IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v296y2022ics0277953622000454.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953622000454
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2022.114742?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    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. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Homan, Patricia, 2024. "Health consequences of structural sexism: Conceptual foundations, empirical evidence and priorities for future research," Social Science & Medicine, Elsevier, vol. 351(S1).
    2. Frank, Sarah M. & Durden, T. Elizabeth, 2017. "Two approaches, one problem: Cultural constructions of type II diabetes in an indigenous community in Yucatán, Mexico," Social Science & Medicine, Elsevier, vol. 172(C), pages 64-71.
    3. Mahalik, James R. & Lombardi, Caitlin McPherran & Sims, Jacqueline & Coley, Rebekah Levine & Lynch, Alicia Doyle, 2015. "Gender, male-typicality, and social norms predicting adolescent alcohol intoxication and marijuana use," Social Science & Medicine, Elsevier, vol. 143(C), pages 71-80.
    4. Schmidt-Sane, Megan, 2022. "Male partners of female sex workers: The intersectional risk environment of HIV/AIDS in a Kampala informal settlement," Social Science & Medicine, Elsevier, vol. 298(C).
    5. Backhans, Mona Christina & Burström, Bo & Lindholm, Lars & Månsdotter, Anna, 2009. "Pioneers and laggards - Is the effect of gender equality on health dependent on context?," Social Science & Medicine, Elsevier, vol. 68(8), pages 1388-1395, April.
    6. Fast, Danya & Bukusi, David & Moyer, Eileen, 2020. "The knife's edge: Masculinities and precarity in East Africa," Social Science & Medicine, Elsevier, vol. 258(C).
    7. Mshana, Gerry & Peter, Esther & Malibwa, Donati & Aloyce, Diana & Kapiga, Saidi & Stöckl, Heidi, 2022. "Masculinity, power and structural constraints: Men's conceptualization of emotional abuse in Mwanza, Tanzania," Social Science & Medicine, Elsevier, vol. 292(C).
    8. Turner, Rachel A. & Szaboova, Lucy & Williams, Gwynedd, 2018. "Constraints to healthcare access among commercial fishers," Social Science & Medicine, Elsevier, vol. 216(C), pages 10-19.
    9. Sánchez-Sandoval, Yolanda & Aragón, Claudia & Verdugo, Laura, 2022. "Future expectations of adolescents in Residential Care: The role of self-perceptions," Children and Youth Services Review, Elsevier, vol. 143(C).
    10. Wiklund, Maria & Bengs, Carita & Malmgren-Olsson, Eva-Britt & Öhman, Ann, 2010. "Young women facing multiple and intersecting stressors of modernity, gender orders and youth," Social Science & Medicine, Elsevier, vol. 71(9), pages 1567-1575, November.
    11. Parker, Rhiannon & Larkin, Theresa & Cockburn, Jon, 2017. "A visual analysis of gender bias in contemporary anatomy textbooks," Social Science & Medicine, Elsevier, vol. 180(C), pages 106-113.
    12. Michelle Calvarese, 2015. "The Effect of Gender on Stress Factors: An Exploratory Study among University Students," Social Sciences, MDPI, vol. 4(4), pages 1-8, November.
    13. Oliffe, John, 2005. "Constructions of masculinity following prostatectomy-induced impotence," Social Science & Medicine, Elsevier, vol. 60(10), pages 2249-2259, May.
    14. Hatcher, Abigail M. & Gibbs, Andrew & McBride, Ruari-Santiago & Rebombo, Dumisani & Khumalo, Mzwakhe & Christofides, Nicola J., 2022. "Gendered syndemic of intimate partner violence, alcohol misuse, and HIV risk among peri-urban, heterosexual men in South Africa," Social Science & Medicine, Elsevier, vol. 295(C).
    15. Luke, Nancy, 2006. "Exchange and Condom Use in Informal Sexual Relationships in Urban Kenya," Economic Development and Cultural Change, University of Chicago Press, vol. 54(2), pages 319-348, January.
    16. Katie Hail-Jares & Ruth C F Chang & Sugy Choi & Huang Zheng & Na He & Z Jennifer Huang, 2015. "Intimate-Partner and Client-Initiated Violence among Female Street-Based Sex Workers in China: Does a Support Network Help?," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-16, September.
    17. Daniele Pennesi, 2020. "Identity and information acquisition," Carlo Alberto Notebooks 610, Collegio Carlo Alberto, revised 2021.
    18. Morioka, Rika, 2014. "Gender difference in the health risk perception of radiation from Fukushima in Japan: The role of hegemonic masculinity," Social Science & Medicine, Elsevier, vol. 107(C), pages 105-112.
    19. Anja Tolonen, 2019. "Endogenous Gender Roles: Evidence from Africa’s Gold Mining Industry," OxCarre Working Papers 209, Oxford Centre for the Analysis of Resource Rich Economies, University of Oxford.
    20. Claudia Doiciar & Remus Crețan, 2025. "Class and Gender Violence: Understanding a Case of Wealthy (Online) Influencers and Misogyny," Societies, MDPI, vol. 15(2), pages 1-19, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:296:y:2022:i:c:s0277953622000454. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.