How Are Heterosexual Men Reached in HIV Prevention?
What would an intervention for heterosexual men look like?
Unfortunately, very few programs exist in the U.S. to address heterosexual male sexual behavior. Most prevention efforts aimed at heterosexual male sexual behavior have taken place in developing countries, where the HIV epidemic continues primarily to affect heterosexuals. These have focused on clients of prostitutes, couples counseling, and condom social marketing. Interventions for heterosexual men can use multiple components, including:
- Counseling both men and women. A study of discordant heterosexual couples (where one is HIV-infected and the other is not) found that counseling men and women together increased consistent use of condoms. Of the 124 couples who did use condoms consistently for vaginal and anal intercourse, none of the negative partners became infected, despite a total of about 15,000 episodes of intercourse.9
- Helping men rethink notions of intimacy. Programs can address different male beliefs, and use consciousness-raising to address the notion of gender roles and coercive behaviors in men, as well as help men embrace an idea of intimacy that can work in conjunction with HIV prevention. Skills building to increase sexual impulse control can also help men deal with violence and coercion, as well as help reduce number of partners.7
- Heterosexual male peer education. In addition to couples counseling, programs should provide counseling for and by men alone. Research has found that men are interested in family planning, but may not want to discuss it only with their wives or partners. Peer educators can teach and model effective preventive behaviors in settings where men may gather, such as gyms, barbershops or sporting events.10
- Helping men communicate with women. Like many people in relationships, heterosexual men may find it difficult to talk about sex and love with their partners. One study of young African-American men, for example, demonstrated that regarding sex, men often say what they think their partner wants to hear.11 Programs that help increase communication skills can be effective.
- Focus on men who have sex with men and women (MSMW). A survey of MSMW found that 54 percent of their female partners did not know about their homosexual activity, and 65 percent of the men had engaged in unprotected sex with their female partners.12 Helping MSMW with communication and disclosure skills, as well as skills for correct and consistent condom use can be beneficial.
- Condom social marketing. In Zaire, careful consumer research produced “Prudence,” a condom designed and priced to be culturally sensitive, attractive and affordable. Total sales of Prudence increased 443 percent from 1988 to 1989, and in many regions of Zaire, the word Prudence has become a generic substitute for the word condom.13 In the U.S., Umoja Sasa (or “Unity Now”) brand condoms have been marketed in African-American neighborhoods with the slogan “protect the blood.”14
What needs to be done?
Focusing HIV prevention efforts on heterosexual male sexual behavior in the U.S. can make a difference in the epidemic among men, their female partners and their offspring. As new AIDS cases are increasing most rapidly through heterosexual contact in the U.S., this new focus will take on even greater importance. Changing male cultural and socialization patterns will certainly not be an easy task, but targeted interventions can be effective. A comprehensive HIV prevention strategy uses many elements to protect as many people at risk for HIV as possible. Prevention for heterosexual men can strengthen men’s roles as sex partners, husbands and fathers.
CDC. HIV/AIDS Surveillance Report. U.S. HIV and AIDS cases reported through December 1995;7:10.
- Avins AL, Woods WJ, Lindan CP, et al. HIV infection and risk behaviors among heterosexuals in alcohol treatment programs. Journal of the American Medical Association. 1994;271:515-518.
- Hammett TM, Widom R, Epstein J, et al. 1994 Update: HIV/AIDS and STDs in correctional facilities. Report prepared for the National Institute of Justice; Washington, DC. 1995.
- Levin LI, Peterman TA, Renzullo PO, et al. HIV-1 seroconversion and risk behaviors among young men in the U.S. army. American Journal of Public Health. 1995;85:1500-1506.
- Campbell CA. Male gender roles and sexuality: Implications for women’s AIDS risk and prevention. Social Science and Medicine. 1995;41:197-210.
- De Bertolini C, Scarso C, Andreetto U, et al. Risk-related sexual behavior: Differences between HIV-positive heterosexual males and females. Presented at the 11th International Conference on AIDS, Vancouver, BC. 1996. Abstract Mo.D.1891.
- Marin BV, Gomez C, Tschann J, et al. Traditional gender role beliefs increase sexual coercion and lower condom use in U.S. Latino men. Presented at the 11th International Conference on AIDS, Vancouver, BC. 1996. Abstract We.C.3519.
- Wiley J, Samuel M. Prevalence of HIV infection in the U.S.A. AIDS. 1989;3(Suppl. 1):71-78.
- de Vincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. New England Journal of Medicine. 1994;331:341-346.
- Men — New focus for family planning programs. Population Reports. 1986; Series J:879.
- Gilmore S, DeLamater J, Wagstaff D. Sexual decision making by inner city Black adolescent males: a focus group study. The Journal of Sex Research. (in press).
- Stokes J, McKirnan D, Doll L, et al. Female sexual partners of bisexual men: What they don’t know might hurt them. Psychology of Women Quarterly. 1996:20;267-284.
- Ferreros C, Mivumbi N, Kakera K, et al. Social marketing of condoms for AIDS prevention in developing countries: The Zaire experience. Presented at the 6th International Conference on AIDS, San Francisco, CA. 1990. Abstract SC 697.
- Contact: Edwin Avent, Umoja Sasa 410/576-8688.
Prepared by Pamela DeCarlo and Carole Campbell
Reproduction of this text is encouraged; however, copies may not be sold, and the Center for AIDS Prevention Studies at the University of California San Francisco should be cited as the source of this information. For additional copies of this and other HIV Prevention Fact Sheets, please call the National AIDS Clearinghouse at 800/458-5231. Comments and questions about this Fact Sheet may be e-mailed to [email protected] Copyright 1996, University of California
AIDS Prevention UCSF, C. (2020). How Are Heterosexual Men Reached in HIV Prevention?. Psych Central. Retrieved on February 28, 2020, from https://psychcentral.com/lib/how-are-heterosexual-men-reached-in-hiv-prevention/