1. Men and STIs/HIV Family Health International

2. HIV/AIDS: A Public Health Crisis That Requires Mens Help 33 million people living with HIV/AIDS worldwide33 million people living with HIV/AIDS worldwide 14 million people have died of AIDS14 million people have died of AIDS 16,000 new HIV infections every day16,000 new HIV infections every day 6 of 10 newly HIV-infected people are women6 of 10 newly HIV-infected people are women Women are 4 times more likely to contract HIV and other STIsWomen are 4 times more likely to contract HIV and other STIs Half of all new HIV infections occur to those under age 25Half of all new HIV infections occur to those under age 25 Source: Gardner, Popul Rep 1999;H(9).

3. Ten New STIs for Each HIV Case 333 million NEW cases of STIs per year for each of the 4 major curable STIs333 million NEW cases of STIs per year for each of the 4 major curable STIs One-third occur to those under age 25One-third occur to those under age 25 Those with an STI are more vulnerable to acquiring HIVThose with an STI are more vulnerable to acquiring HIV Source: Gardner, Popul Rep 1999;H(9).

4. Men are usually the ones who decide about sex – the timing and whether protection is used US Agency for International Development

5. Cairo Plan of Action Innovative programs must be developed to make information, counseling and services for reproductive health accessible to adolescents and adult men. Such programs must both educate and enable men to … accept the major responsibility for the prevention of sexually transmitted diseases. – ICPD Plan of Action, Section 7.8, 1994

6. Prevention Requires Male Involvement: What Do Men Know? In 21 of 22 DHS surveys, at least 90% of men knew of AIDS; most knew of condomsIn 21 of 22 DHS surveys, at least 90% of men knew of AIDS; most knew of condoms In most of these countries, only 25 to 45% knew that condoms can prevent AIDSIn most of these countries, only 25 to 45% knew that condoms can prevent AIDS Source: Gardner, Popul Rep 1999;H(9). P. Almasy/World Health Organization

7. Objections to the Condom K. Best/Family Health International Association with commercial or illicit sex and lack of trustAssociation with commercial or illicit sex and lack of trust Fear of loss of sensation or erectionFear of loss of sensation or erection Providers, peer educators and social marketers can address these fearsProviders, peer educators and social marketers can address these fears

8. Better Condoms Are Needed N. Herndon/Family Health International New inSpiral condom

9. What Motivates Men To Use Condoms? Determine why men DO use condoms instead of focusing only on why men do not use them Determine why men DO use condoms instead of focusing only on why men do not use them Richard Lord

10. HIV/AIDS Education and Condoms Not Available Where Needed HIV/AIDS Education and Condoms Not Available Where Needed Source: MEASURE Project/USAID. Condom availability where people meet new sexual partners (Township in Cape Town, South Africa) Condom availability at site or nearby Bar Shebeen (informal bar) Other NO YES

11. Condoms: Dual Protection Against Pregnancy and STIs/HIV Providers need training to foster couple communication, negotiation skills and condom useProviders need training to foster couple communication, negotiation skills and condom use Many providers are biased against condomsMany providers are biased against condoms A client at high-risk of STIs should use condomsA client at high-risk of STIs should use condoms Few married couples rely on condoms for contraceptionFew married couples rely on condoms for contraception

12. Programs That Increased Use of Male Condoms Family Health International

13. Support Mens Positive Actions Beryl Goldberg To be tested To be tested To support people who have HIV/AIDS To support people who have HIV/AIDS To foster open communication about sexual and reproductive health with their partners To foster open communication about sexual and reproductive health with their partners

14. Address Underlying Gender Issues Help men question masculine risk-taking behaviorHelp men question masculine risk-taking behavior Encourage couple communicationEncourage couple communication Beryl Goldberg

15. Prevention Requires Prevention Requires Community Involvement Health care providers, teachers, religious and community leaders can speak out against exploitative relationships Health care providers, teachers, religious and community leaders can speak out against exploitative relationships Political figures can make public pronouncements about HIV/AIDS and the need for male-female partnerships Political figures can make public pronouncements about HIV/AIDS and the need for male-female partnerships NGOs and CBOs can support strategies that involve men NGOs and CBOs can support strategies that involve men

16. Reaching Youth: Knowledge about HIV/AIDS Is Not Enough Mobilize communities to challenge social norms that foster unsafe sexual behaviorsMobilize communities to challenge social norms that foster unsafe sexual behaviors Create safe and supportive environmentsCreate safe and supportive environments Nurture communication skills about sexual and reproductive health issuesNurture communication skills about sexual and reproductive health issues Foster safe and healthy behaviorsFoster safe and healthy behaviors Source: FOCUS on Young Adults Program Evaluations, 2000.

17. Reaching Youth: Concrete Strategies Emphasize peer outreach, social support, counseling and referralEmphasize peer outreach, social support, counseling and referral Target social marketing to adolescentsTarget social marketing to adolescents Modify service delivery sites/practices to serve youthModify service delivery sites/practices to serve youth Increase access to programs and services relevant to the needs of youthIncrease access to programs and services relevant to the needs of youth Source: FOCUS on Young Adults Program Evaluations, 2000.