HEALTH-ASIA: Slowly, Men Being Roped into Anti-AIDS Efforts

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

BANGKOK, Oct 6 2000 (IPS) - When the United Nations’ department in charge of AIDS launched its global campaign in March this year to combat the killer disease, it had men clearly in mind. Its chosen theme was: “Men Make a Difference.”

The selection by the Joint United Nations Programme on HIV/AIDS (UNAIDS) of New Delhi as the campaign’s launching pad also underscored Asia’s significance in the pandemic.

After all, the region with its 3.5 billion population has the “potential to greatly influence the course of the global epidemic,” according to the U.N. agency.

Now, six months into the global drive, there are initiatives in Asia that suggest the theme of focusing on men’s roles in fighting HIV/AIDS is being heeded.

In the Indonesian resort island of Bali, for instance, men who visit a brothel are encouraged to go beyond spending all their time with the women they seek.

They are invited to visit an outreach centre located at this brothel in the city of Denpasar which has a trained staff to engage the male clients in activities with one aim: to make them more responsible in their sexual behaviour.

There, the men learn about the significance of using condoms, are exposed to ways of stopping the spread of sexually transmitted diseases (STDs) and even get the opportunity to watch videos about the Human Immunodeficiency Virus (HIV) that causes Acquired Immune Deficiency Syndrome (AIDS).

Discussions with the outreach staff, too, are part of the experience.

A similar initiative prevails in Bangladesh, where a recreation centre near a popular ferry crossing has begun supplying AIDS information to men.

“The campaign is crucial for Asia,” says Martin Foreman, director of the AIDS programme at the London-based Panos Institute. “It is Asian men, not women, who usually determine when to have sex, who to have sex (with) and whether to use a condom.”

Paul Toh, the community mobilisation officer at the UNAIDS office in Thailand, echoes a similar view. “This year’s theme is relevant to this region given male behaviour. Men have shown little restraint in their sexual habits,” he adds.

What UNAIDS sought to achieve at the launch of its campaign was, on the one hand, to involve men more fully in the effort against the killer disease. On the other, it tried to bring about “a much-needed focus on men in national responses to the epidemic.”

“Part of the effort to curb the AIDS epidemic must include challenging harmful concepts of masculinity and challenging many commonly-held attitudes and behaviours, including the way men view risk and how boys are socialised to become men,” stated the UNAIDS’ brief on the ‘Men Make a Difference’ campaign.

UNAIDS studies have also revealed the “number of special circumstances” that place men at particularly high risk of contracting HIV. These include men who migrated for work and lived away from their families and, consequently, paid for sex.

In pursuing this year’s campaign, the UN programme spelled out three objectives — to raise awareness of the link between men’s behaviour and HIV, to encourage men and adolescent boys to make a strong commitment to prevent the spread of the virus and care for those affected, and to promote programmes that respond to the needs of both men and women.

If this message is not heeded, warns Foreman, the consequences can be dire: “There is a risk of an (Asian) epidemic the scale of Africa several years from now.”

His assessment, in fact, is not misplaced given the pace at which the killer disease has cut through Asian societies.

According to UNAIDS, there were 1.5 million adults and children who were newly infected with HIV in 1999, pushing the total figure of Asians living with the virus to 6.5 million up to that period.

Of that number, South and South-east Asia were home to 5.6 million victims, with India having the “highest”, estimated at 3.7 million.

By 1999, Asia was home to nearly 60 percent of the world’s adult population and about 20 percent of the world’s estimated HIV infections.

UNAIDS adds, moreover, that since the virus was first detected in this region in the mid-1980s, close to 1.2 million adults and children have died of AIDS.

Men have been singled out for their involvement in such a dismal reality. “The major force driving the epidemic has been heterosexual transmission,” UNAIDS reveals.

Still, these trends have not compelled men enough into changing their behaviour, admit activists working to combat the spread of HIV/AIDS in this region.

There is certainly a lot of awareness among men, yet a shift in behaviour is still not evident, says Julie Klugman, a specialist attached to the Australian Aid-backed HIV/AIDS Prevention and Care Project in Indonesia.

What is more, admits Klugman, men still demonstrate a lack of interest in discussions about safe sex when going to brothels. “It is much more easier to focus on the women, the sex workers.”

“Despite many warnings, men have not changed much over the last 20 years,” adds Chumpon Apisuk, a co-director of the Empower Foundation, a Thailand-based non-governmental organisation that works with sex workers.

Apisuk, in fact, questions “this limited approach” to combating AIDS. “I don’t believe such global campaigns will have any effect on individuals or in communities,” he declares.

Asked how AIDS should be combated, Apisuk replies: “More holistically, by focusing on all aspects of society that are linked to the disease, than isolating them.”

UNAIDS, however, justifies its efforts. “Men need to be encouraged to adopt positive behaviours, and to play a much greater part in caring for their partners and families,” says its briefing document on involving men in anti-AIDS efforts.