HIV-positive men come to terms with their status

[This report does not necessarily reflect the views of the United Nations]

JOHANNESBURG-- [Names of people in this article have been changed]

In the sprawling township of Soweto, adjoining South Africa's economic hub, Johannesburg, HIV-positive men are being forced to confront male stereotypes and deal with the way they relate to women.

It's not difficult to discover what women often think about their men when it comes to HIV/AIDS. Dineo, 30, a Sowetan resident living with HIV/AIDS, has sabotaged several potential relationships because she believes no man will want her when he discovers her status.

She echoed the sentiments of many other women when she told PlusNews: "The men are the ones who spread this thing but they don't want to accept it; they gave it to us but they don't want to take treatment. They are scared. We're supposed to talk to our brothers and our men to get treatment but we, as women, are wasting our time."

Mampho, 28, a mother of two who is also HIV-positive, was angry: "I don't want to see another man next to me. I hate men - so many women I meet are complaining about them. HIV - they don't want to talk about it; they don't want to hear anything about it. I don't know why, because they are the ones who are going ... [about], changing girlfriends."

Men are frequently criticised for being in denial about the disease, and blaming women for "bringing the virus into the home". They are also accused of refusing to take responsibility for their health, and failing to practice safer sex.

Research on how unequal relationships between genders fuel the spread of HIV/AIDS also casts an unfavourable light on men.

But efforts to stem the HIV/AIDS pandemic are now offering an opportunity for a change in the way men and women relate to each other.

Nowhere is this more evident than in support groups for HIV-positive men, run by HIVSA, the psychosocial support arm of the Perinatal HIV Research Unit, based at the Chris Hani Baragwanath Hospital in Soweto.

The men, who meet each week to discuss their problems, have had to re-evaluate 'macho' behaviour, like sleeping with multiple partners, having unsafe sex and being in denial about their health, which no longer benefits them and also makes them more vulnerable to illness and isolation. Like women living with HIV/AIDS, they also experience the consequences of non-disclosure and denial: lack of support and healthcare, illness and death.

Many of the men in the group speak of the relief they feel once they have disclosed their status to partners, family and friends. They realise that communication with their partners is the only way to stay healthy and get the support they need. They also acknowledge that to have unprotected sex is to run the risk of reinfection and the rapid onset of AIDS-related illnesses.

"After disclosing, I thought that my girlfriend wouldn't want anything to do with me but, to my surprise, she wanted to carry on. She said, 'No, I understand'. Now she loves me more and more," said Thami, one of the group members.

Mandla, a middle-aged man, told the group he only truly accepted his status after disclosing it. "When I got my results I didn't tell anyone; I stopped working; I was in denial. I wanted to test again; I went to (many clinics) for testing - for two months I told no-one. Then I told my family.

He eventually realised that he had to "stop doing all the things I was doing and find the right places to go to, like clinics and support groups. Now I have accepted this. It's not only me; it's many people. But there are some people I live with - they have still not accepted their status; they are just doing the same things."

In some support groups, men and women get together to discuss their common problems and the problems they have with each other. In one group, many women recounted how their male partners intimidated them when they suggested using condoms or tried to bring up the subject of HIV.

Instead of shouting the women down, men are often taking the criticism, admitting that threatening behaviour no longer paid off.

"I realise that we, as guys, often take advantage - we know we can intimidate the ladies and get away with it," said one man during a support group meeting.

"Men are stubborn about the HIV issue - we always force our wives not to use condoms; we don't care what happens. We need to love them and look after them," another man added.

A trendy young man, Jacob, said it was time men stopped living up to the 'macho' expectations of other men. "We, as men, must stop being afraid of what other men will say, or that they will judge us. We have to be strong and open our relationships; we have to understand that our partners need to respect us, not fear us."

In the knowledge that this change of heart will go a long way towards curbing the spread of HIV/AIDS, many programmes are beginning to target men more actively.

One such initiative, the Imbizo Men's Health Project, run by HIVSA, was formally opened last week in Soweto. Imbizo's two 'drop in' centres in Kliptown and Diepkloof offer advice on health matters, HIV testing and counselling and other services in an all-male milieu.

Clinics, particularly antenatal clinics - where most of the HIV testing takes place - have been perceived as environments unfriendly to men. The Imbizo Project hopes to bring men into the health sector in a way that makes them feel comfortable, so that health - and illness - are no longer seen as 'women's problems'.

However, manhood was still the main preoccupation of the men who have begun trickling in - most of them inquired about erectile dysfunction, chuckled Imbizo counsellor David Damane.