Dividuality, masculine respectability and reputation: exploring the link between men's uptake of HIV treatment and their masculinity in rural eastern Uganda

Type Thesis or Dissertation - PhD
Title Dividuality, masculine respectability and reputation: exploring the link between men's uptake of HIV treatment and their masculinity in rural eastern Uganda
Author(s)
Publication (Day/Month/Year) 2013
URL http://theses.gla.ac.uk/4213/
Abstract
This thesis discusses the link between men’s HIV treatment seeking behaviour and their masculinity. It is based generally on ethnographic research conducted in Busia district, rural eastern Uganda, and specifically on 26 interviews conducted between 2009 and 2010 with different categories of men: treated for HIV, tested but dropped out of treatment, not tested but suspect HIV infection, and those with other health problems unrelated to HIV. The study explored how masculinity is constructed and discussed among the men from the Iteso ethnic group, how those notions of masculinity influence men’s uptake of HIV treatment, and how HIV diagnosis and/or its treatment, in turn, affects men’s perception of their masculinity. Thematic framework analysis identified recurrent themes and variations across the data. The thesis argues that there are, essentially, two forms of masculinity in rural Uganda, one based on reputation, the other on respectability, and that these emerge in different contexts, and have different effects on men’s behaviours regarding HIV testing and treatment. Respectable masculinities are endorsed largely by the wider society, while reputational masculinities are endorsed predominantly by the men themselves, although some ideals are shared by both. Theoretically, this categorisation is consistent with the distinction between the value systems of respectability and reputation as described by PJ Wilson (1969). Men’s dividuality (Helle-Valle 2004), allowed them to, unproblematically, adopt the different and sometimes contradictory, forms of masculinity, in different social circumstances and phases of life. Individual men can engage in a variety of HIV treatment seeking behaviours that typically correspond with different masculine ideologies and dividualities; some discouraging treatment seeking for HIV, others encouraging it. On the one hand, acknowledging illness is incompatible with men’s notion of strength. Being diagnosed with HIV threatens respectability and ability to work and earn an income, hence treatment is delayed, while couple testing threatens men’s freedom to engage in extramarital sex. On the other hand, HIV treatment may be undertaken and adhered to, in order to regain and maintain health, so as to fulfill family and societal expectations, notably that of provider and being a role model. Through the core themes of ‘dented’ and ‘resuscitated’ masculinities, this study suggests that HIV diagnosis negatively affected masculinity while treatment led to more positive ways to express masculinity.

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