Abstract

THPE624 - Poster Exhibition

HIV, gender and culture: lessons from group discussions in Mozambique

R. Arias, M.E. Figueroa, P. Poppe

Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs, Baltimore, United States

Background: Traditional gender and sexual norms underlie HIV infection in Sub-Saharan African countries. Two qualitative studies conducted in Mozambique provide in-depth understanding of the prevailing cultural views (mental models) related to gender and sexuality that mediate messages regarding HIV testing, sexual exclusivity and condom use.
Methods: A total of 24 focus group discussions were conducted in native languages, with men and women of reproductive age in peri-urban and rural areas. Projective techniques facilitated open discussion among group participants. Cultural discourse analysis using semiotics was conducted with transcripts translated into Portuguese. The results uncovered the mental models underlying sexual behavior among Mozambicans in the study provinces.
Results: Participants were unlikely to use condoms with a “serious” sexual partner, as their mental model dictated that serious relationships must produce children. Condom use represented lack of love, the desire to avoid commitment, and was more strongly rejected by women than by men. Among the younger generation, these views are beginning to change. Based on the traditional mental model that views health and sickness as diametrically opposed, participants had difficulty accepting the concept of an asymptomatic virus (HIV). Without symptoms, they were not motivated to use condoms for protection or get tested for HIV. The definition of faithfulness differed for men and women. To many participants, a man was faithful if he assumed responsibility for supporting his family financially, even if he was not sexually exclusive. The faithful woman, however, remained exclusively available to her husband. In the faithfulness mental model, wives are responsible for the sexual unfaithfulness of their male partners (Figure 1).
Conclusions: Traditional mental models of sexuality, faithfulness and sickness impede the adoption of HIV prevention behaviors such as condom use, sexual exclusivity and asymptomatic testing. Understanding these mental models will help programs develop more effective messages to increase their success in HIV prevention efforts.



[Faithfulness and Unfaithfulness Model]