One World AIDS Day, December 1, The Guardian published a piece in which I railed against leaving men out of our HIV prevention equation. (We can’t wait for equality) This rang bells with Michelle Kermode, from the University of Melbourne in Australia. Michelle is interested in focusing more attention on men in HIV prevention; so at major conference on AIDS in Asia held in Sri Lanka recently, she went to a session on men and AIDS.
“Only one of the five speakers and one of the two chairs turned up and there were a mere twelve people in the audience,” Michelle told me. “After the one speaker had delivered his paper (about working successfully with young men in Punjab) I went next door where there was a session on female-controlled HIV prevention, which was packed to standing room only! So much time, money and energy is being diverted into technical fixes such as female condoms and vaginal microbicides, but few people are working with young men to empower them to make better choices for themselves (which can only benefit women).”
She’s right. Perhaps that’s because we’ve given up on men. They already have the power to make decisions about who they have sex with and whether latex will be involved, and they still they choose unprotected sex with potentially infected partners more often than is convenient for HIV prevention workers. Guys choose to do lots of other daft things, too: driving too fast and shooting up drugs and brawling at the drop of a hat. The instinct to take risks (or to ignore the risks they are taking) is probably hard-wired. Young men are “protected from reality by a strong sense of invincibility (which I guess helped them to step into battle in the not so distant past),” Michelle points out.
The question is, can guys be persuaded to give up some of these daft behaviours? The answer is clearly yes. When there is a risk of getting a girl pregnant, young men become more likely to use condoms. Where the threat of HIV is visible, ever-present, and — crucially — the subject of constant discussion in bars and at funerals (as it was in gay communities in the 1980s) young men become more likely to use condoms. But we’re not going to win any battles with men by shunting the onus for HIV prevention on to women.