You’re not a man until you’re a father. Young men’s desire for fatherhood and HIV-associated risk

Fatherhood, marriage and HIV risk among young men in rural Uganda.

Mathur, S, Higgins, J. A, Thummalachetty N, Rasmussen, M, Kelley, L, Nakyanjo, N, Nalugoda, F, Santelli, J. S, Cult Health Sex 2015 Nov 5:1-15 (Epub ahead of print)

Compared to a large body of work on how gender may affect young women’s vulnerability to HIV, we know little about how masculine ideals and practices relating to marriage and fertility desires shape young men’s HIV risk. Using life-history interview data with 30 HIV-positive and HIV-negative young men aged 15–24 years, this analysis offers an in-depth perspective on young men’s transition through adolescence, the desire for fatherhood and experience of sexual partnerships in rural Uganda. Young men consistently reported the desire for fatherhood as a cornerstone of masculinity and transition to adulthood. Ideally young men wanted children within socially sanctioned unions. Yet, most young men were unable to realise their marital intentions. Gendered expectations to be economic providers combined with structural constraints, such as limited access to educational and income-generating opportunities, led some young men to engage in a variety of HIV-risk behaviours. Multiple partnerships and limited condom use were at times an attempt by some young men to attain some part of their aspirations related to fatherhood and marriage. Our findings suggest that young men possess relationship and parenthood aspirations that – in an environment of economic scarcity – may influence HIV-related risk.

Abstract access [1]

Editor’s notes: Gender-specific HIV risks are influenced by biological, social and structural factors. In comparison to factors that affect women’s HIV risk, relatively little is known about how constructions on masculinity affect men’s HIV risk, particularly with relation to young men’s desire for marriage and biological children. In the context meeting fertility ideals, men’s demonstration of masculinity within structural contexts of social change and economic instability, may be associated with certain risk behaviours, including multiple partnerships and inconsistent condom use.

This study utilised data from in-depth life history interviews with 30 HIV-positive and HIV-negative young men aged 15-24 years in southern Uganda. Young men who had acquired bio-medically confirmed HIV over the course of the year between June 2010 and June 2011 and their HIV-negative counterparts were pair-matched by gender, marital status, age and village of residence. The sample included married (n=10), never married (n=16) and previously married men (n=4). Respondents participated in two interviews, approximately two to three weeks apart. Interviews were audio recorded.

Three major themes emerged from the interviews. First, respondents mentioned fatherhood and formal marriage as milestones in the transition to adulthood for young men and a crucial part of the masculine ideal in rural Uganda. Second, truncated educational options and limited economic opportunities made it difficult for young men to acquire formal marriages and fulfil their desires for fatherhood. Third, young men who faced obstacles in trying to achieve these masculine ideals often engaged in alternative strategies, such as condomless sex or having multiple partners, to fulfil their desires for marriage and children; these strategies in turn increased young men’s vulnerability to HIV infection. Regardless of their HIV status young men consistently expressed their desire for marriage and children; described similar economic challenges, and pursued alternative strategies for achieving their masculine ideals. The findings of this study illustrate how the confluence of idealised male masculinities and structural inequalities may play a key role in young men’s vulnerability to HIV.

Africa [7]
Uganda [8]
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