‘Politicising Masculinities: Beyond the Personal’
An international symposium linking lessons from HIV, sexuality and reproductive health with other areas for rethinking AIDS, gender and development; 15-18th October, 2007, Dakar
COMMENTARY: BROAD BASED GENDER SENSITISATION
THE REAL HIV AND AIDS INTERVENTION
Gareth M Coats: BA Psych
School Without Walls, Southern African AIDS Trust
Introduction
The field of Public Health and especially interventions in the response to HIV and AIDS is constantly changing. One of the key components of a successful HIV and AIDS response is the consideration of Gender in the programming and although there have been some programmes that have addressed gender in their work, such risk reduction efforts have only been tested on a small scale1.
The Southern African AIDS Trust (SAT) is committed to gender mainstreaming within their programming at regional, national and community level. In order to tailor their programming to better address any gender shortcomings, SAT hosted a Gender Workshop through their School Without Walls (SWW) unit in Johannesburg, South Africa.
The activity was intended to address gender issues and engage the participants in sensitisation methods and knowledge sharing. The workshop participants included SAT Country Staff members as well as staff members from Community Based Organisations (CBO) and AIDS Service Organisations (ASO) from across the region – this ensured that there was a diverse mix of individuals in terms of academic, economic and social status. There were 7 males and 14 females in the group.
Towards the end of the programme the evidence had mounted that indicates although there is a high level of ‘Gender Concepts Knowledge’ within CBOs, gender sensitisation is not being implemented throughout programmes and in communities. By using a model that presents men and women as equals, sensitisation is more meaningful and gender mainstreaming in programming will be more meaningful. There is still great need for broad based gender sensitisation, targeting men and women so that HIV and AIDS interventions can address all segments of society without needing to be burdened by separating messaging to target different gender segments.
Methods
A number of participatory approaches were used that highlighted the group’s impressions of gender roles in society, and then worked towards sensitising the participants to clearly understand the experiences, value and needs of their counterparts in society. The participatory approaches were instrumental in aiding the participants in understanding the links between HIV and AIDS and gender.
Before the participatory approaches could be used, it was necessary for the participants to share a common understanding of gender concepts for easier facilitation purposes. This was also a useful means to judge the level of participants understanding and exposure to gender concepts. A comprehensive list of gender concepts was used in the exercise and the participants demonstrated a high level of knowledge on gender concepts.
The participatory methods were conducted by facilitators from EngenderHealth South Africa, using the Men as Partners model, and Women’s Action Group of Zimbabwe.
· Looking at our values – large group activity that is used to identify the participants’ perceptions and impressions of gender issues. Statements are read out and the participants stand under signs that read ‘Agree’ or ‘Disagree’ depending on their personal view for that statement.
· Gender box – large group activity to identify the differences between the rules of behaviour for men and women and to understand how these differences affect their lives.
· Gender fishbowls – large group work where members develop a better understanding of and empathy for the experiences of the other gender
· Levels of Risk – large group work to identify the levels of HIV risk in certain pleasurable behaviours
· Taking Risks / Facing Risks – small group work to identify who faces more HIV risks and who takes more HIV risks
· Men’s Role in HIV and AIDS work – small group work to identify ways that men and male figures can become more involved in HIV and AIDS work
· Sexual violence in our daily lives – large group work to understand the many ways in which our lives are limited by male violence, especially sexual violence
· Healthy and unhealthy relationships – large group work to identify healthy and unhealthy behaviours that exist within relationships
· Risks of alcohol abuse – large group work to identify the physical, emotional and mental effects of alcohol.
· Want / Don’t Want – small group work followed by ad hoc role plays to discuss the variety of reasons why individuals chose to engage, or not engage, in certain activities and behaviours.
Although the above sessions did not make up the entire program, the sessions were instrumental in enabling SAT to identify the gaps in their partner’s gender sensitivity, as well as allowing the partner’s members to identify their own shortcomings and understanding the effects these shortcomings can have in their own communities.
Results
Gender concepts
The participants had a high knowledge level of gender concepts and most reported that they been through some gender based training or toolkit previously. Although the participants could engage in lively discussion related to gender concepts, it became clear that most still held stereotyped views on gender roles in society. This became apparent in later sessions that required the participants to share their opinions with the group.
Gender roles
The participants were asked to think about what it means to act like a man or a women and this ultimately allowed them to create ‘Gender Boxes’ that outlined the rules for being men and women in Southern African society. Once the lists were generated, the participants were asked to give their impressions of the differences between the lists. They were asked to indicate where they felt the most power was situated – with men or with women? There was unanimous agreement that there is uneven distribution of power in the communities where SATs partner CBOs work.
Table 1
Act like a man / Act like a lady· Be strong
o don’t cry
o don’t show emotion
o don’t act like a woman
o don’t be a coward
o don’t be weak
· Be brave
· Be aggressive
· Stick to your decision
· Be in charge
· Have multiple sexual partners
· Must be the one to propose sex
· Be the breadwinner
· Be the head of the family
· Take risks
· Be violent / · Dress smart
o Be well dressed
o Wear a skirt
o Be sexy, but not too sexy
· Be gentle
· Never complain
· Look pretty
· Don’t play boy’s games
· Please your husband
· Be passive
· Be submissive
· Always obey
· Don’t be a representative
· Always be clean
· Your place is in the kitchen
· Be seen and not heard
· Cry
The participants also agreed that these rules led to increased risk of HIV and AIDS in their community.
Transformed gender roles
The participants were asked to think about individuals that behave in ways that are outside the ‘gender boxes’ and to comment on how they are perceived. Men are considered to be cowards, sissies (wimps) and sometimes bewitched while women are considered to be acting like men, lesbians, un-African and being loose.
The participants were asked if they still felt that acting outside of the box was a bad thing or if there were certain behaviours that were acceptable and the participants agreed that some behaviours were indeed acceptable. Separate lists were created for men and women who behave outside of the gender boxes. The lists are shown in table 2
Table 2
Transformed women are / Transformed men are· Assertive
· Informed
· Involved in joint decision making
· Strong willed
· Possessed with correct risk perceptions
· Supportive
· Independent, economically
· Enjoying their human rights / · Assertive
· Informed
· Caring
· Supportive
· Responsible
· Positively able to express their emotions
· Share decision making
· Health seeking behaviour – ‘ABC’
· Tested regularly - knowing his status
The participants were pleased that there were strong similarities between the transformed men and women. They were confident that these similarities would allow power to more equally shared.
Sharing life experiences
In order to allow the different sexes to understand what this uneven power shift feels like for the opposite sex, the participants took part in a ‘Gender Fishbowl’. This required men and women to separate, the women sat facing inwards in a circle in the middle of the room and the men sat in an outside circle. The women were then asked questions and the men were required to listen only. There was no structure for responding, the questions were merely used to instigate conversation amongst the women. After some time, the men changed places with the women and the women were only allowed to sit and listen to the men’s conversation.
Levels of HIV risk
In order to allow the participants to understand how gender roles contribute to increased HIV risk, the participants were lead through a session titled ‘Levels of Risk’. After engaging in small group work, the participants realised that there were definite differences in the risks for men and women and that the difference is largely that men take more HIV and AIDS risks whereas women face more HIV and AIDS risks. This is due to the strong link between risks and power. Table 3 comprises the differences between male risks and female risks as generated by the participants.
Table 3
· Are more daring
· Have economic muscle and this leads to
o Paying for sex
o Acquiring multiple sexual partners
o Drinking excessively
o Taking drugs
· Male gender norms [refer table 1 ‘Act like a man’] / · Their biological ‘make-up’ makes women more susceptible to infection – their vaginal membranes are fragile
· Less power to negotiate for safer sex practices
· Most care givers in the community, caring for HIV positive patients, are women and therefore their exposure is automatically higher
· Some cultural practices relating to females increase risk, such as sexual cleansing
· Women are economically and socially less empowered than men
· Women generally have less access to education
· Gender based violence
Sexual violence
The participants were asked to indicate how they personally handle sexual violence. The men in the group made it known that they felt men were not at risk of being victims of sexual violence and so the facilitator asked them to rather think of reasons why men don’t engage in sexual violence and women to highlight actions they take to avoid being victims. Table 4 contains the outcomes of the session.
Table 4
What motivates men not to commit sexual violence? / What do women do to avoid being the victims of sexual violence· Avoiding Jail / · Walk around with a serious face to look tough
· Don’t walk around at late hours
· Avoid dangerous places
· Avoid bars and getting drunk
· Avoid having to travel at night
· Don’t go out alone
· Stopping only at garages that are well lit
· Don’t wear revealing clothes
· Make sure men don’t get too close
· Avoid talking about sex with men
· Don’t open up to men
· Always watch your back
· Be aware of everything in your surroundings
Discussion
The men in the group agreed that they had not paid much attention to what it must be like to live life as a woman in a very male dominated environment and that they truly were moved towards understanding the nature of a women’s perspective. The women acknowledged that they were made more aware of the pressures men experience, throughout their lives, to ‘act like men’ and match the macho model required by society. All agreed that with this understanding, society can work towards easing the pressures on people to fill gender boxes, and that being a man is not very different from being a woman in terms of pressures and expectations to conform.
‘Gender dynamics can render women powerless to make decisions. Men often hold decision making power over matters as basic as sexual relations and when and whether to have a child or even seek health care. But most reproductive health programmes focus exclusively on women’ 2
In May 2006, the Southern African Development Community hosted an Expert Think Tank Meeting on HIV Prevention in High Prevalence Countries in Southern Africa. One of the key priority areas for programming that was identified at the Think Tank as to address gender issues with a special focus on male involvement and responsibility for sexual and reproductive health, HIV prevention and support. 3
A 2007 draft SADC strategic action plan for 2008-2010 lists gender equity promotion within HIV responses as a remaining gap in regional interventions.4 Key players have acknowledged that interventions have been flawed and somewhat polarised in their approach to gender and, through this activity, SAT has learned a valuable lesson in that true Gender Mainstreaming goes beyond equity and equality.