Masculinity as a barrier to men's use of HIV services in Zimbabwe
Open accessAbstract
BACKGROUND: A growing number of studies highlight men's disinclination to make use of HIV services. This suggests there are factors that prevent men from engaging with health services and an urgent need to unpack the forms of sociality that determine men's acceptance or rejection of HIV services. METHODS: Drawing on the perspectives of 53 antiretroviral drug users and 25 healthcare providers, we examine qualitatively how local constructions of masculinity in rural Zimbabwe impact on men's use of HIV services. RESULTS: Informants reported a clear and hegemonic notion of masculinity that required men to be and act in control, to have know-how, be strong, resilient, disease free, highly sexual and economically productive. However, such traits were in direct conflict with the 'good patient' persona who is expected to accept being HIV positive, take instructions from nurses and engage in health-enabling behaviours such as attending regular hospital visits and refraining from alcohol and unprotected extra-marital sex. This conflict between local understandings of manhood and biopolitical representations of 'a good patient' can provide a possible explanation to why so many men do not make use of HIV services in Zimbabwe. However, once men had been counselled and had the opportunity to reflect upon the impact of ART on their productivity and social value, it was possible for some to construct new and more ART-friendly versions of masculinity. CONCLUSION: We urge HIV service providers to consider the obstacles that prevent many men from accessing their services and argue for community-based and driven initiatives that facilitate safe and supportive social spaces for men to openly discuss social constructions of masculinity as well as renegotiate more health-enabling masculinities.
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Some men may learn their HIV status and keep it a secret to avoid threatening their masculinity.
“On the other hand, some men may learn their HIV status and keep it a secret to avoid threatening their masculinity [17].”
From Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women’s perspectives (2017) · cites this paper as [17]
The fear of receiving a HIV test is well documented in the literature, with previous studies highlighting fears of loss of masculinity, power, and pride with an HIV-positive test result.
“The fear of receiving a HIV test is well documented in the literature, with previous studies highlighting fears of loss of masculinity, power, and pride with an HIV-positive test result [11, 17].”
From Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women’s perspectives (2017) · cites this paper as [17]
HIV is associated with being weak, vulnerable, and requiring help.
“HIV is associated with being weak, vulnerable, and requiring help [17].”
From Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women’s perspectives (2017) · cites this paper as [17]
Clinics are seen to be 'female spaces'.
“Clinics are seen to be “female spaces” [17, 37].”
From Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women’s perspectives (2017) · cites this paper as [17]
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References 45 · Cited by 321
Research works printed but not linked: 4
- Connell R Masculinities 1995 Berkeley, CA: University of California Press
- Clatterbaugh K Contemporary perspectives on masculinity: men, women and politics in US society 1997 2 Boulder; Oxford: Westview Press
- Lindegger G Maxwell J Shefer T, Ratele K, Strebel A, Shabalala N, Biukema R Teenage masculinity: The double bind of conformity to hegemonic standards From boys to men 2007 Cape Town: UCT Press 94 112
- Campbell C Skovdal M Mugurungi O Nyamukapa C Gregson S "We, the AIDS people...": Through what mechanisms have antiretroviral therapy created a context for ARV users to resist stigma and construct positive identities? American Journal of Public Health in press
- Authors
- Skovdal, M., Campbell, C., Madanhire, C., Mupambireyi, Z., Nyamukapa, C., & Gregson, S.
- Affiliations
- London School of Economics and Political Science (GB)
- Biomedical Research and Training Institute (ZW)
- Corresponding author
- Skovdal, Morten
- Venue
- Globalization and Health
- Published
- 2011
- Volume
- 7
- Issue
- 1
- Pages
- 13
- ISSN
- 1744-8603 (ISSN-L)
- PMC
- PMC3107786
- OpenAlex
- W2130327185
- Cited by
- 321
- References
- 45
- Citations by year
- 2026: 12 · 2025: 13 · 2024: 17 · 2023: 15 · 2022: 18 · 2021: 38 · 2020: 26 · 2019: 21 · 2018: 22 · 2017: 22 · 2016: 22 · 2015: 25 · 2014: 32 · 2013: 24 · 2012: 7
- FWCI
- 54.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Globalization and Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (acceptedVersion)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Greater South Information System
- Funders
- Wellcome Trust (84401)
- Topics
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › HIV/AIDS Impact and Responses
- Keywords
- masculinity, HIV service uptake, hegemonic masculinity, antiretroviral therapy, HIV counseling, biopolitics, rural Zimbabwe, healthcare workers, community initiatives
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