Men, masculinities and HIV care work: A small-scale, exploratory study of the role of community care workers in supporting HIV positive men's health-seeking behaviour

Master Thesis


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University of Cape Town

Caring is typically constructed as a feminized practice, resulting in women shouldering the burden of care-related work. Health-seeking behaviours are also constructed as feminine and men have poorer health outcomes globally. Employing men as carers may not only improve the health of the men they assist but also be transformative with regard to gendered constructions of caring. This dissertation adds to the small but growing literature on men in caring by focusing on men as community care workers (CCWs) and their male clients. Using semi-structured interviews and observational home visits, this study explores whether male CCWs have a unique role to play in addressing harmful health-related gender norms and in supporting HIV positive men's health-affirming behaviour. The empirical analysis draws on the perspectives of eight CCWs and three of their male clients from the Cape Town area. Being problem-driven in nature and situated within a 'gender transformative' agenda, it explores male client preferences for gender concordant care workers and the techniques that CCWs (with a focus on male CCWs) employ to support HIV positive men's health-affirming behaviour. CCWs navigate around hegemonic masculine norms that require men to act tough, suppress emotion and deny weakness and sickness by using techniques such as indirectly broaching sensitive subjects, acting friendly and being clear about the intention of their work. The interviews revealed that CCWs strove not to rupture hegemonic masculine norms while encouraging male clients to engage in health-affirming behaviour . This dissertation also explores male client preferences for gender concordant CCWs and the potential that these pairings have to support health and to be 'gender transformative'. Here 'gender transformative' refers to the creation of more gender equitable environments. The variety of intertwined factors that contribute to male client preferences for male CCWs include gendered power dynamics, comfort in sharing intimate health information and a fear of women gossiping. Drawing on current literature on men, caring and gender transformation to inform the analysis of participant perspectives and experiences, this study explores the barriers to encouraging men to seek health and also considers the challenges in recruiting an d retaining men as CCWs. Employing more male CCWs is a strategy that could improve male client's health outcomes and also contribute to the development of more gender equitable norms. Shifting such norms requires much more than simply hiring men. To contribute to gender transformation, male CCWs should ideally resonate emotionally with their work, possess gender equitable beliefs and ground these beliefs in practice.

Includes bibliographical references