male involvement in addressing hiv aids experiences from ippf africa region jan 22 2007
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MALE INVOLVEMENT IN ADDRESSING HIV & AIDS: EXPERIENCES FROM IPPF AFRICA REGION Jan. 22, 2007

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MALE INVOLVEMENT IN ADDRESSING HIV & AIDS: EXPERIENCES FROM IPPF AFRICA REGION Jan. 22, 2007. Dr. Wilfred Ochan, Technical Adviser, HIV/AIDS IPPF Africa Regional Office. Presentation Outline. Why male involvement? Initiatives used to involve men Lessons learned Conclusion.

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male involvement in addressing hiv aids experiences from ippf africa region jan 22 2007

MALE INVOLVEMENT IN ADDRESSING HIV & AIDS: EXPERIENCES FROM IPPF AFRICA REGIONJan. 22, 2007

Dr. Wilfred Ochan, Technical Adviser, HIV/AIDS

IPPF Africa Regional Office

From choice, a world of possibilities

presentation outline
Presentation Outline
  • Why male involvement?
  • Initiatives used to involve men
  • Lessons learned
  • Conclusion
why male involvement concern for the risks burden
Why male involvement: concern for the risks & burden?

1. Sub-Saharan Africa - epicenter of HIV/AIDS, with main mode of transmission as sexual intercourse:

  • 57% of those infected are women & girls
  • 50% of new infections amongst young people are in SSA, young girls account for 75%

2. Male sexuality increases susceptibility of women & girls to HIV infection:

  • Men abuse more substances, use more violence & have more explicit sex partners.
why male involvement a concern over dominance masculinity
Why male involvement – a concern over dominance & masculinity?

3. Men control sexual, reproductive & fertility decisions and practices:

  • Most SRH information & services minimally involved men – yet, women needed approval of men to adopt a specific behavior being promoted
  • Information asymmetry: women with more information through SRH programs, yet without authority. Men with little, yet with authority.
  • Men control the resources essential for uptake & utilization of HIV & AIDS related services
  • Decision making on SRH at family & community levels are dominated by men & this has been exported into formal systems.
why male involvement a question of culture
Why male involvement – a question of culture?

4. Socio-cultural expectations & position of men impose on them, practices that increase their own risk or those of women and/or condone their acts

  • Sexual prowess encouraged
  • Multiple sexual partner relations is praised as sign of manhood (though slowly dying)
  • Marrying of young girls is not sanctioned
  • Rapes, defilement & other acts of sexual violence is condoned .
project 1 young men as equal partners ymep project
Project 1: Young Men as Equal Partners [YMEP] Project

1. Coverage: 4 year SIDA funded joint project between RFSU & MAs of: Uganda, Kenya, Tanzania & Zambia.

2. Purpose: To increase adoption of safer sex practices & utilization of HIV/AIDS/SRH services by young people (especially young men) within project sites.

3. Strategies:

  • BCC [community mobilization, young men as Peer educators; targeting gender issues, sexuality & SRH.
  • services delivery [male service providers, male dedicated clinic days; VCT post test clubs, etc.]
  • Capacity building [training] &
  • advocacy [local authority, school administration & community leaders]
project 1 young men as equal partners ymep project1
Project 1: Young Men as Equal Partners [YMEP] Project

4. Evaluation Results:

  • Increased SRH service utilization including reported condom use by young women and young men.
  • Reduced pregnancy cases in schools.
  • Reduced incidences of STIs & Gender based Violence (reported by teachers & young women). In Zambia girls reporting sexual abuse dropped from 60% to 42%.
  • Reported reduction in # of sex partners by young men.
  • Improved communication & relationship between young men & women on gender & SRH (e.g. TZ: discuss with female choice of methods of protection: 23% to 47%)
  • Improved communication on sexuality issues between teachers & students.
  • Increased percentage of men accompanying their spouses for SRH services.
  • Improved trust on young men by communities.
  • Attitude to female use of condoms (Zambia: 50% to 85%)
project 2 youth to youth project in uganda
Project 2: Youth to Youth Project in Uganda

1. Coverage: Funded by IPPF & DSW and implemented in Uganda since 2003.

2. Purpose: To increase proportion of young people who practice safer sex & utilize SRH services in a supportive socio-cultural environment.

3. Strategies:

  • BCC [community mobilization, young men as Peer educators, community level male dedicated workshops, community theatre, etc.];
  • Services delivery [static clinic, outreaches: event specific & routine
  • Capacity building [training, club formation, cascading & support];
  • Linkage to micro-credit & Income Generation Activity
  • Advocacy [local authority, school administration & community leader]
project 2 youth to youth project in uganda1
Project 2: Youth to Youth Project in Uganda

4. Annual reviews:

  • Increased level of knowledge on HIV/AIDS/SRH issues
  • Increased uptake of condoms & VCT by all, especially women during Sunday church-based VCT outreaches
  • Improved perception of members in the community & viable community groups formed.
  • Linkage to Poverty Alleviation Fund & some German based donors assisted some groups to establish own sources of livelihood: goat rearing, bee keeping; etc.
  • Ability to raise own income: hire of drama clubs for local functions: commemoration of international days
  • Roles of the youth clubs have extended to being used in community mobilization for other health programs: immunization
project 3 safe blood project in botswana
Project 3: Safe Blood Project in Botswana

1. Project

  • Project motivated by concern for high HIV infection rate and lack of safe blood.
  • The concern has been on how to recruit and maintain subsequent age cohorts of low risk & recurrent safe blood donors for Botswana’s blood bank.

2. Approach:

  • A peer education, enter-educate & club based program that mobilizes young people (boys) for safer sex practices; VCT uptake (Positive Lifestyle Group) & pledge to donate blood until age of 25 years (Pledge 25), with adoption of behaviour to reduce risk of donating infected blood.

3. Annual Reviews:

  • Increased uptake of VCT services
  • Increased uptake of condoms
  • Increased amount of blood donated from project sites
  • Reported reduction in number of sexual partners
project 3 other projects
Project 3: Other Projects
  • Male circumcision in Swaziland, coupled with sexuality education and youth friendly services.
  • Jua Kali project in Kenya targeting mainly the black smith with HIV/AIDS information and services.
  • etc.
lessons learned
Lessons learned

1. Programs that specifically target men/boys should aim at:

a. Transforming their risky behaviours by working with them:

    • As clients – using information, services & life skills.
    • As supportive agents of sex partners
    • As change agents – to address norms of masculinity (multiple sex partners, alcohol use, GBV, etc.)
  • Linking such programs to livelihood opportunities & other concerns for boys/men.

c. Integrating HIV/AIDS with SRH in order to create window of opportunity for men to view traditional SRH service not only as for women, but also theirs; and to access & use such SRH/HIV/AIDS services.

2. In African setting, programs that empower women & girls & address their SRH needs will not achieve much unless we involve men & boys in them, because of relative male control on decisions & practices on issues of sexuality, fertility & reproduction.

conclusion recommendations
Conclusion & Recommendations
  • Girl child education remains the most strategic opportunity for addressing female vulnerabilities to HIV infection in both the near and long term measures.
  • Strategies to improve HIV must first focus on creating awareness of the true dimensions of the problem & its dire consequences amongst community leaders & men; and of their role in its prevention. With their support we can rapidly create awareness and services expansion for young girls and women and remove the prevailing “norms”
  • We need programs that involve non-formal cultural institutions to address socio-cultural beliefs & practices that create expectations for men & give them advantage positions on issues of sexuality, fertility & reproduction that put women at risk. Program approaches such as community conversations could be useful in such efforts.
  • We need to have a better understanding of female sexuality and other factors that increase their vulnerability, especially in the context of observed increase in sero-positivity amongst women in sero-discordant couples. What would explain their infections?
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