The invisibility of heterosexuality in HIV/AIDS prevention for men

Abstract

Heterosexual men have been a forgotten group for HIV/AIDS interventions and research. Our goal was to identify the different elements that interfere in the prevention of HIV/AIDS among heterosexual men, covering both traditional methods of prevention (especially safe sex practices and testing) and new strategies for prevention (pre- and post-sexual exposure prophylaxis, prevention treatment, and circumcision) in this population. This exploratory article consists of a nonsystematic review of the literature. We discuss the invisibility of heterosexual men in policies, in programs, and in health services. The several interventions analyzed are still poorly monitored and evaluated, so there is a lack of consistent evidence regarding the impact of prevention strategies in this population. Different masculinities, including hegemonic conceptions of masculinity, must be the foundation for interventions targeting men. Men must not be seen merely as a "bridge" in the spread of the HIV/AIDS epidemic, but also as victims of gender patterns that make them vulnerable.

What are the factors associated with human immunodeficiency virus/sexually transmitted infection screening behaviour among heterosexual men patronising entertainment establishments who engaged in casual or paid sex? – Results from a cross-sectional survey in an Asian urban setting

“…This prevalence was lower compared to MSM from gay venues and hotspots in Cambodia (65.1%) [10], MSM living in Bangkok or Chiang Mai, Thailand (74.1%) [11], MSM from bar, bathhouse, park, and internet setting in Beijing, China (56.2%) [12] and MSM from bar, brothel and internet setting in Chongqing, China (58.0) [13] but higher than heterosexual men who attended the STI clinics in China (9.3%) [20]. One reason for this phenomenon is probably due to the social movements and advocacy from various interest groups [14] that has led to more research and corresponding delivery of interventions for the MSM [34]. This is in contrast to heterosexual men, who have received far lesser attention and are generally invisible in HIV/STI prevention [35].…”

“…Interventions to improve HIV/STI testing are generally lacking among heterosexual men, particularly for this group who patronises EEs and engages in casual or paid sex [6, 14]. Future interventions for them should use strategies to enhance their risk perception and encourage HIV testing as well as to address stigma and discrimination associated with testing.…”

“…Second, most studies have focused on men who have sex with men (MSM), rather than heterosexual men [10–13]. The available literature provides little data to allow understanding of how sexually active heterosexual men behave in relation to HIV/STI testing [14]. Third, the few studies on sexually active heterosexual men are often from the West [15, 16] and Africa [17–19] where their sexual behaviour and HIV/STI transmission knowledge are likely to be different from that of Asia men [20].…”

Análise do atendimento nos serviços de saúde entre pessoas vivendo com HIV/AIDS

“…No entanto, o atual perfil da doença tem demonstrado que todos estão vulneráveis a contrair a doença, sendo indiferente ser do sexo masculino ou feminino 1,3 . A epidemia de HIV/AIDS vem sofrendo diversas modificações em seu perfil ao longo do tempo, entre as quais, os fenômenos de feminização, heterossexualização, pauperização e envelhecimento, ou seja, os padrões de vulneráveis ao vírus têm-se modificado, e não há mais a antiga estereotipação dos sujeitos vulneráveis 2,21,22 .…”

Homens heterossexualmente ativos e gerenciamento do risco de infecção pelo HIV no contexto da profilaxia pós-exposição sexual (PEPsexual): experiências em cinco cidades brasileiras

“…Se, à primeira vista, é bastante razoável supor que tanto homens quanto mulheres heterossexualmente ativos, precisam ser considerados de modo equânime nas intervenções de prevenção à infecção pelo HIV, na prática isso pouco acontece, mesmo quando os dados epidemiológicos são claros no que diz respeito ao lugar ocupado pelos homens heterossexualmente ativos no contexto da epidemia (HIGGINS; HOFFMAN; DWORKIN, 2010;LEAL;KNAUTH;COUTO, 2015). Os relatórios e documentos governamentais e de instituições internacionais, por exemplo, ainda insistem em tratá-los de maneira genérica e com pouco destaque aos contextos que podem colocá-los em risco e em situações de vulnerabilidade.…”