This thesis investigates the role of masculinities on men’s sexual and reproductive
health in Botswana. Botswana is currently in the throes of a severe heterosexually
driven HIV/AIDS epidemic that has eroded some of the developmental gains the
country had achieved since independence. A unique feature of Botswana’s HIV
epidemic is the rapid and phenomenal increase in infection and prevalence rates in the
face of good levels of knowledge of HIV prevention and an early and comprehensive
HIV prevention strategy that guaranteed access to free HIV prevention and treatment
services, including ARV treatment.
The lack of effectiveness of the country’s HIV efforts and subsequent increase in
infection rates have been blamed on men’s risky sexual behavior and lack of support of
their partners’ decisions to utilize these services. In fact, quantitative studies on men’s
sexual behavior and HIV such as the Botswana AIDS Impact Surveys show that men are
less likely to use VCT services and more likely to engage in risky sexual behavior that
increases risk of HIV infection to themselves and their partners. While studies provide
the evidence that implicates men in the rapid growth Botswana’s HIV epidemic, the
studies provide little or no explanation of factors that motivate men’s behavior in
reproductive health. This lack of insights on factors that motivate men’s behavior leads
to stereotypes about male promiscuity and may contribute to the lack of effectiveness of
HIV prevention strategies.
The current HIV epidemic has thus thrust heterosexual masculinities at the centre of
HIV prevention efforts and provides an opportunity for research to interrogate the role
of heterosexual masculinities in reproductive health, especially HIV transmission and
prevention. The thesis employs qualitative data to provide in-depth appreciation of the
prevalent masculine norms and beliefs and to highlight contextual factors and processes
that shape and give rise to various masculinities. It further uses quantitative data to
provide measures of levels of men’s masculine and gender role beliefs that may
influence HIV prevention and transmission and to test the association between
masculinities and men’s sexual and reproductive health attitudes and practices.
The results show that men’s sense of identity is socially constructed, and revolves
around the notion of superiority to women, independence and having and being in
control of the family. However, men face many challenges to the realization of this
masculine ideal. Men’s perceived difficulty or failure to live up to socially constructed
Men, Masculinities and Sexual and Reproductive Health in Botswana
vii
notions of masculinities affects their experience of sexual and reproductive health
programs, especially women’s empowerment and HIV prevention programs. By their
nature, these programs tend to challenge men’s dominance of women’s decision on
sexuality, and are therefore experienced as a threat to some men’s sense of identity.
Quantitative results indicate an association between masculinities and sexual and
reproductive health. While men’s sense of masculinities is not the overriding factor
determining their sexual and reproductive health attitudes and practices, the results
show a strong association traditional masculine beliefs and negative sexual and
reproductive health beliefs and practices.
However, there is also strong evidence that men and masculinities are responding to
contextual factors, such as the HIV epidemic, which has become a specific stress on the
local construction of masculinities. In focus group discussions, many men challenged
traditional masculine norms, beliefs and practices that increase their vulnerability to
HIV infection and those that either encourage or condone violence within intimate
relationships. Significantly high proportions of men had positive attitudes towards HIV
prevention programs. It is evident that now more than ever (and thanks to the
HIV/AIDS epidemic) many men are ready to question the predominant masculine
norms, beliefs and practices that increase their vulnerability to infection and disease.
These voices of change represent a window of opportunity for research and programs
can meaningfully engage with men and masculinities on issues of sexuality, gender
roles, sexual and reproductive health and HIV/AIDS prevention and transmission.
There is need for future research and interventions to move away from focusing
exclusively on individual models of preventive health behaviors to more multilevel,
cultural and contextual explanations. Taking account of multilevel, cultural and
contextual factors that shape masculinities and men’s sense of identity will ensure
increased effectiveness of sexual and reproductive health programs, especially
HIV/AIDS prevention programs. On the other hand, failure to account for cultural and
contextual factors that shape individuals’ behavior will only ensure that the
shortcomings of such intervention program will continue to be blamed on the
individual.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/9406 |
| Date | 12 April 2011 |
| Creators | Rakgoasi, Serai Daniel |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf, application/pdf |
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