Exploring masculinities in the context of ARV use: a study of men living with HIV in a South African village

Abstract

Abstract The dominant social constructions concerning what it means to be a man have been studied in relation to various HIV risks that they may pose for men and women. It has been shown that men worldwide tend to embrace notions of manhood that encourage them to have multiple partners and not pay attention to their health needs. This study focuses on men who have taken an HIV test, disclosed their HIV results and are using antiretroviral medicines provided in a public health facility in South Africa. It investigates their experiences of living with HIV in relation to how they constructed and experienced their masculinity. This focus is unusual in South Africa. Most research focuses on men who are resisting health services and who have not taken an HIV test. Based on a fourteen-month ethnographic fieldwork in a South African village, findings show that living with HIV poses unique challenges for a man. From the onset of a disease men are faced with difficult decisions to make, such as whether or not to seek help, where and with whom. These decisions, I argue, are not made in a vacuum, but are highly mediated by pre-existing views about manhood, culture, HIV stigma, perceptions of treatments, and other belief systems. Thus when someone becomes ill he draws from the various meanings offered by these discourses to decide on how to respond to a physical discomfort. Most men in this study embraced the dominant social definitions of what it means to be a 'real' man before they became ill. These definitions discouraged men from using public health facilities; they encouraged men to have multiple partners as a way of proving manhood and gaining social respect, and they constructed manhood as a powerful, controlling and an independent gender. This thesis engages with men living with HIV to find out how they dealt with these expectations when they became ill and needed to receive help. Most importantly it investigates how these definitions and experiences of masculinity have been challenged and then transformed by the experience of being ill and what 'alternative' definitions of manhood have been forged out of experiences of being sick and using lifelong medications.