In order to understand men, masculinity and sexuality in rural and urban East Af­rica it has been necessary to locate men and women within the complex and changing social, political and economic systems. As my research from both rural Kisii and urban Dar es Salaam shows, sexuality and sexual behaviour do not occur in a vacuum but in (changing) social contexts where men and women are submit­ted to prescribed gender roles, norms, values and expectations. However, though still anchored in traditional values, present norms and values have become con­flicting and contradictory and men have difficulties in maintaining their expected role as head of household and provider. Ideologically, men are the dominant gen­der and women’s position is clearly subordinate. In practice, however, and as al­ready observed a decade ago in Kisii, men’s dominant position is slowly being wa­tered down—contrary to that of women (Silberschmidt 1992).

Men in my research studies are perfectly aware that they are in a process of los­ing control over women. In this situation, and faced with increasing demands for women’s empowerment and rights, including their sexual and reproductive rights, most men are not welcoming the traditional safe sex messages, including ‘sticking to one partner’. Therefore, strategies to empower women and improve their deteriorating sexual and reproductive health are only meaningful if they are balanced against efforts to deal with men’s increasingly frustrating situation. This, I shall argue, is a major development issue that has so far remained unnoticed both on the development agenda and also in the existing efforts to ‘involve men’.

Returning to the question raised at the beginning of this chapter: ‘Are disem – powered men in East Africa motivated for responsible sexual behaviour and HIV/AIDS prevention?’, the immediate answer is ‘no’. With present masculini­ties still being strongly rooted in the past, with men faced with increasing disem – powerment, I argue that men will not willingly let go of their previous privileges. Men seem to cling to their previous positions of power. And as demonstrated above, they do this through irresponsible sexual behaviour. As long as men con­form to hegemonic masculine values and behaviours not only women’s health is at serious risk but their own health is at stake.

Consequently, there is first of all an urgent need to analyse in more detail the commonly accepted notions of male domination and women’s subordination. While the patriarchal ideology may be embodied and expressed in the lives of men and women, this does not mean that all men are successful patriarchs or that all women are submissive victims. In actual fact, as demonstrated above, matters work out very differently in practice. Nevertheless, to a large extent such stereo­types still underlie today’s HIV/AIDS prevention efforts by international agen­cies and local NGOs.

ConclusionsConclusions
Most HIV/AIDS prevention campaigns today target women. Obviously women are in an exposed and vulnerable situation— there is no doubt about that, in particular as reagards their sexual and reproductive health. Even if many wom­en have acquired control and even power in many spheres of their life, they are also exposed and victimised in their sexual relations—much more than in any

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Margrethe Silberschmidt

other relationships. It is my argument, however, that more attention must be paid to men.

Efforts to address men, however, are charged with considerable difficulties. First, men’s interest in maintaining patriarchy is defended by all the cultural ma­chinery that exalts hegemonic masculinity. Consequently, a focus on male sexual and reproductive behaviour addresses and threatens established male privileges in societies that are strongly patriarchal. Second, an understanding of support to men as being a support to women is seriously lacking. Instead, there seems to be a profound fear that activities aimed at men might result in being at the cost of those aimed at meeting women’s urgent needs. Third, men’s changed roles, their disempowerment and the consequences for their sexual behaviour seem to have escaped general attention among local governments and also donors. Fourth, nei­ther policy makers nor information, education and communication (IEC) cam­paigns deal with the fact that sexuality and reproduction in East Africa are sym­bols vested with different, often opposite meanings for men and women.

Based on my research findings, I want to argue that HIV/AIDS preventive ef­forts need to be based on an understanding of the cultural and social context in which sexuality occurs; an understanding that recognises that sexuality is deeply rooted in male gender identity and that men and women engage in sexual relations for different reasons. ‘Male involvement’ requires specific education and services addressing the reproductive health needs of men and not only those of women as is the case today. My findings strongly indicate that male involvement cannot take place unless men’s self-interest is addressed (cf. Bandura 1997), and men feel that they themselves will also benefit from such involvement, that involvement and male responsibility in sexual matters do not mean losing their masculinity but the opposite. This being said, I also support the following notions of Baylies and Bujra based on their studies from Tanzania and Zambia:

While self-interest needs to be highlighted, it is crucial that the mutuality of interests of men and

women be kept at the forefront of anym strategy. It is gender relations, the position, interaction,

rights and responsibilities of both women and men, which are pivotal (2000:23).

Thus in order to best meet the needs of women and to improve their sexual and reproductive health, men must be addressed in the same way as women and with efforts that are appealing to men—for women’s sake.