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Marginal men, respectable masculinity and access to HIV services through intimate relationships with female sex workers in Kampala, Uganda

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  • Mbonye, Martin
  • Siu, Godfrey
  • Seeley, Janet

Abstract

Masculinity influences men's sexual risk-taking behaviour and affects uptake of HIV services. We draw on data from a year-long (2019) ethnographic study focusing on men in relationships with female sex workers (FSW) in Kampala, Uganda to examine how and why two marginalised groups of people may interact to produce positive health behaviours. Data from in-depth interviews, focus group discussions and participant observation were collected and analysed. We discuss three main themes; the first of which focuses on marginalised masculinities and HIV risk. In this theme we show how accounts of men's life trajectories portrayed a remarkably similar pattern of early deprivation of opportunities and how this shaped construction of risky masculinities. The second theme describes men's relationships with FSW and how this facilitated access to HIV services. We discuss how very marginal women (FSWs) help very marginal men adopt more positive health behaviours. We show how threats to masculinities arising from sex work stigma, men's failure to have exclusive sexual rights over their FSW partner, and men's economic disadvantage are negotiated and dealt with to create an enabling environment for men's uptake of HIV services. The final theme focuses on the positive and negative practices of the men after engaging with HIV services. We conclude that the two marginalised groups can mobilise and combine new aspirations to produce positive health behaviours manifested through FSW assisting their male partners to access HIV services. We suggest that this perspective opens up new opportunities for engaging with marginalised groups and tackling the problem of high HIV infection among key populations.

Suggested Citation

  • Mbonye, Martin & Siu, Godfrey & Seeley, Janet, 2022. "Marginal men, respectable masculinity and access to HIV services through intimate relationships with female sex workers in Kampala, Uganda," Social Science & Medicine, Elsevier, vol. 296(C).
    • Handle: RePEc:eee:socmed:v:296:y:2022:i:c:s0277953622000454
    DOI: 10.1016/j.socscimed.2022.114742
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    References listed on IDEAS

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    1. Schmidt-Sane, Megan M., 2021. "Provider love in an informal settlement: Men's relationships with providing women and implications for HIV in Kampala, Uganda," Social Science & Medicine, Elsevier, vol. 276(C).
    2. Courtenay, Will H., 2000. "Constructions of masculinity and their influence on men's well-being: a theory of gender and health," Social Science & Medicine, Elsevier, vol. 50(10), pages 1385-1401, May.
    3. Mahalik, James R. & Burns, Shaun M. & Syzdek, Matthew, 2007. "Masculinity and perceived normative health behaviors as predictors of men's health behaviors," Social Science & Medicine, Elsevier, vol. 64(11), pages 2201-2209, June.
    4. Silberschmidt, Margrethe, 2001. "Disempowerment of Men in Rural and Urban East Africa: Implications for Male Identity and Sexual Behavior," World Development, Elsevier, vol. 29(4), pages 657-671, April.
    5. Syvertsen, J.L. & Bazzi, A.R. & Martinez, G. & Rangel, M.G. & Ulibarri, M.D. & Fergus, K.B. & Amaro, H. & Strathdee, S.A., 2015. "Love, trust, and HIV risk among female sex workers and their intimate male partners," American Journal of Public Health, American Public Health Association, vol. 105(8), pages 1667-1674.
    6. Wojcicki, Janet Maia & Malala, Josephine, 2001. "Condom use, power and HIV/AIDS risk: sex-workers bargain for survival in Hillbrow/Joubert Park/Berea, Johannesburg," Social Science & Medicine, Elsevier, vol. 53(1), pages 99-121, July.
    7. Campbell, Catherine, 1997. "Migrancy, masculine identities and AIDS: The psychosocial context of HIV transmission on the South African gold mines," Social Science & Medicine, Elsevier, vol. 45(2), pages 273-281, July.
    8. Kippax, S. & Stephenson, N., 2012. "Beyond the distinction between biomedical and social dimensions of HIV: Prevention through the lens of a social public health," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 789-799.
    9. Scambler, Graham & Paoli, Frederique, 2008. "Health work, female sex workers and HIV/AIDS: Global and local dimensions of stigma and deviance as barriers to effective interventions," Social Science & Medicine, Elsevier, vol. 66(8), pages 1848-1862, April.
    10. Siu, Godfrey E. & Seeley, Janet & Wight, Daniel, 2013. "Dividuality, masculine respectability and reputation: How masculinity affects men's uptake of HIV treatment in rural eastern Uganda," Social Science & Medicine, Elsevier, vol. 89(C), pages 45-52.
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