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In AIDS fight, men make a difference
Vincent Nwanma, Africa Recovery
Extracted from Africa Recovery, Vol.15 #4,
December 01, 2001

http://www.un.org/ecosocdev/geninfo/afrec/vol15no4/154aids.htm

Nigeria, like other African countries, is marked by a "patriarchal society," says Mr. Owei Lakemfa, a leader of the Nigerian Labour Congress (NLC). "Men think they have the liberty to have as many wives or girlfriends as they want," thereby contributing greatly to the spread of HIV/AIDS. Given this reality, he explains, Nigeria's central trade-union federation believes that "a lot of attention should be given to men" in the struggle to combat the disease.

Mr. Ubon Akpan, a Nigerian media executive, agrees. He highlights the inordinate power that men have over women in economic, political and family life. "The man has the financial backing," he says, "as well as the backing of tradition." In many African cultures, he points out, adultery is considered a "female crime," while men are permitted to "parade" multiple women.

Ms. Nkechi Nwankwo of the Women Leadership Group, a non-governmental organization (NGO) in Nigeria, believes that aspects of traditional culture can themselves be utilized to alter men's behaviour. Although men exercise considerable power over women in traditional African cultures, she says, those norms also obligate men to take care of their wives, children and other family members. "Real men protect women from HIV/AIDS," proclaimed T-shirts worn by participants in a workshop for media practitioners from Nigeria and Ghana organized by the NGO in Jos, Nigeria.

In Zimbabwe, another group, known as Padare/Enkundleni, argues that prevailing notions of male roles and behaviour can be changed, both through more open dialogue with women and through critical self-examination by men themselves. Initially organized by a group of male friends, Padare has since grown into a network of 13 groups of men across Zimbabwe, one of its founders, Mr. Jonah Gokova, told Africa Recovery in New York. The organization received an "Africa Leadership Prize" from The Hunger Project, a US-based international NGO, in October.

"Now it's time to take on the challenge and begin to find a way of discovering who we are and encouraging each other to project a positive image of manhood that is not dependent on the oppression and abuse of women," Mr. Gokova says. In addition to questioning gender stereotypes, Padare addresses the spread of HIV/AIDS, asking men: "What role have men played in perpetuating unhelpful assumptions that have resulted in women taking the burden of HIV and AIDS?"

Such examples of positive action are in line with the "Men Make a Difference" campaign of the Joint UN Programme on HIV/AIDS (UNAIDS) and other anti-AIDS organizations. Their goal is to complement prevention programmes for women and girls with work that more directly involves men as well. "The time is ripe to start seeing men not as some kind of problem, but as part of the solution," declared a May 2000 UNAIDS report.*

Pushing condom use
Recognizing that women are at a disadvantage in negotiating sexual relations with men, Nigeria's NLC takes a very practical approach, by trying to convince the many men who belong to its affiliated unions to use condoms. The labour federation does not preach, says Mr. Lakemfa, or tell its members "don't do this or that." It seeks instead to help its members identify the dangers and issues involved. "All you can do is to help a man reach his own conclusions and make his decisions."

The NLC has a membership of about 5 million. It encompasses all industrial labour unions in Nigeria, as well as teachers, non-academic staff at educational institutions up to the universities and employees of the local government councils. "Most of our members are men," Mr. Lakemfa says, adding that the congress's size and composition place it in a "unique position" to carry the anti-AIDS message down to the grassroots.

As part of its campaign against the spread of HIV/AIDS, the NLC has held several workshops of trade union leaders, coordinated by full-time union staff employed specifically to work on its AIDS campaign. "The strategy is to get the union leaders sufficiently enlightened and organized, and let them mobilize their own members," says Mr. Lakemfa. For example, at an AIDS rally on 16 October 2001 in Abuja, the capital, the NLC invited union leaders from the states and mandated them to hold similar rallies in the 36 state capitals. In turn, other rallies and events will be held at the unions' 778 local government council headquarters throughout Nigeria.

In Zimbabwe, Padare/Enkundleni is finding it harder to promote condom use. "There's quite a high level of awareness," says Mr. Gokova, "but it is very difficult for a man who is married to agree to use a condom with his wife, since condoms are [considered to be] for prostitutes." This is one of the beliefs that need to be changed, he says, to achieve some meaningful results in the "Men Make a Difference" campaign.

According to UNAIDS, "In many cultures, fathering a child is regarded as a proof of masculinity. This belief virtually proscribes condom use, providing increased opportunities for HIV infection within the family, and possibly to the next generation through mother-to-child transmission."

Messengers of change
The Planned Parenthood Federation of Nigeria (PPFN), an affiliate of International Planned Parenthood, has also been involved in the campaign to reach men. It enlists community-based "agents" to talk to men in rural areas about sex, health and family planning issues. The agents include tailors, barbers and other rural professionals who are trained by the PPFN in sexual and reproductive health matters and are expected to share that knowledge with other men as they pursue their trades.

"The idea is that as other men come to patronize them in their shops, the agents will educate them, and also sell health kits to them," says Mr. David Omorebokhae, a PPFN communications officer. The programme is based on the assumption that the selected agents "know the men in the community who are exposed to risk, and can counsel them on the need for change in sexual behaviour and use of contraceptives."

The federation sells the agents non-prescription contraceptives. They in turn sell the contraceptives to the men who visit their shops, retaining a 25 per cent sales commission as an incentive.

Targeting truckers
The PPFN is currently developing another campaign aimed at men, specifically truck drivers. "They are responsible, to a large extent, for the spread of HIV/AIDS," says Mr. Omorebokhae. The first known AIDS patient in Nigeria -- discovered in 1986 -- was a truck driver.

UNAIDS has identified long-distance truck haulers as a group that is especially exposed to risk in the HIV/AIDS epidemic. Their jobs take them away from homes for days or weeks, and they often move from one region to another, engaging in sexual relations with different women along their routes.

The PPFN programme, launched in October 2001, seeks to recruit and train drivers to educate their fellow truckers about the need for safe sex and other AIDS-prevention issues, starting initially in the states of Edo, Kano, Niger and Jigawa. It will include the use of community theatres to entertain the drivers at major stopover points. So in addition to education, the campaign will provide the drivers with alternative forms of relaxation, other than sex with the commercial sex workers who ply their trade along the truck routes.

In Zimbabwe, the National Employment Council for the Transport Operating Industry works with truck drivers on similar programmes.

Churches also involved
The Assemblies of God Church, Ikate, in Surulere, a suburb of Lagos, holds Sunday evening programmes to educate its 2,000 members about the dangers of HIV/AIDS. It brings in outside speakers, such as Dr. Dickson Eze of the Lagos University Teaching Hospital, who recently explained to parishioners how men are far more likely to infect women with HIV than the other way around.

"We want to create awareness by bringing in experts to speak on this deadly disease," explains Rev. Samuel Oshodipe, the church's pastor. While the education programme is for every member of the church, he says the prime target is the younger members.

The church now makes HIV/AIDS testing a pre-condition for the marriages it conducts, "so that an innocent party does not enter into trouble unknowingly," says Rev. Oshodipe. He realizes how difficult the campaign will be, but believes it will make an impact if "we can preach more and teach more about the purpose of marriage. We should be able to teach men that the purpose is not only sex." The church, he says, emphasizes the Biblical injunction that men honour their wives and give them due respect.

Need for dialogue
Dr. Eze told of one case in which a husband was HIV-positive and the wife HIV-negative, but she insisted on sex without a condom so that she could conceive another child. Such complex responses to the anti-AIDS message emphasize the importance that UNAIDS and other campaigners attach to greater dialogue on sex and family matters among and between the sexes. They insist that men, women, children and other community members talk openly and frankly about issues that were previously regarded as the exclusive preserve of men. Efforts to promote such dialogue require sensitivity and a lack of recrimination, they say, since neither men nor women should be blamed for the disease's spread.

In talking with their children in particular, says Ms. Nwankwo of the Women Leadership Forum, fathers need to learn to listen to open discussions about sexual subjects that have long been regarded as taboo. They also need to know that "shouting their children down is not the answer."

Meanwhile, ways need to be found to help women negotiate safe sex with their partners, Ms. Nwankwo argues. Improved education will be key, since women "tend not to know what to do." Above all, she says, women "need to be encouraged to be assertive."

Women's empowerment is also crucial
In the fight against AIDS, intensified efforts are needed to "challenge gender stereotypes and attitudes, and gender inequalities in relation to HIV/AIDS, encouraging the active involvement of men and boys," declares the Declaration of Commitment adopted at the UN General Assembly's 25-27 June special session on the disease. At the same time, says the declaration, the "empowerment of women" is fundamental for reducing their vulnerability to infection.

Specifically, this should include "the elimination of all forms of discrimination, as well as all forms of violence against women and girls, including harmful traditional and customary practices, abuse, rape and other forms of sexual violence, battering and trafficking in women and girls." The declaration also cites discrimination in inheritance. In many parts of Africa, there are no effective legal provisions for women to inherit land and assets from their deceased husbands, often leaving widows destitute. Legal reforms backed by implementation mechanisms would go a long way toward preventing the downward spiral into poverty that makes women and children even more vulnerable to infection.

*This article may be freely reproduced, with attribution to "Africa Recovery, United Nations". For more information on the UNAIDS Men Make a Difference Campaign, see the Website www.unaids.org/wac/2001/index.html. UNAIDS has programme advisers in most African countries who can help involve local groups in the campaign.

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