, were perceived as integral to Amajita’s identity and masculine prowess and are an important need to prove one’s masculinity to Amajita. Moreover, the stigma surrounding HIV and AIDS and fear of emasculation were found to deter young men from seeking HIV testing and healthcare services. Conclusion: The findings highlight the critical role masculinity plays in shaping HIV risks and health-seeking behaviours among young men in Malukazi. Addressing the traditional norms of masculinity is essential as it promotes HIV prevention and care initiatives tailored to address the needs of this vulnerable population. There is a need to conduct research with the aim of providing an evidence base to develop and implement Interventions that challenge harmful gender norms, empower young men so that they adopt healthier behaviours and provide culturally sensitive healthcare services that prioritise confidentiality and respect. Addressing the intersection of masculinity with HIV-related risks and health-seeking behaviours can help advance efforts being made to mitigate the impact of the HIV epidemic among young men residing in informal settlements such as Malukazi.