Conflicted masculinities: understanding dilemmas and (re)configurations of masculinity among men in long-term relationships with female sex workers, in Kampala, Uganda

Abstract

This ethnographic study explores the experience of men in longterm relationships with sex workers and their construction of masculine identities in Kampala, Uganda. Data were collected in 2019 and comprise in-depth interviews with 13 male partners and two group discussions of women with long-term male partners. Thematic analysis used an intersectional lens to frame reconfigurations of gender and masculinity in the context of relationships with sex workers. All men had been clients of sex workers before progressing to become long-term partners. We discuss the complex ways in which men participated in value systems of respectability and reputation to (re)configure gender relations that made sense of their long-term relationships with sex workers. Men viewed their relationships with women through the normative lens of traditional masculine roles associated with monopoly over a partner's sexuality, provider and father. However, poverty, HIV, the failure to have exclusive sexual rights over a partner, and the shame associated with sex work intersected and disrupted masculinities. Despite this, men found meaning in these relationships through the woman's commitment to the relationship, her financial support, her help in accessing HIV services, and the children from the relationship, thereby attaining respectability and avoiding a crisis of masculinity.

Uptake of and adherence to oral pre-exposure prophylaxis among adolescent girls and young women at high risk of HIV-infection in Kampala, Uganda: A qualitative study of experiences, facilitators and barriers

“…In a study carried out among AGYW in Malawi exploring the association between HIV risk, risk perception and PrEP interest, it was found that while epidemiologic risk scores were positively associated with PrEP interest, high numbers of AGYW both above and below the high-risk cutoff were very interested in PrEP (68% vs. 63%) [37]. Factors contributing to AGYW believing that they were at high-risk of HIV infection included; involvement in sex work, having multiple sexual partners and mistrust of regular sexual partners, indeed some sex workers tend to have regular sexual partners alongside clients [38]. Similar findings have been reported among high risk populations in Uganda and Zimbabwe [39,40].…”

“I prefer to take pills when I plan to have sex”: Perceptions of on-demand versus daily oral pre-exposure prophylaxis among adolescents in Kampala, Uganda

“…While we generally did not find any gendered preference for either PrEP regimen, there were underlying stereotypes often showing a lack of autonomy when it comes to making sexual decisions by females, as documented elsewhere ( Duby et al, 2021 ). On the other hand, for the males, concerns about upholding their masculinity related to reputation and respectability influenced their PrEP preferences ( Siu et al, 2013 ; Mbonye et al, 2021 ) such as a preference for condom-less sex which would be facilitated by taking PrEP to protect themselves from HIV infection.…”

Young migrant men managing risk and seeking protection in a small town in Southern Uganda

“…Perhaps for each of the young men in our study an important protective factor was not only someone to turn to or someone to help them navigate their way through life in the town, as proposed by Kabiru et al. (2012) , but their own sense of pride in becoming ‘a man’, upholding prized masculine ideals through their potential earning power and their sexual prowess ( Mbonye et al., 2021 ); ideals which may compromise their readiness to access sexual health services and manage their sexual risks ( Siu et al., 2012 ).…”