Esto fue publicado en esta revista, como esta en ingles la traduccion es libre:
Changing ingrained male attitudes is crucial to HIV prevention in El
Salvador, writes Progressio development worker John Bayron Ochoa
THE LEADING ROLE THAT MEN PLAY in the spread of HIV in Latin America poses questions about masculinity, men’s practices and risks. I will share some reflections about my experience in El Salvador on this issue. The organisation that I work with is called CONTRASIDA: it’s a Christian inspired organisation, made up of people committed to responding to the HIV epidemic in El Salvador. I work with the masculinities team within CONTRASIDA’s prevention programme. The masculinities approach seeks to raise the awareness of key men – leaders and role models, from different political, social and cultural backgrounds, aged from 17 to 60 – and of men involved in working on effective responses to HIV. This is so that they continue their transformations towards fairer and more equitable relationships with women, with other men, and with themselves. All this will contribute to an increase in the number of men playing a positive role in HIV prevention. What does it mean to be a man in El Salvador? Generally, being a man is characterised by domination, control and violence towards women and other men, and innumerable risky practices in exercising his sexuality. To overcome this – that is, ‘to leave behind, defeat, resolve’ this – will contribute notably to a clear reduction in the spread of the HIV epidemic in Latin America. It is for this reason that working on the relationship between masculinities and HIV, in groups made up exclusively of men, has an effect on the knowledge, attitudes and practices related to the virus and its spread. In the workshops, real life and participatory processes are used, with methods such as theatre, interactive techniques, team games, music therapy and art therapy, amongst others. No distinctions are made between the participants on the basis of age, level of education or knowledge. The aim is to raise the participants’ awareness of the implications, risks and challenges that hegemonic, traditional or machista masculinities have, and of the way these represent a large obstacle in the path to HIV prevention.
The following are some myths and practices related to the way of being a man, as identified by many of the participants. You can see the implications that the myths have for the men themselves, the people with whom they have intimate relationships, and at a social level in the context of risk in which they find themselves.
Myths, practices and the context of risk in the sexuality of Salvadorian men
• Doesn’t think about the consequences
• Must have sex
• It’s only numbers and more numbers
• When drunk it doesn’t matter who you do it with
• Must not be afraid
• It doesn’t feel the same with a condom
• Has sex with many women; likes to be promiscuous
• Does not use a condom
• Does not care for himself sexually, which leads to passing infections to the opposite sex
• Alcohol is an excuse not to remember
• Always ready for a sexual encounter
• Lots of sex with lots of people
• With prostitutes you can do everything
• Is violent
• He decides when he wants it and how he wants it
• Is opportunistic, takes advantage of everything he encounters
The following myths and beliefs often strengthen discrimination against people with HIV.
Myths and beliefs about HIV and AIDS
• It’s contagious, it’s synonymous with death, and people with HIV or AIDS should be isolated and hospitalised
• People with HIV are dirty
• A punishment from God
• It’s a gay disease
• It’s their own fault
• Keep away from him (or her) because
focus: HIV and AIDS
they’ve got AIDS
• It happens because of the people you hang around with
• If only they would die, then they can’t infect any more people
• They deserve it
• They are paying for it
• It goes away if you go to church
• You shouldn’t touch people
• A punishment for lack of sexual control
• Perverts get it
• It’s an illness created in order to reduce the population
This is more evidence that hegemonic or machista masculinities generate vulnerability for men and for women, and that they are an obstacle to sustainable and effective prevention campaigns.
What do men say, and in what ways do they change?
The first reactions during the processes or the monitoring days are of shock at the existence of spaces exclusively for men to talk about being a man and HIV.
A commitment and willingness to participate in the whole process and similar events emerges. Three or four months after having begun the process, the male participants begin to express small changes in their lives. In addition, the people with whom they live or work notice significant changes in the men’s behaviour.
The following are some accounts by some men about changes in their lives, after having participated in the CONTRASIDA Masculinities and HIV Prevention basic processes.
On a personal level
They themselves recognise that they already think a bit more about expressing aspects related to their personal lives, and in relation to the treatment of women. Looking at what has been their experience of being a man, or their masculine identity, has allowed them to achieve a greater capacity for introspection and self-reflection, which they often said they did not have previously:
• ‘It has made me more aware of attitudes and behaviours that I had before, even if I have not managed to make many changes… more than anything it has helped me to do a self-diagnosis of myself…’
• ‘It has made me reflect on what I was like when I was young, what I am like now, and what I want to become. Now I have clear aims and I am excited to see what I was missing when I was more machista…’
• ‘I have realised that I am quite machista, despite the fact that I have lived with just women…’
At an interpersonal level
A key aspect of the masculinities approach is that the majority of participants become advocates of the workshops, promoting them and
recommending that their friends and family participate in the workshops, or at least making sure that they know what the workshops consist of:
• ‘For me it was a shock, as I did NOT consider myself to be machista, so I shared it with my friends. The good thing is that my family support me in continuing this process…’
• ‘I have had changes with my family, in my attitude towards my son. There have been things that I have changed as I go along, the way I educate my son is one of those things. My wife works, and I take care of the house. I cook… I am happy to be doing what I am doing. It’s going well for me. My oldest daughter is 18 and she says to me: “Dad, what’s happened to you? You’ve changed!” There has been a
At an objective level
This sphere takes into account changes in aspects which are directly related to the projects and themes of HIV prevention:
• ‘It has made me want to get an HIV test…’
• ‘It will be really useful for me, given that in the gay community machismo is also present…’
• ‘I like the diversity, the difference in ages. It’s never too late to learn. It’s really important to be in a group of men…’
Those of us involved in this work strongly believe that the masculinities approach can make a big contribution to effective and sustainable prevention. But it is very important that in the work with men who are looking at their masculine identity and their relationship to the
spread of HIV, attention is given to the structural changes in each person: that is, the real changes in the conception and negotiation of daily life. Because in the traditional masculine vision, it has always been that changes and transformations have to be firstly at a structural level so that personal changes can occur. So perhaps Progressio’s slogan could be taken further: changing lives, changing minds, changing structures…
John Bayron Ochoa Holguín is a
Progressio development worker with
CONTRASIDA, the María Lorena
Salvadorian Foundation for the Fight
Against AIDS, in El Salvador."