A promising opportunity in HIV/AIDS intervention? : the men as partners programme and its lessons for a wider gender interpretation in HIV/AIDS intervention in Southern Africa

Van Vliet, Mirjam (2007-03)

Thesis (MA)--Stellenbosch University, 2007.

Thesis

ENGLISH ABSTRACT: The HIV/AIDS epidemic in Southern Africa continues to outpace the response to it and, as such, forces a re-evaluation of the nature of the imminent health crisis. The nature of the epidemic in this region reveals that it is fundamentally about the role of gender norms and values in forming male and female attitudes toward sexual behaviour that place both men's and women's sexual and reproductive health at risk. In addition, there is a seeming deficiency with regard to the notion of gender in HIV/AIDS intervention in that gender is a highly contested concept and has often been interpreted from a mainly feminist perspective. Both the contours of the HIV I AIDS epidemic in Southern Africa and the deficiencies in gender theory itself, suggest the need for a wider gender interpretation in HIV I AIDS intervention within this region. Since the need for a wider gender interpretation is multi-layered and manifests itself on a theoretical and practical level, this study differentiates between theoretical and practical usages of gender in HIV/AIDS intervention as reflected in the academic discourse on gender and HIV/AIDS and the international institutional responses to the epidemic respectively. This distinction reveals that the academic discourse is predominantly feminist-centred and inforn1s the conceptual approach toward gender within international organisations such as UNAIDS and the World Health Organisation (WHO) and their practical articulation of gender in the design of HIV I AIDS policies and intervention programmes. As a result, despite awareness of the need for an approach to HIV/AIDS intervention that is sensitive to gender dynamics, both fail to incorporate a satisfactory wider gender interpretation. This study examines the Men as Partners Programme and its implementation in the Western Cape region in South Africa at tertiary level as a case study. The MAP program seems to suggest a promising opportunity in HIV/AIDS intervention in Southern Africa by promoting constructive positive male involvement in HIV/AIDS policies and intervention programmes. This study is exploratory, qualitative and ethnographic and includes face-to-face semistructured interviews and a self-administered questionnaire. Stellenbosch University https://scholar.sun.ac.za The MAP case study reveals an awareness of the need for a more balanced gender perspective in HIV/AIDS intervention. Nevertheless, MAP is not informed by a gender-sensitive discourse and has not incorporated a satisfactory wider gender interpretation in its HIV/AIDS policies and intervention programmes. This study moves beyond the case study of MAP at tertiary level and discusses the main lessons that the initiative yields for a wider gender interpretation in HIV I AIDS intervention in Southern Africa. These lessons are positive in the sense that MAP demonstrates that men can and should be involved, alongside women, in HIV/AIDS intervention. However, on a less positive note, MAP also demonstrates the obstacles that emerge from such involvement. The findings of this study reveal general trends and patterns that provide insight in the limitations and necessary improvements in HIV/AIDS intervention in Southern Africa to facilitate an approach that is sensitive to gender dynamics. Most importantly, it emphasizes the need for a multi-layered approach to a wider gender interpretation in HIV/AIDS intervention m Southern Africa that differentiates between theoretical and practical usages of gender. On a final note, this study identifies potential pitfalls and proposes some relevant recommendations for future HIV I AIDS intervention.

AFRIKAANS OPSOMMING: Die MIV/Vigs epidemie in Suider-Afrika groei teen 'n sneller tempo as enige respons daartoe. Dit noodsaak 'n herbesinning oar die aard van hierdie dreigende gesondheidskrisis. Die aard van die epidemie toon aan dat normes random geslag en die vorming van waardes en houdings - die van mans sowel as vroue - jeens seksuele gedrag 'n fundamentele rol vertolk, en dat sulke houdings mans en vroue se reproduktiewe gesondheid op die spel plaas. Verder, daar blyk 'n gebrekkige plasing van die begrip van geslagtelikheid in meeste MIVNigs intervensieprogramme te wees. Dit is deels te wyte aan die wye betwisting van die begrip, 'geslagtelikheid,' wat tot op hede grotendeels vanuit 'n feministiese oogslag interpreteer was. Tog, die omtrek van die epidemie in Suider-Afrika, sowel as die gebrekke in geslagtelikheidsteorie opsigself, doen die noodsaak van 'n breer vertolking van die rol van geslagtelikheid in MIVNigs intervensies, aan die hand. Uit die aard van die saak bevat 'n breer interpretasie van geslagtelikheid vele lae, en openbaar op teoretiese en praktiese vlakke. As sulks onderskei hierdie studie tussen die teoretiese en praktiese gebruike van geslagtelikheid in MIVNigs intervensies, soos dit weerspieel word in die akademiese diskoers oar geslagtelikheid en MIV /Vigs en die institusionele response tot die epidemie op intemasionale vlak. Op hierdie wyse word getoon dat die akademiese diskoers oorwegend feministies-gesentreerd is en dat dit die konseptuele benadering tot geslagtelikheid m intemasionale orgamsas1es soos UNAIDS en die Wereld Gesondheidsorganisasies (WGO, oftewel die World Health Organisation (WHO)) onderle, en die praktiese ontwerp van MIVNigs intervensieprogramme deur sulke organisasies belnvloed. Gevolglik, ten spyte van die bewustheid van die belangrikheid van 'n benadering tot MIV/Vigs intervensies wat sensitief tot geslagsdinamika is, slaag albei organisasies nie daarin om 'n meer bevredigende en breer interpretasie van geslagtelikheid in hul programme in te werk nie. Hierdie studie ontleed as gevallestudie die Men as Partners-program en hoe dit uitvoering vind in tersiere instellings in die Wes-Kaap-streek. Dit wil voorkom asof die MAP-program 'n belowende geleentheid bied vir die bestryding van MIV/Vigs in Suider-Afrika deur opbouende en positiewe manlike betrokkenheid m MIVNigs-beleide en intervensieprogramme te bevorder. Hierdie studie is verkennend, kwalitatief en etnografies van aard, en maak gebruik van aangesig-tot-aangesig, semi-gestruktureerde onderhoude en vraelyste. Die gevallestudie toon aan dat daar wel 'n skerp bewustelikheid oor die belangrikheid van 'n meer gebalanseerde geslagtelikheidsbenadering tot MIV Nigs intervensies is. MAP word egter nie deur so 'n gebalanseerde benadering onderle nie, en het nie daarin geslaag om 'n meer bevredigende en breer interpretasie van geslagtelikheid in sy MIVNigs-beleide en programme in te lyf nie. Hierdie studie bespreek ook die belangrikste lesse wat uit die MAP-program geneem kan word vir die omvang en betekenis van 'n breer interpretasie van geslagtelikheid in MIV Nigs intervensieprogramme in Suider-Afrika. Hierdie lesse moet in 'n positiewe lig gesien word, in dat MAP aantoon dat mans betrek kan word - ook in vennootskap met vroue - by die bestryding van MIV/Vigs. Maar, minder positief is die struikelblokke tot sulke betrokkenheid wat in hierdie studie uitgewys word. Die bevindinge in hierdie studie ontbloot bree tendense en patrone wat insig bied tot die beperkinge en verbeteringe wat nodig is om 'n meer geskikte en gebalanseerde geslagtelikheidsbenadering in Suider-Afrika teweeg te bring. As allerbelangrik, word klem geplaas op die behoefte aan 'n veelvlakkige benadering wat onderskeid tref tussen die teoretiese en praktiese behandeling van geslagtelikheid. Laastens, identifiseer hierdie studie ook moontlike struikelblokke en maak aanbevelings oor die inhoud en omtrek van toekomstige MIV/Vigs intervensie-programme.

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