Recently, an uproar was created when the details of late Yfm DJ Khabzela’s sexual behaviour were published in a new biography penned by Liz McGregor.
Khabzela, who fashioned himself as a role model for the youth, consciously made the wrong decisions about his sexual health. Despite having the relevant knowledge about HIV at his disposal, he knowingly infected many women with the virus, including some who bore him children.
On air, he would preach safe sex but, the book claims, he practised a bonding ritual with friends that involved sleeping with the same women — who were said to have queued outside his bedroom.
As his condition deteriorated, Khabzela maintained his scepticism about anti-retrovirals (ARVs) and went home to be cared for by his mother and sister until he died.
This high-profile case is by no means isolated. Most men still consider voluntary counselling and testing for HIV/Aids and accessing ARVs as a woman’s duty.
Besides shouldering the burden of caring for relatives dying of Aids, women generally have to take the initiative to negotiate safe sex and bear the brunt of stigma attached to HIV.
Research by Health Systems Trust found that only 21% of people accessing voluntary counselling and testing were men, in effect making women the bearers of the burden of disclosure. ”Most healthy men do not go to a doctor unless they are injured because they do not want to acknowledge vulnerability and frailty,” explains Dean Peacock of multinational NGO EngenderHealth. ”[Similarly,] they access ARVs at death’s door, which impacts negatively on the health system. They test by proxy, which is dangerous.”
Testing by proxy refers to people who use a partner’s HIV results to determine their own status. There are a variety of reasons why men do this, says Peacock and these are not necessarily connected to the often unequal power balance in heterosexual relationships.
”I don’t think men do it to oppress women but because of a poor understanding of HIV. It’s not uncommon for people to believe that if their partner is negative then they must be negative. Most have never heard of discordancy, where people are regular partners but one is positive and the other negative. It’s not usually talked about because it doesn’t contribute to prevention.”
Elaine Chakela, coordinator of HIVSA’s Johnson & Johnson home-based care project — which works with 39 organisations in Soweto, Gauteng, and Whiteriver, Mpumalanga — says that only about 2% of people involved in these home-based care organisations are men. ”None of the organisations I work with are headed by men.”
”Men are afraid to offer caring because they feel their manhood will be called into question,” adds Peacock. ”Also, they are afraid to show that they can’t do it. They are afraid to look like fools and there is pressure not to show that.”
The Men as Partners (MAP) project was initiated in 1998 by EngenderHealth and the Planned Parenthood Association of South Africa. Its principal aim is curbing the spread of HIV/Aids and violence against women by challenging men’s attitudes and galvanising their active participation in doing so.
MAP’s Gauteng coordinator, Dumisani Rebombo, believes male reluctance to access HIV-related services is shaped by socialisation, which affects the way men perceive public health spaces such as clinics and hospitals.
”Men step into clinics and see little in the way of posters and messages directed at them. They see these spaces as female-friendly. They would rather talk to male counsellors because they fear a lack of privacy. So part of our responsibility at MAP is to change how these spaces feel to men.”
Using the ”mystery client methodology”, which is akin to police officers going undercover, a group of volunteers recently visited five clinics in Soweto and one in Hillbrow, noting aspects that made them feel at ease and those that needed improvement.
Rebombo says the process of transforming these clinics, which is being done in conjunction with MAP’s partner organisations, is still in the process of consultation. MAP has enjoyed obvious success in recruiting young and articulate peer educators (see sidebars) to lead workshops and the organisation’s community action teams — which were conceived to sustain commitment from participants.
Thokozile Budaza
Thokozile Budaza (23) got involved with Men as Partners (MAP) while studying at the University of the Western Cape. She currently works for the Global Call to Action against Poverty in Newtown, Johannesburg.
”Four weeks ago, we had a men’s voluntary counselling and testing day at Esselen Street clinic in Hillbrow, where about 23 men tested for HIV. Being a woman, men are always like: ‘There she is coming to tell us. Ungenaphi. Yinto zamadoda [Stop minding men’s business].’ But I’ve learnt the language of the streets. It’s how you interact with them. For example, if I’m talking about a penis or a sexually transmited infection, I tell them ‘Your AK-47 will end up as a Z3’ [a slang term for Aids].
”When I started, I couldn’t believe I was doing something for men because I felt that men were disgusting, but now I see this as a platform for healing me from my abusive background. In my immediate family, there are five women and all have been abused one way or another.
”I know a lot of people who are HIV-positive — friends and family members — but they don’t want to disclose. They ask me questions openly even though they have never admitted [they are positive]. We just have a silent understanding.
”MAP addresses disclosure by helping to create an environment where it is easy to disclose. In the research we did in Soweto, men said they don’t want to talk to female counsellors because they believe women gossip. I think it’s bull because those people are professional.
”A lot still needs to be done. I think there are changes like the Fathers’ Day ‘Not In My Name’ march held in Thokoza and attended by thousands of men. I can’t pinpoint certain numbers but I think we are making a difference.”
Thami Nkosi
Thami Nkosi (23) is a Men as Partners (MAP) peer educator who lives in Jabulani, Soweto. He joined MAP after his father died of Aids-related causes five years ago.
”My brother, who is HIV-positive, drinks a lot. Even before he was infected he was just carrying on with the same behaviour as my dad, who died of Aids-related complications. He lives with his fiancÃ