“One Man Can” (OMC) is a rights-based gender equality and health program implemented by Sonke Gender Justice Network (Sonke) in South Africa. The program seeks to reduce the spread and impact of HIV and AIDS and reduce violence against women and men. To understand how OMC workshops impact masculinities, gender norms, and perceptions of women’s rights, an academic/non-governmental organization (NGO) partnership was carried out with the University of Cape Town, the University of California at San Francisco, and Sonke. Sixty qualitative, in-depth interviews were carried out with men who had completed OMC workshops and who were recruited from Sonke’s partner organizations that were focused on gender and/or health-related services. Men were recruited who were over age 18 and who participated in OMC workshops in Limpopo and Eastern Cape Provinces, South Africa. Results reveal how men reconfigured notions of hegemonic masculinity both in terms of beliefs and practices in relationships, households, and in terms of women’s rights. In the conclusions, we consider the ways in which the OMC program extends public health research focused on masculinities, violence, and HIV/AIDS. We then critically assess the ways in which health researchers and practitioners can bolster men’s engagement within programs focused on gender equality and health.

Gender has long been recognized as being key to understanding and addressing HIV and AIDS. Gender roles and relations that structure and legitimate women’s subordination and simultaneously foster models of masculinity that justify and reproduce men’s dominance over women exacerbate the spread and impact of the epidemic. Notions of masculinity prevalent in many parts of the world that equate being a man with dominance over women, sexual conquest and risk-taking are associated with less condom use, more sexually transmitted infections, more partners, including more casual partners, more frequent sex, more abuse of alcohol and more transactional sex. They also contribute to men accessing treatment later than women and at greater cost to public health systems. The imperative of addressing the gender dimensions of AIDS has been clearly and repeatedly articulated. Many interventions have been shown to be effective in addressing gender-related risks and vulnerabilities including programmes designed to reach and engage men, improve women’s legal and economic position, integrate gender-based violence prevention into HIV services, and increase girls’ access to secondary and tertiary education. Despite this, the political will to act has been sorely lacking and not nearly enough has been done to hold governments and multilateral institutions to account. This paper argues that we can no longer simply pay lip service to the urgent need to act on what we know about gender and AIDS. Simply put, it is time to act.

Evidence shows that men are significantly underrepresented in HIV and AIDS testing and treatment services -both in sub-Saharan Africa and globally. HIV policies within sub-Saharan Africa also have insufficient focus on ensuring national HIV responses encourage men to test, access anti-retroviral treatment and support the disproportionate burden of HIV care on women. Addressing these challenges is important for everyone's sake and must be approached within a context of addressing power differentials between men and women at all levels. This includes challenging the broader patriarchal power structures in which gender plays out, such as the assumption that care work is 'women's work' and therefore less valued, and the rigidity of gender norms that encourage men to participate in risk-taking behaviours that put their life and the life of those around them in jeopardy.

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IntroductionCommunity mobilizing strategies are essential to health promotion and uptake of HIV prevention. However, there has been little conceptual work conducted to establish the core components of community mobilization, which are needed to guide HIV prevention programming and evaluation.ObjectivesWe aimed to identify the key domains of community mobilization (CM) essential to change health outcomes or behaviors, and to determine whether these hypothesized CM domains were relevant to a rural South African setting.MethodWe studied social movements and community capacity, empowerment and development literatures, assessing common elements needed to operationalize HIV programs at a community level. After synthesizing these elements into six essential CM domains, we explored the salience of these CM domains qualitatively, through analysis of 10 key informant in-depth-interviews and seven focus groups in three villages in Bushbuckridge.ResultsCM domains include: 1) shared concerns, 2) critical consciousness, 3) organizational structures/networks, 4) leadership (individual and/or institutional), 5) collective activities/actions, and 6) social cohesion. Qualitative data indicated that the proposed domains tapped into theoretically consistent constructs comprising aspects of CM processes. Some domains, extracted from largely Western theory, required little adaptation for the South African context; others translated less effortlessly. For example, critical consciousness to collectively question and resolve community challenges functioned as expected. However, organizations/networks, while essential, operated differently than originally hypothesized - not through formal organizations, but through diffuse family networks.ConclusionsTo date, few community mobilizing efforts in HIV prevention have clearly defined the meaning and domains of CM prior to intervention design. We distilled six CM domains from the literature; all were pertinent to mobilization in rural South Africa. While some adaptation of specific domains is required, they provide an extremely valuable organizational tool to guide CM programming and evaluation of critically needed mobilizing initiatives in Southern Africa.