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Men and STIs/HIV Family Health International HIV/AIDS: A Public Health Crisis That Requires Men’s Help • • • • • • 33 million people living with HIV/AIDS worldwide 14 million people have died of AIDS 16,000 new HIV infections every day 6 of 10 newly HIV-infected people are women Women are 4 times more likely to contract HIV and other STIs Half of all new HIV infections occur to those under age 25 Source: Gardner, Popul Rep 1999;H(9). Ten New STIs for Each HIV Case • 333 million NEW cases of STIs per year for each of the 4 major curable STIs • One-third occur to those under age 25 • Those with an STI are more vulnerable to acquiring HIV Source: Gardner, Popul Rep 1999;H(9). US Agency for International Development Men are usually the ones who decide about sex – the timing and whether protection is used Cairo Plan of Action “Innovative programs must be developed to make information, counseling and services for reproductive health accessible to adolescents and adult men. Such programs must both educate and enable men to … accept the major responsibility for the prevention of sexually transmitted diseases.” – ICPD Plan of Action, Section 7.8, 1994 Prevention Requires Male Involvement: What Do Men Know? P. Almasy/World Health Organization • In 21 of 22 DHS surveys, at least 90% of men knew of AIDS; most knew of condoms • In most of these countries, only 25 to 45% knew that condoms can prevent AIDS Source: Gardner, Popul Rep 1999;H(9). Objections to the Condom • Association with commercial or illicit sex and lack of trust • Fear of loss of sensation or erection • Providers, peer educators and social marketers can address these fears K. Best/Family Health International Better Condoms Are Needed New inSpiral condom N. Herndon/Family Health International What Motivates Men To Use Condoms? Determine why men DO use condoms instead of focusing only on why men do not use them Richard Lord HIV/AIDS Education and Condoms Not Available Where Needed Condom availability where people meet new sexual partners (Township in Cape Town, South Africa) Condom availability at site or nearby NO YES Bar Shebeen (informal bar) Other Source: MEASURE Project/USAID. Condoms: Dual Protection Against Pregnancy and STIs/HIV • Providers need training to foster couple communication, negotiation skills and condom use • Many providers are biased against condoms • A client at high-risk of STIs should use condoms • Few married couples rely on condoms for contraception Programs That Increased Use of Male Condoms Family Health International Support Men’s Positive Actions • To be tested • To support people • Beryl Goldberg who have HIV/AIDS To foster open communication about sexual and reproductive health with their partners Address Underlying Gender Issues • Help men question masculine risk-taking behavior • Encourage couple communication Beryl Goldberg Prevention Requires Community Involvement • Health care providers, teachers, religious and community leaders can speak out against exploitative relationships • Political figures can make public pronouncements about HIV/AIDS and the need for male-female partnerships • NGOs and CBOs can support strategies that involve men Reaching Youth: Knowledge about HIV/AIDS Is Not Enough • Mobilize communities to challenge social norms that foster unsafe sexual behaviors • Create safe and supportive environments • Nurture communication skills about sexual and reproductive health issues • Foster safe and healthy behaviors Source: FOCUS on Young Adults Program Evaluations, 2000. Reaching Youth: Concrete Strategies • Emphasize peer outreach, social support, counseling and referral • Target social marketing to adolescents • Modify service delivery sites/practices to serve youth • Increase access to programs and services relevant to the needs of youth Source: FOCUS on Young Adults Program Evaluations, 2000.