The multidimensionality of masculine norms in east Zimbabwe: implications for HIV prevention, testing and treatment
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background: Research and intervention studies suggest that men face challenges in using HIV services in sub-Saharan Africa. To address these challenges, quantitative measurements are needed to establish the individual-level determinants of masculine norms and their implications for HIV prevention and treatment programmes.
Methods: Survey questions for four masculine norms identified in qualitative research were included in a general-population survey of 3116 men in east Zimbabwe, 2012-2013. Two sets of regression analyses were conducted in an SEM framework to examine: 1) which socio-demographic characteristics were associated with high scores on each masculinity factor; and 2) how high scores on these masculinity factors differed in their associations with sexual risk behaviour and use of HIV services.
Findings: Socio-demographic characteristics associated with high factor scores differed between masculine norms. In HIV-negative men, more men with scores exceeding one standard deviation above the mean (high scorers) for Anti-femininity than men with scores under one standard deviation below the mean (low scorers) took steps to avoid infection (61% versus 54%, p<0.01). Fewer high than low scorers on Social status reported a recent HIV test (69% versus 74%, p=0.04). In HIV-positive men, more high scorers on Sex drive had been diagnosed (85% versus 61%, p=0.02), were on antiretroviral treatment (91% versus 62%, p=0.04), and were in AIDS groups (77% versus 46% p=0.03).
Conclusions: HIV treatment, prevention programmes looking to engage men must consider the multi-dimensionality of masculine norms. The scale developed in this study is robust and can be used by other large multi-purpose surveys to examine masculine social norms.
Methods: Survey questions for four masculine norms identified in qualitative research were included in a general-population survey of 3116 men in east Zimbabwe, 2012-2013. Two sets of regression analyses were conducted in an SEM framework to examine: 1) which socio-demographic characteristics were associated with high scores on each masculinity factor; and 2) how high scores on these masculinity factors differed in their associations with sexual risk behaviour and use of HIV services.
Findings: Socio-demographic characteristics associated with high factor scores differed between masculine norms. In HIV-negative men, more men with scores exceeding one standard deviation above the mean (high scorers) for Anti-femininity than men with scores under one standard deviation below the mean (low scorers) took steps to avoid infection (61% versus 54%, p<0.01). Fewer high than low scorers on Social status reported a recent HIV test (69% versus 74%, p=0.04). In HIV-positive men, more high scorers on Sex drive had been diagnosed (85% versus 61%, p=0.02), were on antiretroviral treatment (91% versus 62%, p=0.04), and were in AIDS groups (77% versus 46% p=0.03).
Conclusions: HIV treatment, prevention programmes looking to engage men must consider the multi-dimensionality of masculine norms. The scale developed in this study is robust and can be used by other large multi-purpose surveys to examine masculine social norms.
Date Issued
2019-03-01
Date Acceptance
2018-09-06
Citation
AIDS, 2019, 33 (3), pp.537-546
ISSN
0269-9370
Publisher
Wolters Kluwer Health, Inc.
Start Page
537
End Page
546
Journal / Book Title
AIDS
Volume
33
Issue
3
Copyright Statement
© 2018 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the
Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
Sponsor
Wellcome Trust
Medical Research Council (MRC)
Grant Number
084401/Z/07/Z
MR/R015600/1
Subjects
Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Virology
HIV treatment
masculine social norms
masculinity
Zimbabwe
ANTIRETROVIRAL TREATMENT
MEN
GENDER
AFRICA
SEX
CONSTRUCTIONS
BEHAVIORS
THERAPY
STIGMA
ADULTS
Virology
06 Biological Sciences
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
Publication Status
Published