Initiatives involving men and boys - MASVAW (India)
Responding to imbalances of power for HIV prevention: What is needed?
1. Transforming gender attitudes, behaviour and norms at multiple levels
Need to address imbalances of power
According to public health experts, it is necessary to devise and implement strategies and interventions that directly and intentionally address imbalances of power between men and women in their sexual relationships. This implies overcoming the obstacles these power imbalances present for communication, safer sex negotiation, and HIV and AIDS risk reduction. Research findings show that addressing gender issues in the context of HIV prevention can lead to improvements in reducing HIV risk through, for example, increased condom use and reduction in partner violence.
Most programmes focus on men and boys
For real change to take place, experts argue, more programmes need to work to change gender-based attitudes, behaviour and norms. Yet most of the programmes that work in this transformative way focus on men and boys, rather than on women and girls or on both men/boys and women/girls. Therefore much of the evidence for reducing HIV risk through interventions that directly address gender-based, attitudes, behaviour and norms has come from projects targeting masculinity and men/boys.
Successful short-term programme
- "Programme H" from Instituto Promundo
In Brazil, Instituto Promundo’s Programme H is an example of a short-term programme that has successfully tackled gender-based issues. The six-month programme involved working with young men aged 14-24 who live in poor neighbourhoods in two different cities. Both groups participated in an set of educational activities that included a video and interactive group sessions (once a week for two hours). In one of the cities, the programme also included a community-wide ‘lifestyle’ social marketing campaign, using gender-equality messages to promote condom use.
Positive results impact study
The impact study integrated into Programme H revealed that, at the end of the six months, many participants in both groups agreed less with gender norms associated with higher HIV risk, such as thinking that men need multiple sex partners or that it is justified to beat a woman if you think she deserves it. Participants reported fewer STD symptoms, higher condom use with primary sex partners, and increased communication between couples about HIV and AIDS. The outcomes tended to be even stronger in the group where the lifestyle campaign ran. A one-year follow up showed that the positive changes were maintained. Furthermore, a control site that did not undergo any intervention showed no changes on any of the factors studied.
Intervening beyond the level of the individual
The evidence from Programme H confirms that HIV and AIDS programmes that focuse on changing gender perceptions and norms should include approaches that intervene beyond the level of the individual. Working at community level provides the support and sustainability for change. Community-oriented efforts can include a range of activities, from group discussions with leaders to broader level awareness raising and social marketing.
What else is needed?
If you are interested to learn what else is needed to respond to imbalances of power for HIV prevention, click on the heading of your interest:
2. Women's rights: A framework for positive change
3. Material support
