• Public health vs rights based approaches

Public health vs rights based approaches

Across the world, people working on HIV/AIDS now recognise the importance of developing their work with men in order to have a real impact on the epidemic. This has involved identifying what their roles and responsibilities are in different contexts, and developing strategies to work with men on them. This case study collection, produced by the International HIV/AIDS Alliance, presents experiences and lessons from a range of projects that are working with men.

This collection describes not only HIV/AIDS projects, but also other kinds of projects that address other issues relating to men (for example, gender identity, sexuality and violence). It is organised into two parts. Part one provides an overview of HIV/AIDS and working with men, looking at why we should work with men, which men we should work with, what issues should be covered, and how to work with men. Part two contains thirteen separate case studies organised into sections covering background to the project, its goal, the issues it covers, who it works with and how, the results, and lessons from the work.

Key findings are as follows:

• Botswana has one of the worst HIV/AIDS epidemics in the world. Men play a central role in the epidemic. One project has focused on male sexuality rather than just HIV/AIDS education and the response has been positive. The number of men’s groups has grown in the last five years, and men have reported a number of changes in their sexual attitudes and behaviour.
• In Bulgaria, violence against women is a major issue. One project tackled the issue by providing health and gender education to boys and girls in secondary schools. At the end of the course boys showed less tolerance of violence and the girls showed more self-confidence.
• In Mongolia, there is no visible HIV/AIDS epidemic, but the county is vulnerable to an increase. A project targeting military recruits, focusing on HIV and sexually transmitted infection (STI) risks, used peer educators and prevention supplies. Peer educators have reported a steady increase in demand for condoms.

Lessons drawn include the following:

• The belief that men are not interested in discussing issues of sexual health, gender and sexuality is false. Given the opportunity, men are willing to learn from other’s experiences.
• It is important to be patient and sensitive in developing discussions with men on issues of gender and sexuality.
• In order to be effective in HIV/STI prevention work, it is necessary to work with men and women both separately and together.
• Working with older men or men with strong religious beliefs is a challenge because of their preconceived ideas. The best way is to listen and learn from them, and adapt your information and message based on what they have to say.
• It is necessary to challenge the view that men’s attitudes and behaviours are ‘fixed by nature’.
• Starting discussions about gender and sexuality issues with communities can lead to controversy and conflict. It is essential to create and maintain strong relationships with formal and informal community leaders.

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