Engaging men and boys

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“It’s important that we engage men and boys. If we’re serious about finding solutions, all genders must be sitting at the same table, having conversations and finding solutions that will help everyone.”

Ndumiso Madubela, Program Specialist, My Journey Programme

In South Africa, most new HIV infections occur among adolescents and young adults, with HIV prevalence among young women over three times greater than men their age. NACOSA implements several programmes focused on vulnerable children, adolescents and young people. While these mostly focus on young women, engaging men and boys through dialogues and other services also forms part of the interventions.

Ndumiso Madubela, the program specialist for the My Journey Adolescent and Young People program at NACOSA, is running a dialogue session in the Northern Cape. He tells us this work is about creating a safe space for men to interrogate their roles in society and, more directly, their roles in gender-based violence and HIV prevalence in their communities. He says, “We want men to understand how they could be part of the problem and how they have the potential to be part of the solution. We want men to have these discussions in their closed circles with their friends and their families, on the street corner, and take the contents of the Dialogues back to their homes, because I think that’s what’s going to help us in moving forward.” 

In addressing the problem of HIV and its drivers, much of our effort in South Africa has been focused on response. This is, of course, vital work. But we also need to address the underlying and interlinking causes so that we can prevent it in the first place. There is, for example, a strong link between gender-based violence and HIV and AIDS, and we know that men are the primary perpetrators of this type of violence, so it follows to include them in prevention strategies. Men can become powerful allies in promoting health and gender equality if they are educated and equipped to challenge harmful gender norms, advocate for women’s rights and take action to prevent violence and promote HIV prevention. 

But how do we do this, especially when cultural and societal norms and beliefs may discourage men from seeking healthcare or discussing sexual health issues openly? 

For Ndumiso, it’s about taking the conversation to the men in their communities. He explains, “Having done the research and through working with young boys and men, we see they don’t have the space to unpack and to look at their vulnerability.” To encourage participation and engagement, today’s dialogue session is happening at a sports centre in the heart of a community in Kimberley. There’s music playing, soccer matches on the go, free haircuts and meat on a braai, alongside HIV testing, sex education and discussion groups. And the response? The event is well attended, and the discussions surprisingly robust and honest. 

Ndumiso is an informed and considered facilitator. Having grown up in a community like this one, he has a handle on many of the challenges these men are facing, and he knows how to hold a space so the participants feel they can share their experiences and views without feeling exposed. We hear a discussion about rape in marriage; “If you have sex with your wife when she doesn’t want to, is it considered rape?” Ndumiso listens carefully and allows the discussion to unfold but he doesn’t shy away from asking the men to consider new perspectives. “We live in a patriarchal society,” he says, “And statistically, women are disproportionately affected by gender-based violence, as well as HIV. So we can’t just leave things like that.” He asks participants to think about their entrenched roles of authority and privilege in society because, “It’s important that we engage men and talk to men, and we try to unpack, and we try to find solutions with men. We can’t just say, okay, just because men, certain men, or a certain group or certain gender are that particular way, we leave things like that.”

In these dialogue sessions, we learn that many men feel that when they try to access healthcare – particularly for issues related to sexual and reproductive health – they feel uncomfortable and discriminated against by the community and sometimes even the clinic staff and patients. Ndumiso shares that the participants don’t feel the traditional healthcare space is for them, “It’s female-centric, not youth-friendly, and it’s uninviting for them, which is why they don’t take up those services. But when we ask them, what is it that you want? They say they want fast, free and convenient services. And that’s why we have the mobile clinics testing.” 

Today, Ndumiso is expecting about 100 men to get tested for HIV, which, he explains, is not the norm for this area. He goes on to say that when services are offered outside of the traditional healthcare spaces and brought into the community, people respond. As Ndumiso puts it, “If adolescent boys and men have a space to be vulnerable, good things come out. And specifically with GBV, specifically with testing. Today is evidence of that. If you look behind you right now, men are testing. And that’s what we want.”

Lukhano Mendu, one of the participants, tells us that he had been thinking about testing but wasn’t sure. When he heard he could get a free haircut and get tested at the same place, he decided to come. We ask him about his experience at the dialogue sessions, and he tells us, “It gave me a chance to see how other guys think besides the opinions I have. So it broadened my horizon and the way I think.” Later in our interview, he says, “At the end of the day, the only thing that is killing us is not talking. We don’t talk to each other. We think we are vibing. We think we are good as gents when we are together, but actually, we are not good because we don’t talk about our feelings. We talk about what we are facing at that moment and then pass. But at the end of the day, when we all go to sleep, we know what is eating us inside.”

We cannot only focus on equipping young women and girls with the skills to defend themselves and reduce their vulnerabilities. It’s equally important to engage boys and men because, while it may not be possible to change decades of ingrained behaviour overnight, small steps like encouraging men to access healthcare services and inspiring young boys and men to reflect on their roles in their communities can make a significant impact towards reducing gender-based violence and preventing HIV transmission. As Ndumiso says, “I think we’ve achieved something if a man accesses a health care service – like testing – when they ordinarily wouldn’t have gone to a clinic. I think we’ve achieved something today if a young boy understands that his actions have consequences. I think we’ve achieved something today if adolescent boys and young men return home and reflect and think about their role in their communities in preventing gender-based violence. Then we would have done something right.”

Engaging men in conversations about gender-based violence and HIV is crucial in creating a safe environment for everyone, and today’s event shows us one of the ways this can be done.