McDonald: Males need to be resocialised from a culture of aggression. - CARLINGTON WILMOT/FREELANCE PHOTOGRAPHER
DR. DOUGLAS McDonald, senior medical officer, Victoria Jubilee Hospital, and consultant gynaecologist:
GENDER HAS a powerful influence on sexual behaviour and gender stereotypes of passive women and active men encourage patterns of behaviour that put both sexes at risk, compromising their sexual well-being and increasing their vulnerability to HIV infection.
SOCIAL PRESSURE
Men are socialised to believe that masculinity is associated with action. They should be dominant and domineering, aggressive and assertive, combative and competitive, reckless and risk takers.
They must be seen as strong and virile and by implication promiscuous. Having many sexual partners is part and parcel of manhood. A man's prowess and ability to produce many children is seen as a sign of strength.
As part of their dominance, it is men who decide where, when and with whom they have sex and whether or not a condom is to be used, believing that women have no control over their bodies and fuelling the myth that when a woman says no to sex she really means yes. Young men are encouraged to be sexually active at an early age and sexual initiation is often seen as having arrived at the 'pearly gates' of manhood.
The perceived need for men to maintain a strong heterosexual male identity thus leads to a high degree of risk taking, which includes drinking, smoking, violence and unsafe sex, all of which increases their vulnerability to HIV infection.
WOMEN MISEDUCATED
Society prepares girls to be submissive, faithful, obedient and inferior to men. If she appears to be too sexually knowledgeable, she is not considered a lady. If her sexual behaviour is linked to pleasure rather than to reproduction, she is thought to be immoral.
WOMEN VULNERABILITY
The vulnerability of women and girls is locked into their lack of equality, resources and opportunities and their powerlessness put them at greater risk of HIV infection. Women are more likely than men to be raped, sexually molested and (be) victims of incest ... of course, heightening the risk of HIV infection in young women and girls.
Because many women are economically dependent on their partners, few can refuse unwanted or unprotected sex, few can negotiate condom use or even use contraceptive against a husband's or partner's wishes. If she attempts to do so, she faces the risk of abuse, violence, abandonment or withdrawal of his financial support.
For this reason, many women accept their partner's extramarital affairs, though these behaviours place them at increased risk of HIV infection from their philandering spouses, many of whom will actually be having sex not only with other women but, in many instances, other men. For these reasons, married women or women in a stable intimate relationship are the largest group of women currently at high risk of HIV infection.
