Heterosexual Men and HIV/AIDS
Key Issues:
- Men are encouraged to take risks that can jeopardize their health and increase the risk for contracting HIV and other sexually transmitted diseases.
- In Canada, a 1995 study showed that only 22% of men used condoms.
- The Canadian rate of condom use by males is one of the lowest in the industrialized world.
The different gender roles of men and women in our society are reflected in different attitudes and behaviour. Social norms, upbringing, peers, and the media socialize men to meet standards of masculinity that set them apart from women. Men are generally expected to project the image of being strong, assertive, dominant, self-reliant, and willing to take risks1. When these patterns of thinking and acting are expressed as attitudes towards sex and in sexual behaviour, they often increase men's chances of contracting and transmitting HIV.
The main patterns of behaviour that place heterosexual men at greatest risk of contracting HIV/AIDS are having multiple sexual partners, injecting drugs and the failure to practice safer sex.
Heterosexual men generally have more sexual partners than heterosexual women do2. In part this reflects a double standard: it is socially more acceptable for men to be sexually active than for women3. Men may even derive status (as "studs") from having multiple partners, while women who have multiple partners are often labeled negatively (as "sluts").
Married men are more likely than married women to have extra-marital relationships. Studies estimate that between one-half and two-thirds of married men have at least one affair, compared to between one-third and one-half of married women4.
Having multiple partners increases the risk of contracting sexually-transmitted diseases (STDs) including HIV. Although safer sex practices reduce this risk, many men do not practice safer sex.
Studies show consistent condom use is not widely practiced by men. For example, a 1992 US study found that 46% of a sample of unmarried heterosexual men in San Francisco never used condoms. A 1998 study found that 33% of teenage heterosexual males did not use condoms.
In Canada, a 1995 study showed that only 22% of men used condoms as their primary form of contraception. Young men and unmarried men were more likely than older men and married (or formerly married) men to use condoms. The Canadian rate of condom use by males is one of the lowest in the industrialized world5.
The reasons for failure to use condoms range from embarrassment at buying them to a belief that they reduce sensitivity and pleasure6. Moreover, condoms are associated not only with the prevention of sexually transmitted disease but also with contraception, and many heterosexual men believe that condoms are unnecessary if their partner is using a contraceptive such as the pill. In addition to this, many men who do use condoms regularly, have sex without one on some occasions.
It may be that there is less chance of changing men's tendency to have multiple sexual relationships than persuading them to practice safer sex. But in order to encourage such a change, sex education campaigns must be maintained. It may be that condom use has declined as men have become used to the safer sex campaigns that were prominent when HIV/AIDS first became a major public health issue in the late 1980s.
Studies have shown that sexual health education can be effective in delaying first intercourse, increased use of condoms for first intercourse and increased reporting of condom use for the most recent intercourse. Canadian research has also confirmed that the majority of parents support sexual health education in schools. Despite these findings, a Health Canada report indicates that the average number of hours spent on sexual health education is very low (between 2 and 2.5 hours) and that not all schools require that HIV prevention education be provided at any grade level. Parents and citizens need to raise concerns about the quality and quantity of sexual health education available in schools7.
These behaviour patterns are made even more serious because men tend to be less concerned than women about health issues8. Men are less likely than women to visit a doctor regularly and many are reluctant to seek professional advice even when they suspect they may have a problem. This reflects men's sense of themselves as self-reliant and not in need of help. One result is that many men do not know that they have sexually-transmitted diseases or HIV, because they have not been tested.
Men should be encouraged to understand and take responsibility for the consequences of their sexual actions-for themselves and their partners. Healthy peer support among men may allow men to become more comfortable discussing issues related to their sex lives and personal relationships.
There are precautions that can be taken to prevent HIV infection. They include, using a new condom with each sexual act, and if injecting drugs, using needles and other injection drug equipment that are sterile.
Society must also take some responsibility for permitting and encouraging men to behave in ways that are considered "male" or "masculine," but that are potentially unsafe to themselves and others. Instead, safer and more responsible behaviour should be encouraged.
For more information on how to prevent HIV infection please contact the Canadian AIDS Society at 1-800-499-1986 or visit our web-site at www.cdnaids.ca
- Men & AIDS - A Gendered Approach, 2000 World AIDS Campaign. UNAIDS, 2000. p. 6
- Ibid. p. 5
- Ibid. p.8
- Lawson, A. Adultery, An Analysis of Love and Betrayal, New York: Basic Books, 1988.
- General Social Survey, Statistics Canada, 1995
- Men & AIDS - A Gendered Approach, 2000 World AIDS Camapign. UNAIDS, 2000. p. 9
- Schools, Public Health, Sexuality and HIV: A Status Report. (1999). Council of Ministers of Education: Toronto
- Men & AIDS - A Gendered Approach, 2000 World AIDS Camapign. UNAIDS, 2000. p. 1