Transcript Slide 1
The role of men in challenging gender inequality in the context of HIV?
Tim Shand, Sonke Gender Justice Network, South Africa
Why discuss engaging men within NSPs?
• • • • • • • Prevention: fostering +ve attitudes/behaviours Men’s role in supporting others : direct benefits or health implications for women and children Regional public health concerns require men as part of solution : HIV, GBV, MCH, care Men’s own HIV needs and concerns Men as gender justice advocates Existing global mandate It works – evidence-base
Principles for work with men
Promote women’s and girls’ rights.
Accountable to /allies with women’s rights orgs Engage men from positive and enabling perspective Diversities among men, including sexual diversity Human rights and gender as relational perspective Addressing structural determinants Building on the evidence base / existing UN mandates Taking work to scale
WHY GENDER NORMS MATTER
In numerous applications of the Gender Equitable Man (GEM) Scale, gender-related attitudes correlated with men’s and boys’ Self-reported physical violence toward female partners Participation in care work, caregiving of children Use of health services Self-reported acts of delinquency Number of sexual partners
Condom use
Substance/alcohol use Rates of self-reported STI symptoms
The underlying norms that create and sustain men’s domination of women also create harmful outcomes for men’s and boys’ lives and inhibit men from connecting to others in relationships of equality and solidarity.
HIV
HIV Burundi
Cote D’Ivoire 2006 2010
Ethiopia
2009 – 2010/11,
Kenya
2009/10 – 2012/13
HIV and Gender Attempts to challenge or transform gender norms Engaging men for prevention of GBV Men’s support of PMTCT Male circumcision Mozambique Namibia
2011 – 2016
Rwanda
2009 - 2012
Sierra Leone South Africa
2007 – 2011
Tanzania
2008 – 2012
Uganda
2007/8 – 20011/12
Condoms Men’s use of VCT Marginalized men & boys Treatment Home Based Care Zambia
2011 – 2015
Zimbabwe
2011 - 2014 Adequate Room for improvement Inadequate
Key
GBV In spite of 5-10 years of laws against GBV and prevention activities, rates still alarmingly high Results from the International Men and Gender Equality Survey – ICRW and Promundo
GBV
Key factors associated with men’s reports of Intimate partner violence
Economic/work stress Childhood witnessing of IPV and experiences of violence in the home, school and community Gender norms Alcohol use Other trends: Higher rates in the last year among younger men; higher lifetime use among older men
Many of these same factors are related to HIV related vulnerabilities and risk
Evidence confirms that it works:
interventions with men can lead to changes in attitudes and practices
Effective Promising Unclear Type of Intervention n
Group Education Services-Based Community Outreach/Mobilization
Integrated
(includes more than 1 of the above)
TOTAL
20 8 8 21 2 6 6 11 4 2 5 9 2 10
57 14 (24.5%) 22 (38.5%) 21 (36.8%)
WHO-Promundo review: evaluation data from 57 programs engaging men & boys in health-based interventions (Barker, Ricardo, Nascimento, Segundo, 2007)
Gender Transformative Programmes
Seem to be Even More Effective in Achieving Attitude or Behaviour Change (n=27 programs
) 30% 44% 26% Effective Promising Unclear
Program evaluations: services/clinics, outreach/campaigns and education
•
Group education: Program H in (Brazil/India)
: Group education + community campaign = increased condom use, lower STIs rates, attitude change •
Group education: One Man Can (South Africa)
Workshop based training and awareness campaigns led to increased HIV testing, increased condom use and increased reporting of GBV •
Clinic based: Men As Partners (Africa and Asia)
: Changes in attitudes after participation •
Campaigns: Soul City (South Africa)
: exposure to TV shows led to more gender-equitable attitudes and increased communication re GBV
Final thoughts – International Men and Gender Equality Survey
Growing percentage of men participating in care work
Gender equitable men report
more life satisfaction and satisfaction with relationships In some countries evidence of generational change: younger
men more equitable norms
A few countries showing dramatic changes due to policies, eg men’s participation in childbirth in Chile
Key messages….
Well designed interventions with men to
improve HIV and GBV outcomes can
change behaviours
Gaps in HIV and GBV programming (NSP analysis) Most interventions small scale and not
included within public policies
Should be integrated within a gender relational and women’s empowerment