Male Sexual Practices

The Relationship Between Gender Norms and Expectations and the
Sexual Practices of Ugandan Men
Margaret E. Brawley
A thesis submitted in partial fulfillment of the
requirements for the degree of
Master of Public Health
University of Washington
Program Authorized to Offer Degree:
Public Health and Community Medicine – Health Services
University of Washington
Graduate School
This is to certify that I have examined this copy of a master’s thesis by
Margaret E. Brawley
and have found that it is complete and satisfactory in all respects, and that any and all revisions
required by the final examining committee have been made.
Committee Members:
Ann Downer
Hendrika Meischke
In presenting this thesis in partial fulfillment of the requirements for a master’s degree at the
University of Washington, I agree that the Library shall make its copies freely available for
inspection. I further agree that extensive copying of this thesis is allowable only for scholarly
purposes, consistent with “fair use” as prescribed in the U.S. Copyright Law. Any other
reproduction for any purposes or by any means shall not be allowed without my written
University of Washington
The Relationship Between Gender Norms and Expectations and the Sexual Practices of Ugandan
Margaret E. Brawley
Chair of Supervisory Committee:
Senior Lecturer, Ann Downer, EdD, MS
Department of Health Services
Men are critical to improving the health of a family in Africa, but their role is often ignored. A
better understanding of men’s beliefs, attitudes and practices about health is required in order to
effectively direct such efforts. However, these elements are significantly impacted by beliefs
about manhood and enactments of masculinity and a consideration of the link between gender
identity and specific health practices is pivotal. This paper presents the findings from focus
group discussions with Ugandan men regarding how they define what it means to be a man, their
common sexual practices, and their views on the role of women. Results show that manhood was
framed into 10 general categories: provider, employment/income, ownership, meeting cultural
norms, characteristics/age, moral values, caring figure, leadership, sexual activity and
power/control. In addition, the data show a strong connection between beliefs about manhood
and multiple sexual partners and faithfulness. Although a mix of masculine and un-masculine
beliefs supports the act of faithfulness, the behavior of having multiple partners is a compelling
representation of manhood. Condom use or lack of condom use was also associated with a mix
of masculine and un-masculine beliefs. This lack of decisive sentiment toward manhood in either
case may be a reason why condom use is variable.
List of Figures ..................................................................................................................... ii
List of Tables ..................................................................................................................... iii
Chapter 1: Introduction ....................................................................................................... 1
Gender ............................................................................................................................. 1
Male Gender Identity ...................................................................................................... 2
Male Sexual Practices ..................................................................................................... 3
The Woman’s Role ......................................................................................................... 5
Chapter 2: Overview of Study ............................................................................................ 7
Purpose............................................................................................................................ 7
Conceptualization ........................................................................................................... 7
The Research Question ................................................................................................... 9
Theoretical Context......................................................................................................... 9
Chapter 3: Methodology ................................................................................................... 11
Research Location ......................................................................................................... 11
Sampling & Recruitment Strategy ................................................................................ 11
Research Team .............................................................................................................. 12
Demographics ............................................................................................................... 14
Coding & Analysis ........................................................................................................ 14
Chapter 4: Findings & Discussion .................................................................................... 16
Description of Findings................................................................................................. 16
Definition of Masculinity & What It Means to Be a Man in a Ugandan Context .... 16
What Are Common Male Sexual Practices? ............................................................. 24
What is the Role of Ugandan Women According to Ugandan Men? ....................... 29
Discussion ..................................................................................................................... 32
The Relationship Between the Gender Norms & Expectations of Ugandan Men and Their
Sexual Practices ........................................................................................................ 32
Study Limitations ...................................................................................................... 42
Future Implications ................................................................................................... 43
Bibliography ..................................................................................................................... 45
Appendix 1: Focus Group Discussion Guide.................................................................... 49
List of Figures
Figure 2.1: Conceptual Framework…………………………………… 8
Figure 4.1: Theoretical Framework…………………………………… 34
Figure 4.2: Link Between Masculinities & Multiple Partners………... 36
Figure 4.3: Link Between Masculinities & Faithfulness……………… 38
Figure 4.4: Link Between Masculinities & Condom Use…………….. 40
Figure 4.5: Link Between Masculinities & Not Using A Condom…… 41
List of Tables
Table 3.1: Sampling Framework……………………………………… 13
Table 3.2a: Marital Status …………………………………………….
Table 3.2b: Number of Children………………………………….…..
Table 3.2c: Education Level…..………………………………….…..
Table 3.2d: Type of Employment……………………………….…….
I would like to acknowledge the YEAH (Young, Empowered and Healthy) Campaign in
Kampala, Uganda for providing me with the opportunity to conduct this fascinating research;
specific thanks go to Cheryl Lettenmaier and Anne Gamurorwa. My sincere appreciation also
goes out to the men and women of the research teams whose efforts and assistance allowed this
research to be conducted. Finally, thank you to the Ugandan men who openly contributed their
views and opinions.
Chapter 1: Introduction
The gender dynamic is often overlooked by mainstream public health initiatives. Only
in recent years has the recognition of gender norms and expectations in a cultural context
begun to play a more valuable role in health program development, communication and
HIV/AIDS in Africa. Still, much of the focus has centered on the position of women and
strategies for enhancing their empowerment. Despite the fact that many Sub-Saharan
African countries remain patriarchal societies and that men continue to maintain an
autonomous place of power and decision-making within a given family, the possible
influence of men in health initiatives continues to be largely ignored.
In order to significantly impact future health interventions, it is imperative that we
begin to explore the role of men in creating change for healthy behavior. An in-depth
examination should ascertain men’s beliefs, attitudes and practices regarding health, as
well as how these elements are enacted within a given family, community or society.
Despite some initiative towards increased integration of gender and health dynamics,
there is still a large gap in research aimed specifically at examining the relationship
between manhood and male sexual practices.
The literature around gender is immense and highly complex. Biological sex is
defined as the chromosomal, chemical or anatomical differences that make someone
either a male or a female (Kimmel, 2004). Gender is the manifestation of social,
economic, political and cultural elements, meanings or structures that are associated with
being either male or female. The construction of social identity is dependent on
contextual and situational changes over time (Campbell, 1997; Eckman, Huntly, Bhuyan,
2004). Although definitions of gender vary enormously (WHO, 1999; Eckman, Huntly,
Bhuyan, 2004; Kimmel, 2004), they are nonetheless instrumental to our life long
development. At an incredibly early age, gender enables us to develop a concept of self,
and this remains a lens through which we continually filter and analyze our life
experiences (Deaux & Major, 2004). This evolution continually shapes who we are and
how we make decisions, as well as permitting us a perspective of the world and the
ability to adopt a personal sense of responsibility within that framework (WHO, 1999).
Ultimately, gender identity forms a foundation for how we connect with our environment
including physical and psychological development, family interactions, health, culture,
education, socio-economic status and even sexual behavior, etc. (Barker, 2005).
Male Gender Identity
Manhood is the promulgation of beliefs that men imagine are the cornerstone of who
they are. However, it is not an inherent, biological manifestation. Rather, manhood is
socially constructed over time with affect from a wider historical cultural context
(O’Brien, 2005). Men often wrestle with the numerous variations of manhood and their
conflicting intricacies, while at the same time, requiring constant validation (Barker,
2005; Hearn & Morgan, 1990). Male gender is built around two central ideologies.
“First, being a man is natural, healthy and innate; second, a man must stay masculine; he
should never let his masculinity falter” (Silberschmidt, 2001, p. 667). Masculinity is
defined as the enactment of a man’s belief about manhood and there is far from just one.
In fact, masculinities often compete with each other – some appear dominant, while
others are marginalized or stigmatized (Kimmel, 2004; Hearn & Morgan, 1990). Robert
Brannon proposed that normative or hegemonic masculinity, i.e. white, middle-class and
heterosexual, has four key rules: 1) Don’t be a Sissy: avoid and disparage the appearance
of feminity; (b) Be the Big Wheel: maintain success and status; (c) Be a Sturdy Oak:
Demonstrate toughness, independence and dependability with emotional distance; (d)
Give’em hell: be aggressive and take risks (Hearn & Morgan, 1990; Jack, 2005).
Although narrow in scope, he suggests that this is the defined masculinity against which
all other masculinities are compared.
In an African context, manhood is shaped by cultural histories, religion, interactions
and power relations with other men, education, urban or rural environments, western
influences and global media (Barker, 2005; UNFPA, 2000. Chapter 5). Typically,
manhood might be symbolized by realizing financial independence, gaining employment
or generating income and starting a family. Men’s lives are generally believed to revolve
around the sphere of production, as women’s revolve around domesticity. Intertwined
with the standard concept of man as an economic provider, is that of a “macho sexuality”
(Campbell, 1997). When the economic status of a man is threatened or no longer exists,
than proof of his masculine identity often rests upon sexual virility, which includes
insatiable sexuality, the need for multiple sexual partners and desire for pleasure.
Sexuality becomes an important alternative to the creating of a masculine identity
(UNFPA, 2000. Chapter; Campbell, 1997).
Gender dynamics aside, new research demonstrates that manhood is fraught with
negative implications for men and this alone is ample justification for increasing the
focus on the health and well being of boys and men (WHO, 1999). Young men face high
health risks, especially evidenced by their higher risk of dying prematurely than girls,
from violent acts, suicide, accidents and drugs or alcohol abuse. The health behaviors
learned and adopted in adolescence often play a pivotal role in causes of death for men
later in life. The health of boys is directly correlated with the health of girls. The
relationships between men and women involve intricacies of pregnancy, sexually
transmitted diseases, reproductive health, violence and abuse. Finally, ignoring the role
of boys and men in HIV/ AIDS and other health related practices will be detrimental to
the future development of a country and will have tremendous impact on vital resources
(WHO, n.d.). Under the guise of masculinity, men are vulnerable and at risk for illness
and early death. The promotion of men’s health requires that we look beyond the façade
of gender identity and examine the harmful elements of traditional and cultural beliefs of
masculinity (Sabo, 2005). Underneath the possible justified written condemnation of
men’s behavior around alcohol abuse, domestic violence and multiple partners, we must
ascertain a deeper understanding of men’s roles in households and reproduction given
their cultural context (Barker, 2005).
Male Sexual Practices
Ten million people between the ages of 15 and 24 years have HIV/AIDS in SubSaharan Africa. Seventy five percent of these people are women (UNAIDS, 2004). The
statistics from Sub-Saharan Africa, suggest that between 20-80% of men have ever used a
condom, however less than 40% used a condom the last time they had sex (Barker, 2005).
According to the Uganda Demographic and Health Survey (2001), overall use of
condoms by men is a low 15% of those surveyed (p. 187). Research shows that men also
tend to utilize condoms as an indicator of how serious a relationship is versus as a means
of protection (Barker, 2005) and there is a visible discrepancy in regular condom use
reported by Ugandan men dependent on if the partner was cohabiting - 3.9% or noncohabiting – 58.9% (UDHS, 2001, p. 189). These statistics suggest that we need to take a
closer look at the relationship between manhood and sexual activity. Twelve percent of
married men described having one or more partners other than their spouse or cohabiting
partner in the previous year (p. 184) and eleven percent of unmarried men reported being
more likely to have had multiple partners. The practice in both married and unmarried
men was found to be more common in younger men (ages 15-30) and those living in
urban areas (p. 185).
Similar to gender, sexuality is also socially constructed. “The meanings and behaviors
are constructed from images, values and prescriptions in the world around us. Such
constructions are as much coerced as they are voluntary” (Hearn & Morgan, 1990, p. 97).
Sexuality is continually influenced by dimensions of culture, time, society and the life of
an individual (Hearn & Morgan).
Research illustrates that sexuality and the ability to function sexually are inherently
interwoven with a man’s experience of self, confidence, self-esteem and social value
(Hearn & Morgan; Silberschmidt, 2001). Often sexual activity such as multiple partners
or sexual control over women serves as compensation for the loss of masculinities in
other dimensions such as economic empowerment. As a result, manhood is conceivably
threatened by the mere suggestion of sexual deficiencies or problems. Masculinity in
relation to sexual practice is squarely predicated on a man’s physical sexual capabilities
versus mutual pleasure (Hearn & Morgan, 1990). There is evidence to suggest that a
man’s sexual virility may also be compromised when a man is required to use condoms
(Campbell, 1997). This is further argument for considering the important social context
of masculine identities in public health interventions.
Michael Kimmel makes an interesting argument about the enactment of hypermasculine sexuality in gay men, which is parallel to men within the African context. In
the late 1960s and early 1970s, the masculinity of gay men suffered tremendous damage.
At the time, the very concept of being gay defined these men as “failed men” since
having sex with men was akin to behaving like women (Hearn & Morgan, 1990). After
the Stonewall riots, a new gay masculinity emerged that elevated some men to a butchlike status, utilizing more visible representations of masculine attributes including
clothes, muscular tone, moustache, etc. Gay men began to enact what Kimmel calls a
“hyper-masculine sexuality,” defined as plentiful, anonymous sex with little foreplay or
attachment (Hearn & Morgan). These exaggerated behaviors of masculinity were
“detached, phallaocentric, orgasm-focused, often anonymous, sexually adventurous” (p.
107). With the arrival of HIV/AIDS, safer sex campaigns began to encourage gay men to
reduce their number of partners, avoid casual encounters, avoid dangerous sexual
practices and use condoms.
In short, safer –sex programs encouraged men to stop having sex like men. In a
sense the term ‘safe sex’ is an oxymoron: that which is sexy is not safe; that
which is safe is not sexy. Sex is about danger, risk, excitement; safety is about
softness, security, comfort…If we are to make safer sex into sexy sex we must
confront this issue of masculinity, just as we will need to confront the issue of
masculinity to help men with sexual problems. (p. 108)
This same ideology is applicable to men in Africa and Uganda specifically. Research
shows that men engage in multiple partners, believe they must have regular sexual
activity to maintain their health, and have a high sex drive that requires satisfaction
(Silberschmidt, 2001). Maybe safe sex is simply not sexy enough for men to make a
change in their behavior. Until we better understand the impact of masculinities on these
various sexual practices, we could be hopelessly dispersing irrelevant and ineffective
health messages and education.
The Woman’s Role
Under a relatively patriarchal realm, the role of women in Africa remains regulated to
one of domesticity. Women are charged with taking care of the household and
childbearing responsibilities. The woman is also responsible for achieving and
maintaining a family’s health, although this is seldom valued. Gender bias and
disempowerment have widespread detrimental affects on the health of families, but
women are vulnerable to the sexual behavior of men and often lack the ability to change
the power dynamic found in these relationships (Barker, 2005).
The role of gender norms and expectations has remained relatively unacknowledged in
development. Organizations are beginning to realize that the improvement of women’s
health is contingent upon male engagement. In 1994, the International Conference on
Population and Development (ICPD) developed a mandate which recognized the
importance of the men’s role in women’s health, as well as their own (Cohen & Burger,
2000). The mandate sought to “promote gender equality in all spheres of life, including
family and community life, and to encourage and enable men to take responsibility for
their sexual and reproductive behavior and their social and family roles” (Barker, 2000, p.
African women’s responsibilities have increased with the economic disempowerment
of men. The resulting impact has been a discernable effect on men’s social value,
identity and self-esteem. Consequently, sexual behaviors such as multiple partners and
aggressive practices fortify beliefs in manhood. Clearly “strategies to improve sexual
and reproductive health must take into account how socioeconomic changes have
effected traditional gender roles and male sexual behavior” (Silberschmidt, 2001, p. 657).
Altering gender roles is not something that will happen over night, and it often creates
stress in an already tense environment. We must be cognizant of the fact that even those
in positions to change policy can be hindered by their own gender perceptions and
inherent beliefs. The idea of integrating gender needs into program development and
research must be more broadly applied in order to help us reduce risky sexual behavior.
Instead of identifying men as simply a problem in relation to women’s sexual and
reproductive health, we should value their motives and concerns. Investment in future
gender research that can be applied to practical interventions is a necessary step on the
way to changing future behavior and improving the health of women and children in
Chapter 2: Overview of Study
The government of Uganda is attempting to tackle a multitude of health risks within
their borders. Improving the health of women and children is invariably linked to
decreasing poverty. A lot of money has been spent on increasing access to services for
women and targeted health education campaigns, but less has been directed towards men.
This work has often neglected the role men have within a family and the influence they
wield in regards to health matters.
Men are often the decision makers and maintain control of the family finances. It is
critical to consider their position. What are their attitudes, beliefs and knowledge about
sex, reproductive health, and gender roles? If we can better understand how and why
men behave in certain ways, we will be better equipped to provide services and
information that may enable men to engage in more positive behaviors under these
This qualitative research was designed to learn how men in Uganda define what it
means to be a man and to learn how these gender norms, beliefs and expectations impact
their personal practices in sexual relationships. We may better serve men and their
families in an attempt to improve health by learning more about beliefs in manhood or
enactments of masculinities. With this insight we can create strategies, messages and
services, as well as utilize appropriate communication mechanisms and community
activities to directly communicate with men. We will be better informed to devise
methods that integrate men in discussions about the health of their family and the role
they play.
Development of the research tools and design began under the guise that there are
three primary mechanisms integral in defining a man’s masculine identity: 1) the gender
norms and expectations of others (e.g. peers, family, friends, leaders); 2) cultural
influential mechanisms of gender concepts including religion, historical and economic
systems; and 3) the inherent, biological facets of gender. A person’s beliefs about gender
roles evolve through a process of socialization where people internalize what is expected
of them from society. Many different elements contribute to this socialization including
family, culture, education, socio-economic status, religion, ethnicity, media and
environment. In turn, these beliefs about gender and the broader cultural dynamic
constitute the formation of a man’s ideology about what it means to be masculine or to be
a ‘real man’ and often continually reinforce that dogma. Masculine is defined as a
characteristic of a man or pertaining to the male sex, but the term masculinity denotes the
concept of enacting a man’s beliefs about his manhood. Consequently, the research
theorizes that beliefs about manhood can influence man’s sexual practices.
Figure 2.1: Conceptual Framework
The basis for this conceptualization is routed in information learned during the
literature review, as well as the researcher’s personal experience. The research is
designed with a humanist approach. As with any study of humanity, there is an element
of subjectivity. It is impossible to ascertain the intricacies and mysteries of the human
brain with a single method of study. Development of attitudes, reasons for behavior and
the retention of knowledge are dynamic mechanisms that interact based on how a person
thinks, makes decisions and understands his/her environment. The levels of conscious
and unconscious reasoning and awareness alone create complicated psychological layers.
Understanding this process or gaining some insight into the larger picture requires
multiple study approaches. Undeniably, it is impossible to escape the use of one’s own
feeling, values and beliefs in order to understand the nature of human experience. This
research used an inductive approach to better understand how beliefs that define gender
impact sexual practices. The focus group questions were designed in keeping with the
conceptualized idea of learning more about how beliefs in manhood are formed, what
sexual practices men engage in, and, consequently, linking how enacting masculinity may
influence these male sexual practices. The questions were created to capture broad,
general information about these concepts without influencing the participants’ ideology
or beliefs, so as to leave the data open for interpretation.
The Research Question
The main research question asks how do Ugandan men articulate their role as men and
their attitudes, beliefs and practices towards sexual relationships? Specifically, the
research aims are:
How do Ugandan men define what it means to be a man or masculinity?
What are common sexual practices of men?
What do Ugandan men think about Ugandan women and their role in this society?
How do beliefs in manhood influence men’s behaviors and practices in regards to
sexual relationships?
Theoretical Context
The theoretical framework for this qualitative research is grounded theory. As defined
by Strauss and Corbin, grounded theory is “theory that was derived from data,
systematically gathered and analyzed through the research process. In this method, data
collection, analysis, and eventual theory stand in close relationship to one another”
(Strauss & Corbin, 1998, p. 12).
The central feature of grounded theory allows a theory to rise from the data and speak
its own truth, versus a truth that is heavily pre-conceived by the researcher. In a way, the
process is similar to that of putting together a puzzle where an exact final picture is
unavailable or unknown. One might have an idea of how the final product should look
based on a description on the box or conceptions and knowledge of the world, but,
inevitably, the picture is created with the integration of individual puzzle pieces. A
researcher examines the information collected, conceptualizes reoccurring ideas,
organizes the various dimensions of the information and continually makes comparisons
and asks questions. This interactive process between the researcher and the data allows a
continuum of information extraction and analysis of the raw data.
Data for grounded theory is processed utilizing open, axial and selective coding in
order to conceptualize categories, as well as the properties and dimensions within those
categories and, ultimately, integrating the categories into a theoretical framework. Open
coding is a method of classification. Collected data is reviewed line-by-line for
reoccurring ideas or concepts, which can be codified. These codes are representations of
the story the data was trying to tell. Over time, many of these concepts are grouped
together as characterizations or dimensions of a larger theme. Often these sub-elements
help to explain the events by answering when, where, why, who, how and what
consequences result (Strauss & Corbin, 1998). This process of linking broad categories
with properties and dimensions is called axial coding. At this point the researcher
examines how these various concepts relate to one another in the given situation. While
immersed in the data, the researcher must maintain objectivity and sensitivity.
Eventually, a level of theoretical saturation can be obtained and no new information
emerges from the data. Subsequently, the researcher utilizes selective coding as a process
of integrating the themes and categories into a possible theory.
A theory explains phenomena via the relationships of categories, themes or concepts
(Strauss & Corbin, 1998). Strauss and Corbin (1998, p. 12) suggest that “theory derived
from data is more likely to resemble the “reality” than is theory derived by putting
together a series of concepts based on experience or solely through
speculation...Grounded theories are likely to offer insight, enhance understanding, and
provide a meaningful guide to action.”
Chapter 3: Methodology
Research Location
The research was conducted in five distinct regions of Uganda under the auspices of
the Young, Empowered and Healthy (Y.E.A.H.) Campaign. The Y.E.A.H. Campaign
began in 2004 to address the growing need to improve health and social practices among
young people in Uganda. It is a multi-channel communication campaign that combines
mass media, person-to-person and community interactions to stimulate dialogue and
action among communities, families, schools and health institutions and model positive
practices. One of its nationwide campaigns will address gender inequities, targeting
Ugandan men. This qualitative research provided baseline information needed to build
the communication strategy for the intervention.
Uganda is a developing country located in Eastern Africa. Its population consists of
approximately 26 million people (Index Mundi, 2004). Most of the population lives in
rural areas with limited access to clean water and health care. Thanks to the recent
advent of Universal Primary Education, the first four children of any family are permitted
free primary education. Thus a great majority of girls and boys (87-89%) attend primary
school. The same cannot be said of secondary school (Ministry of Gender & Sports,
2003/4). Literacy rates in the country range from 60 % for women to 70% for men
(Index Mundi, 2004). The country is an amalgamation of more than 40 different tribes
and languages, although the government typically utilizes eight primary languages. In
order to capture a range of responses from different ethnic groups in the country, the
research was conducted in five areas with a mix of rural and urban locations.
Sampling & Recruitment Strategy
For the purpose of this paper, 10 focus group discussions (FGDs) with men were
utilized for analysis about masculinity and the relationship to sexual relationships. Each
focus group contained between 10 and 12 people. A stratified purposeful sampling
framework was designed too collect input from different ethnic groups in the country in
five regions in which to conduct focus groups: Southwest (Mbarara District), West
(Kabarole District), North (Gulu District), East (Soroti District) and Central (Luwero
District). These regions were illustrative of five distinct ethnic groups, cultures,
languages and various socioeconomic situations (rural vs. urban). In addition, the focus
groups were stratified by gender and age groups of 18-24 years and 25-35 years to
ensure a level of comfort within the participants, as well as allow the opportunity to view
any notable differences in responses for these groups. The choice of participants was
theoretically driven and the sample was not a measure of representative ness within the
country. The research findings are not meant to be “generalizable” to the rest of the
population, but rather a method of informing the audience about what some men believe
to be true in regards to this subject matter.
The focus group participants were recruited with the assistance of community-based
organizations (CBOs) in each locale including the Kabarole Research Center, AMREF (2
regional offices), ACORD and Save the Children Foundation. The CBO managed the
mobilization for that region and in conjunction with the researcher, discussed the most
feasible methods for recruitment in that area. Mobilizers of the CBO were asked to
recruit according to the age and gender guidelines from a large segment of the population
in that community and not involve people from their own programs. Mobilizers recruited
from schools, churches, health centers, community venues, local neighborhoods,
businesses, etc. Recruitment was done via one-on-one interaction with the mobilizer and
word of mouth. Interpersonal communication is a standard method for mobilization in
this developing country. Pure economics prevents the use of advertising in newspapers
and utilizing telephones, since most people will not have the financial capability to
answer an ad or return a telephone call. Poor roads (or no roads) make movement
difficult. The best dynamic for mobilization was to work with a person familiar with the
community and its people. Mobilizers were paid a transport fee and per diem to allow
them to recruit effectively and participants were given a minimal transport
reimbursement, soda and snack on the day of the event.
Research Team
The focus groups were conducted by a team of research assistants fluent in the
appropriate languages and matching the respective ethnic groups in the area when
possible. The research assistants were identified from a pool of experienced individuals
with assistance of the project staff and the principal investigator (PI). Two male research
assistants facilitated the male focus groups. One person was responsible for leading the
discussion, while the other took notes and tape-recorded the session.
Table 3.1: Sampling Framework
18-24 yrs = 12 pple
25-35 yrs = 12 pple
18-24 yrs = 10 pple
25-35 yrs = 11 pple
18-24 yrs = 12 pple
25-35 yrs = 12 pple
18–24 yrs = 10 pple
25–35 yrs = 11 pple
18-24 yrs = 11 pple
25-35 yrs = 11 pple
10 groups = 112 Males
The researcher trained the research assistants on facilitation and documentation of
the FGDs. In addition, there was a supervisor for each region to help manage the regional
team and ensure the research assistants were completing their responsibilities and had
adequate skills to conduct the research. The training consisted of a review of
methodology and tools, practice role modeling and conducting sample FGDs in the field
as a method of pre-testing the translated tools. This pre-testing activity took place in
various areas of Kampala and utilized the five different languages. The pilot test ensured
that the terminology used in the focus group guide was understood and the meaning was
translated appropriately. The pilot test also provided a realistic time frame for these
activities, as well as highlighting questions that were not well understood. A couple of
weeks after the training, the teams went to the field to conduct the focus groups. The
actual locations of focus groups varied in accordance with the availability of meeting
spots in the community. Churches, schools or other local meeting venues were utilized.
A total of 112 men participated in the focus group discussions. The majority of men
were either single or married and the number of children ranged from zero to five. Most
men had some level of either primary or primary and secondary education and generally
considered themselves to be employed in the agricultural field.
Tables 3.2a-d: Demographic Statistics
3.2a. Marital Status
3.2c. Level of Education
Some or All Primary
Some or All Secondary
Other: University or
3.2b. No. of Children
3.2d. Type of Employment
Skilled or Casual
Manual Labor
Coding & Analysis
The data was collected via written notes of the research assistants, which were later
turned into typed reports, as well as tape recordings. The recordings were transcribed in
the vernacular languages and subsequently translated back to English and checked. This
process, which utilized three different groups of people – transcribers, translators and
checkers, was established to ensure accurate replication of the conversations in each
focus group with little personal interpretation. Nonetheless, this procedure of passing
information through multiple hands inevitably lead to some loss of information and data
reduction. The data was conceptually rich, but the context of how the information was
collected and processed was an important consideration throughout the analysis.
The coding process consisted of open, axial and selective coding. Initially, a basic
thematic coding process was utilized in Uganda directly after the data had been collected.
A team of three people – female and male, Ugandan and American - identified potential
categories or themes that might emerge from the data. As the transcripts were read, these
initial categories were expanded, collapsed and integrated to accommodate the story of
the data. The process was interactive and continuously evolving throughout the analysis
of the data.
A few months later, the transcripts were reviewed again and a formal codebook of
categories and properties was developed utilizing the prior work as a foundation. The
codebook is in fact an integral link to the theoretical framework. The framework was
constructed to explain what external influences impact masculine identity and male
sexual practices. The codebook is an outline of broad categories concerning definitions of
masculinity was defined, sexual practices of men and the role of women, followed by
dimensional, descriptive elements within each of these categories.
The Atlas.ti v.5 was the tool employed to organize the data. Transcripts and codes
were entered and subsequent coding was initiated line by line. Little time was spent on
the analysis of actual words used, given that the words could have been modified or
misinterpreted in the process. However, linguistics were considered in some instances in
order to clarify the meaning of a word. For example, the terms of ‘house’ and ‘home’
have distinct meanings in a Ugandan cultural context and this was an important concept
to be aware of during analysis. But generally, the focus remained on broad conceptual
This research was an inductive approach to understand how beliefs that define a
gender impact the practices and behaviors in everyday life. It is important to note
positionality of the study (i.e. how the researcher might influence the design and
interpretation of the data). In this case, the researcher was a white, American female and
the participants were black, Ugandan males. Although there was no direct interaction
between the two, and although the researcher took some steps to utilize Ugandan men in
the analysis, as well as to continually inhabit a role of objectivity and sensitivity, there
was nonetheless a variation in cultural, social and economic dynamics that could
influence how information is perceived during the analysis.
Chapter 4: Findings & Discussion
Description of Findings
Many assumptions have been made about why men act and behave the way they do and
how this ultimately impacts their own health and those of their families. Surprisingly, few
have taken the time to ask men about these issues. These research results outline the
descriptions, experiences and stories that men used to explain what it means to be a man
in Uganda, common sexual practices and their view of women. By no means are the
results meant to be representative of all men in Uganda. Rather, this research provides a
snapshot of beliefs, attitudes and practices from a few men in different regions of the
country that may illuminate a better understanding of men and gender issues
Definition of Masculinity &
What It Means to Be a Man in a Ugandan Context
Masculinity is a multi-dimensional, monolithic, subjective and linked inextricably
with cultural norms and expectations and gender dynamics. Not surprisingly, there was a
proliferation of ways that Uganda men defined masculinity or what it meant to be a ‘real
man.’ Masculinity was regularly associated with direct physical acts, as well as specific
characteristics or ways of being and routinely quantified with individual experience, as
well as the perceptions, encounters and attitudes of fathers and male role models. The
Ugandan men from the focus groups identified a series of elements that they deem
significant to manhood or enacting masculinity. These elements can be categorized into
the following 10 overarching themes:
Provider: caring for your wife, children and other relatives by providing a home,
food, clothes, school fees, school supplies, health care expenses
Employment/Income: generating an income by way of a job, business or
ingenuity; demonstrated attempt to work hard and make a living.
Ownership: Financial ownership of a home, farm animals, transportation and/or
Meeting Cultural Norms: in keeping with long-standing cultural and tribal
beliefs, men should be married and have many children
Characteristics/Age: displaying specific characteristics (well-mannered,
respectful of others, not lazy, greedy or jealous) and obtaining a certain level of
maturity denoted by age
Moral Values: upholding moral values such as honesty, not stealing, not being
adulterous, following religious teachings and not participating in witchcraft
Caring Figure: maintaining a loving, caring relationship with your wife and
children; being involved in their lives and knowing problems/issues that arise
Leadership: demonstrating an involvement in community activities; people seek
you out for advice and assistance; providing guidance
Sexual Activity: men have an inherent right to engage in sex as illustrated by a
high sex drive and natural, uncontrollable lust; engaging in regular sexual activity
that is pleasurable and satisfying; sexually satisfying your partner; demonstrate
virility; desired by wives; remaining faithful/ability to control sexual urges and
sexual responsibility.
Power/Control: position of authority in the community; managing people; control
of sexual relationships including instigation & length of the relationship and
contraception use; designated authority figure and decision-maker in the family.
The average Ugandan male embraces or laments his masculinity on a daily basis in the
constant struggle to provide for his family. Undeniably, this is the most prominent
distinction of male capability, which is publicly flaunted via spouse(s) and children. The
type of food a family eats, if the children attend school, what type of home is provided,
the manner of clothes worn by family members and meeting health care needs are all
standard indications that determine if a man is meeting his primary responsibility.
Providing for a family is also the cornerstone of a man’s masculinity. Ugandan men, not
unlike other men in the world, have been raised to believe that providing for their family
is largely a function of what it means to be a man. Thus, if provision is perceived to be
insufficient, a man is disgraced and generally believed to be less of a man.
When you become a man, you look for money and when you get it, you
look after your family. – Mbarara 25-35 years
You should have money, provide medical care for the children, clothe and
educate them. – Gulu 18-24 years
Subsequently, adequate provision of a family is recognized by peers, family and
neighbors and becomes a driver of a man’s respectability within his community. At the
same time, not providing for your family holds negative consequences and often in order
to avoid humiliation, a man will take steps to keep the reality a secret or drown his
shame, embarrassment and guilt with alcohol or drugs to allow a moment respite.
You have to take care of your home, clothing your wife and the more you
dress her the more you get respect. – Luwero 18-24 years
…(if) you have failed to support your family, it can make you to be less like
a man. Even if it is clear that a man has really failed to support his family,
such a man cannot admit because he knows that his friends can make fun
of him. – Soroti 25-35 years
Providing for one’s family has a direct correlation with being employed, earning an
income and working hard. Ugandan men believe they should continually demonstrate
initiative in this regard, and, if possible, improve the lives of their family members at an
economic level. Sustaining some level of employment is a key piece to the puzzle, but
men also reference the importance of meeting financial obligations, paying government
taxes, engaging in financial planning and not carelessly wasting generated income.
However, a man is not required to be rich to prove his manhood in this regard or even to
hold down a regular job. Men are very aware of the difficulties in the Ugandan economy,
so at a minimal level men should appear to be making diligent, concerted and honest
efforts to try and earn money to support their families.
…if you have a job and come home with a loaf of bread that makes you
respectable. – Kabarole 18-24 years
…if he is a farmer, he wakes up very early in the morning and goes to the
garden to dig. When he gets the harvest he uses for feeding his family. He
does not waste, he apportions it accordingly. (This) man plans well on how
to cultivate his crops. – Soroti 25-35 years
If a man has a job, money and is better than you, you admire him. –
Kabarole 18-24 years
Further along this continuum of providing for a family and generating an income is
the concept of ownership. Owning a house, farm animals, land or a car is justifiable
evidence of man’s ability to provide for his family and his own independence.
Ownership brings status and respectability. As an indication of wealth, ownership of
property or the like is widely respected and admired because it is something most men
are eager to gain themselves. Furthermore, it is a clear indication of a man’s personal
achievement and success.
I think one turns into a man when he constructs a house. (Until then) you
can be a man, but not a full man. – Luwero 25-35 years
What we value most is land because all the wealth comes from land. –
Soroti 25-35 years
Yes, even just dressing – the way I look at it I am not doing well on my
side, but the dress code of my neighbor is good. So I imagine the way I
can get the wealth I want to be in, but there is no way I can get to it. –
Soroti 18-24 years
Fulfilling cultural obligations is another piece of masculinity. Getting married and
having children are common directives that Ugandan men feel obliged to follow. Men
may not necessarily pick a spouse from a love match, but rather from the needling
pressure to meet the marriage demand. Marriage is often contrived as a duty and
responsibility to your tribe. Thus, it is important to find a wife who can shoulder the
domestic burdens, bear many children and obey and honor her spouse. Ironically,
marriage can often not be achieved unless a man has met the previous requirements of
earning an income and ownership of animals or property. Many of the younger men
complained of having to face great community pressure to marry, yet being financially
unable to pursue this option.
If a man has his family and children, people respect him. – Kabarole 18-24
If you have a house, whether rented or built, you have to have a woman
and get married. (Then) produce children and you will look after them. –
Mbarara 25-35 years
Children, even more so than a wife, are a physical measurement of a ‘real’ man in
Uganda. There is ornate prestige centered about the number of children a man has sired.
The more children a man has, the more sexually virile and strong he appears. Having
many children earns him respect from others.
You can produce about six children, and the other thing it is prestigious.
Women will refer to you as a powerful man. – Luwero 18-24 years
The first thing is to make a woman pregnant and the second thing is that they have
40 children. (laughter) – Mbarara 25-35 years
The context of having a large number of children has important historical context.
Farmers needed a large number of children to help cultivate and harvest crops. Children
were commodities necessary to achieve survival. Over time, this has transformed into a
representation of sexual validity and domination for men.
…they consider children as wealth, so if you are married and you are not
able to produce you become a laughing stock. – Soroti 25-35 years
Being a Ugandan man requires a mix of personality traits and characteristics. A man
who behaves well towards others through honesty, good manners, not gossiping, not
using vulgar language, not engaging in witchcraft, stealing or fighting with his wife is a
deemed a worthy male model. Men say repeatedly that they admire other men with “good
moral values.” Good moral values seem to encapsulate the above and also indicate a level
of religious belief and involvement.
To be a man depends on how you behave, when you have a family, and
when you have good manners, when you have a job, then you are a man. –
Kabarole 18-24 years
Men were equally quick to identify characteristics that were unseemly and unmanly
including: laziness, jealousy, being rude, greedy or being bigheaded.
…even laziness. Laziness also makes him weak...if you do not want to
work, it makes you weak. – Kabarole 18-24 years
Next is being selfish and greedy. This makes a man to be less like a man
and people even ridicule you. – Soroti 25-35 years
One characteristic especially noted as important for men was the ability to emotionally
care about others, his wife and children. Men generally believed that a real man loves and
respects his wife, advises his children and is knowledgeable about matters that are
occurring with his children and other family members.
In addition, you get involved in their lives, like find what problems they
have, how are they doing in school, etc. You also make sure that your
children are safe - Kabarole 25-35 years
Finally, most Ugandan men seem to agree that the move from ‘boy’ to a ‘man’ occurs
between the ages of 16 and 20 years. Some men suggested that the maturity of a boy
plays a more pivotal role in determining his manhood versus age. A male’s interaction
with his community, contributing to perceived “adult” discussions, seeking advice,
advising others and his relative independence from his family are all signs of a
blossoming maturity that is highly valued for men.
The role of leadership within a community is a well-respected masculine attribute.
Men who are involved in community activities, listening to, advising and uniting people,
solving problems and generally showing respect to others are trusted and admired by
other men. It is a feature beyond simply caring and seems more akin to the ability to
actually help other people and invoke a sense of trust, which encourages people to seek
out these men.
(these men) have good personalities, talk well to people and even give
people very good advice. They are not the kind of men who give wrong
advice for example telling someone that ‘my friend, your wife is a very
nagging woman, beat her and chase her away’. Or ‘ your brother is a
pain, do such thing to him.’ They are men who give good advice about
how to manage a home. – Gulu 18-24 years
It is that one who maintains the road, supports those who lose their loved
ones and keeps the night vigil by the fireplace and being helpful to others
when you become a man. – Mbarara 25-35 years
Men are positively defined by these efforts. The combination of good character, moral
values, leadership and others elevates men to a higher level of popularity and thus, grants
him more recognition.
Like a man has a good job or dresses very well, why do you respect those things?
Because those things make you popular and therefore, people respect him. –
Kabarole 18-24 years
Such things give you recognition. For instance, if you are someone’s boss, one
can say pass through so and so’s home. You become a directory. – Kabarole 1824 years
Sexuality is an integral piece of a man’s self-awareness and his own personal
empowerment. Dependency on sexuality to illustrate one’s masculinity becomes even
more significant when that man believes he is failing on an economic level. Although the
link to sexuality and masculinity may appear obvious, the dimensions of what is required
from a man to maintain that masculine image can be encompassing. First and foremost,
most men believe it is their natural inherited right to go forth and enjoy the fruits of sexual
encounters. Sex gives them great pleasure and men typically describe themselves as
having a higher sex drive than women and a “natural lust,” which must be satisfied.
Second to that is the importance of a man’s sexual performance or virility. The ability to
perform sexually and to do so, on a frequent basis is representative of a strong stamina
and a powerful man. Physical evidence of this behavior amounts to the creation of many
children with your wife and the sexual interaction with additional women. The behavior
of multiple partners is further justified by myths or cultural dynamics that suggest women
are not sexually aggressive and lack a sex drive, there are less women than men, women
are exhausted by continual sex acts and when pregnant or for weeks after delivery,
couples should not engage in sex. Often the men describe these as reasons why they feel
compelled to seek out sexual fulfillment from other partners, but satisfying a partner’s
needs and the appearance of being wanted sexually by your wife is important component
to men’s masculinity. Men report feeling shamed and disgraced if their wives refuse to
engage with them sexually.
You feel vulnerable when you provide your wife with everything but
sometimes when you come back home with an urgent sexual urge she turns
her back to you. This brings shame. – Gulu 18-24 years
Men also suggest that there is a small amount of attention paid to sexually satisfying your
partner, remaining faithful or monogamous and being sexually responsible (i.e. using
condoms if you have sex with women other than your co-habitating partner).
Furthermore, not having sex or the perception to that effect has direct consequences on
a man’s masculine appeal. It is generally assumed in these cases that the man suffers
from sexual problems such as impotence or disease or that the man is just sexually weak.
The possibility of defamation is clearly feared by men and causes them to speak in
serious, reverent tones.
…being impotent, a man will always fear to say that he is impotent in
public and also when he is with a woman he will always give lame excuses
that “I have a hydro cell, so I can’t have sex with you” because he knows
the moment he discloses this to people, they will make fun of him. Then
also when a man contracts an STD, e.g. gonorrhea, he can not disclose to
his family or friends because they will ridicule him and he gets ashamed,
but later when the signs show up he will have nothing to do. – Soroti 2535 years
Being a man means you as a man first of all have your male sexual organ.
Secondly, if you go to bed with a woman, your thing (penis) will not
embarrass you. That to me is what is meant by being a man. – Gulu 25-35
Power – whether an illusion or real - is an important backdrop of masculine identity on
several levels. First, there is the power and control associated with economic
empowerment. One’s ability to gain wealth, influence and direct other people and the
independence to control your own path is widely wished for. Men often cited the
admiration for men with “government” jobs, as these are generally believed to be secure,
well-paid positions with authority. Second, there is the feeling of power obtained when
men play the role of the strong, dominant sexual initiator. It’s the combination of
perceived sexual know-how and control of the encounter – from instigation to use of
contraception to continuation of the relationship. Third, there is great weight attached to a
man’s ability to “control” or maintain authority over his family – even if it is just the
appearance of authority and it is not accompanied by personal responsibility for the
family. This level of control can often be undermined by marital discord, frequent arguing
or a disorganized household. Appearances are significant in Ugandan society. A wife is
viewed as the physical extension of a man. Should his wife appear dirty, unclean, poorly
dressed, greet guests inappropriately or be negligent with her domestic responsibilities,
the man takes this as a direct offense to his own personal dignity and presentation to the
community and thus, will take immediate steps to solve the situation.
...a man must have strong control over his family...he must ensure that he settles
any problem that his household may suffer because a woman may not be able to
solve it. – Gulu 25-35 years
Power denotes a level of strength and control, which is often found at the heart of
masculinity. The men in the focus groups regularly disparaged those who abused
substances such as alcohol and drugs. The resulting negative behavior, such as urinating
or defecating in public, passing out on the side of the road and fighting, represents a loss
of control that reflects badly on your manly image. A man in such a state has no ability to
reason and thus, appears powerless.
Also another bad characteristic of men is - they consider drinking alcohol
as the most important thing in their lives. When they get drunk, they start
quarreling, fighting and even urinating in the trousers. They forget about
providing for the family and farming. – Soroti 25-35
What Are Common Male Sexual Practices?
When it comes to sex and sexual relationships, men engage in having sex with
multiple women, practice faithfulness, use condoms or don’t use condoms. It is important
to note that the term faithfulness can have different meanings. In this research the term
faithfulness, as discussed by the men, signified the notion of a man being monogamous,
i.e. having sexual relations with only one woman over a given period of time. Each of
these sexual interactions has implications on the health of men and women, and they are
influenced by multiple dimensions of gender beliefs, cultural traditions, religion and
The practice of men having multiple wives has a lengthy historical context in Uganda.
In earlier times, farmers had multiple wives to help them with the planting and harvesting
crops, as well as to produce children to assist in this endeavor. More laborers meant more
production and ultimately, more success for the farmer. Although there is less need for
this situation now, the justification of multiple partners has distorted to the belief that
these relationships are necessary to prove a man’s self-worth and masculine virility. A
man’s manhood is substantiated by having multiple partners. The actions have a
connotation of prestige, garner respect and earn admiration from both men and women.
Most men have many sexual partners to show their manhood. – Gulu 18-24
Traditionally having many wives was prestigious; men have many sexual
partners for prestige. – Gulu 18-24 years
Engaging in multiple sexual relationships is further warranted by the belief that men have
a natural, often uncontrollable lust, which gives them a higher sex drive than women.
Men feel an innate right to fulfill their sexual desires, which is often fortified with
religious teachings, for example “when God was creating a woman she came from a
man’s rib” (Luwero, 25-35 years) or “In the bible, the woman came last. Therefore, she
has to be under the man” (Luwero, 18-24 years) or the idea that women were simply born
for sex. There also seems to be a general impression that there are many more women
than men in the country and it would be shameful to let a woman suffer from sexual
neglect. In fact, the percentage of men to women in Uganda is 49.9% to 50.1%; not a
large differential (Index Mundi, 2004). The combination of these convictions reinforces
the use of multiple partners.
Some men are naturally promiscuous, whereby a character is just in born
with them. – Soroti 25-35 years
Some men have a very high sexual urge and then his wife on the other
hand has a low sexual drive, so this one woman alone can not satisfy a
mans desire, this makes a man to look for other women in order to satisfy
himself sexually. – Soroti 25-35 years
Some men claim that women purposefully incite their lustful disposition by dressing
seductively or in a sexually suggestive manner. This apparel invites a sexual feeling,
which they feel powerless to ignore. Yet other men simply claim some men lack the will
to resist and they define these men as desperate, loose, greedy, heartless and fake. Other
times, these men are thought to be dangerous or mentally disturbed since the perception
is that they are failing to consider the consequences of their actions.
The use of multiple partners is also a method of sexual exploration and discovery.
Men claim they want to sleep with different types of women in order to learn new sex
styles or tricks. They want to know the sexual differences between women of diverse
clans, tribes or races.
Some men do it for adventure, others want to discover the difference in
sweetness in different races. – Luwero 18-24 years
Money is a conduit to having multiple partners. There is an unequivocal correlation
between the two. If a man is wealthy, men presume he has multiple partners. If a man
has multiple partners, men assume he is wealthy. However, these presumptions are
predicated on belief and not fact.
…you find that those with money always spend it on women. They
normally want to have women in each and every center. – Soroti 25-35
This theory also holds true in the reverse. Faithful men are believed to be relegated to
this condition because they have no money. Being poor does not allow them to keep
multiple women. Alternatively, faithful men are thought to be misers or saving money
for their family.
A man’s relationship with his wife also plays a pivotal role in the pursuit of multiple
partners or lack thereof. A woman is required to meet several conditions in her role as a
wife. She must be obedient, respectful and loving, satisfy a man’s sexual needs, fulfill her
domestic responsibilities, remain attractive and young in appearance and produce many
children, especially boys. Failure to do so on any of these fronts gives the man
justification to satisfy his needs elsewhere.
(He) may also be married to a barren wife and yet the meaning of
marriage is children. This makes a man to look for other women to have
children. - Luwero 18-24 years
Men also claim that having multiple sexual partners is a way of disciplining their wives
for bad behavior or to earn their respect and obedience. Often this is a learned behavior
from their fathers, which hints at the importance of role models for sexual behavior in
future interventions. On the other hand, a wife can also be blamed for a man’s
faithfulness. Some men claim that faithful men are either bewitched or controlled by their
wives. Only a few men acknowledged that some men are faithful because the couple
loves and respects each other.
Some men will respect him because he is faithful but some will say that the
wife made him stupid, she bewitched him. – Kabarole 25-35 years
If your woman does everything well like cooking nice food, nothing can come into
your mind to go and eat from the market, you will always come back home. –
Soroti Male 25-35 years
A man’s religious faith is often an instigator of sexual practice as well. Uganda is
16% Muslim, 33% Roman Catholic, 33% Protestant and 18% indigenous beliefs (Index
Mundi, 2004). The religion of Islam subscribes to the practice of polygamy, which has
been a widely accepted practice in the past. Although, societal support of this practice is
slowly decreasing the religion is still held up as a rationale for maintaining multiple
partners. On the other hand, Christian religions advocate for faithfulness between
partners. Some men adhere to this principle in order to remain true to their religious
teachings and their marriage vows.
Other men believe that such a man is faithful and loves his wife. Men in the
community always respect such a man citing that, “this is the only upright
man with good manners in this community.” – Soroti 25-35 years
Sexually, faithfulness can often have a negative connotation for men. Faithful men
are sometimes believed to have sexual problems such as impotence or an inability to
perform. These problems or the fear of HIV/AIDS prevent them from pursuing other
Condom use or lack thereof is another sexual practice frequently discussed by
men. While there are both positive and negative views on condoms, men seem to
be well aware that determining whether or not to use a condom strengthens men’s
dominance and power in a sexual encounter. Men explained that women are often
more desperate to maintain a partner out of financial need and thus, will cooperate
in any way necessary to fulfill his sexual desire. Nonetheless, several men
indicated that they would be agreeable to women playing a larger role with
condom use in the future.
Men, in most cases, they use condoms. However when it comes to women,
their bargaining power in using a condom is weak as compared to men and
this puts them at a high risk of getting infected than men. Most women
think that when a man refuses to use a condom and she gives up so easily
with the fears that, a man can chuck her. – Soroti 25-35 years
Men know that condoms can be used to prevent the spread of HIV/AIDS and STDs.
However, a consortium of factors seems to contribute to preventing the regular,
institutional use of this preventive measure. Men state they do not engage in this practice
because they do not have the money to buy condoms, can not access a supply, do not
want to lose pleasure in the sexual act, believe that condoms simply do not work or claim
to be impaired by drugs and alcohol and forget to use them.
After getting drunk one forgets to use them and they are in the shirt. –
Luwero 18-24 years
As for me in my community, men don’t usually use condoms. They have (a
saying) that “if you have to eat a sweet do you eat with its wrappings?
How then will you derive its sweetness?” – Soroti 25- 35 years
Condom use seems more likely in encounters with women outside of marriage,
to prevent pregnancy and in the event of family planning with your wife.
Otherwise, condom use with your wife is deemed unnecessary and represents lack
of trust in the relationship. This trust element also plays a crucial role in the initial
stages of a sexual relationship with girlfriends. The men indicated that condoms
are important for early sexual encounters as the relationship is blossoming, but
eventually the relationship becomes more permanent and requires a level of trust
that allows one to disregard condom use. The timing of this more permanent
relationship seems to vary from man to man – one week to two months. This trust
seems predicated on the fact that the woman has an outward healthy appearance,
belief that the woman is speaking the truth about any disease she might have and is
willing to be in a relationship with the man and have sex. There is relatively little
discussion of sexual history or HIV/AIDS testing. Interestingly, condoms seem to
represent and magnify the idea that one or both of the people in the sexual
encounter have an unsafe sexual history. Just the mere suggestion of use by either
a man or a woman incites a reason not to trust that person.
Finally, it is important to acknowledge that some men are fearful of HIV/AIDS
and the suffering that it causes. However, often the way these men cope with the
fear is to ignore the fact that HIV/AIDS exists at all. This method of escape allows
them to enjoy pleasure with little thought about the consequences of their actions.
It is also believed that some men, who are infected with the virus and aware of
their status, fear dying alone. It is thought that these men purposefully sleep with
many women to spread the disease.
Some boys run many relations because you find that they are HIV positive
and they have that stupid thinking of saying “I can’t die alone.” So he goes
on a rampage seducing any girl or woman he comes across to infect, so he
ends up in many relations since he wants to die with other people. – Soroti
18-24 years
Some men want to spread HIV to other families and people. When he knows that
he is sick he wants to spread it. – Kabarole 25-35 years
What is the Role of Ugandan Women According to Ugandan Men?
Men clearly view a distinguishable difference between the role of men and women in
Ugandan society. This begins at a very early age as young girls are made to be involved
with domestic chores such as cleaning, cooking, getting water or firewood, sweeping,
greeting guests, etc. and young boys are more or less required to tend cattle/goats.
The way you raise a girl child you should correct her and teach her how to
stay in someone’s home because she will marry, you can’t raise her
without teaching her how to cook, or to dig because she is going to be
cooking. Her mother should teach her how to cook when visitors have
come. – Kabarole 18-24 years
I have produced boys and girls, but the first important thing is to see that a
boy child, you teach him about being a man i.e. manhood e.g. every
morning you have to take animals for grazing, then you also teach him
farming. On the side of education you have to endeavor to find out whether
he is interested in studies and his ambitions. On the side of the girl, one is
supposed to grow up knowing what her mother does e.g. being involved in
domestic chores like cleaning the house, cooking, washing dishes, etc. This
way is good because each child grows knowing his duties as a man and a
woman in a home. – Soroti 25-35 years
There is a general belief that it is more important to educate boys because they must
learn to survive on their own. Girls, on the other hand, are often absorbed into another
family and continue with their domestic abilities. It is not as vital to forward their
education since ultimately they will marry out of the clan. The family continues to
support this notion because with that marriage comes a pay off for the family.
Traditionally boys were cared for more than girls with the reason that girls
would later get married off. That a boy is the pillar of the home. So boys
were more loved more than girls, but I guess every homestead has its ways
of doing things. – Gulu 18-24 years
A commonplace practice in Uganda is the bride price. Prior to marrying a
woman, a man must meet the financial demands of his bride’s family. This is
often a lengthy negotiation process where money, cattle, goats, food and
household supplies are bartered in return for the family’s agreement to the
marriage. Men may take several years to save up enough money before initiating
initiate this process. Bride price is a historic institution and it has influenced the
perceived role of a woman in a marital relationship. As indicated by the research
data, bride price equivocates women to property -- property of men. In many
ways, this is how they are valued in a relationship.
When I marry you and dowry is given, then I have paid for you. Did I pay
for you so that you come and relate with other men?…You as a woman are
supposed to listen to what I say because I have married you. – Soroti 1824 years
(Women) are born for sex. That’s why they don’t even live long at their
(parents’) home. – Gulu 25-35 years
A woman is expected to fulfill domestic responsibilities which include working in the
fields, keeping the house clean, cooking, washing clothes, bearing and raising the
children, as well as satisfying her husband’s sexual demands.
Our culture teaches us that it is the woman’s responsibility to manage a home. –
Gulu 18-24 years.
In addition, she should listen, consult and obey her husband on all counts. Not doing so,
can have dire consequences for herself and her children.
I have a wife. She opted for an operation to block the fallopian tubes. We had the
ratio of boys to girls not balancing and I wanted to balance. When I discovered it
I wanted to even kick the scars, blaming her. I got another wife now. (Laughter) –
Luwero Male 25-35 years
…you may leave orders for the wife to do some things, but she will neglect you for
more than once and you have the option of sending her back to her parent’s
home… - Luwero Male 25-35 years
The ability to control your wife and family life is tethered tightly to a man’s
masculinity as explained earlier. Some men fear the loss of that control as it
represents a loss of his power. Sometimes women bear the brunt of that fear and
are considered almost malicious in their actions.
I think that too much power has been given to women. Some women who
have grown horns should have their horns trimmed off because they have
grown too many of these horns (laughter). Men should be given more
powers and be allowed to control women. – Gulu 18-24 years
When men describe women and their role in society, there are diverse points of view.
On the one hand, some men acknowledge the hard work their wives do to fulfill their
domestic responsibilities and praise their ability to act as a support system for the family,
for example, giving emotional love and care to the children. At the same time, since the
wife is viewed as an extension of the man, she is a representation of him to the broader
community and has the power to make him look less like a man. If a wife she does her
job well, the husband will look good too. Alternatively, some men view some women as
merely wanting money their money and being untrustworthy people. Women are also
occasionally viewed as children. Men of this opinion think women are uneducated,
ignorant and in need of continual guidance and clearly unable to control their emotions.
Men also recognize women as sexual beings, but believe that they are not aware of
their own sexual power or have little control over their sexual urges. As a result, they
must be watched and monitored closely.
There are some women who are very difficult, in one day she can have sex
with ten men. Therefore, you cannot manage her. – Kabarole 18- 24 years
Most men argue unequivocally that women should only have one partner. Multiple
partners for a woman simply create family disunity, invite disease into the household,
create uncertainty about the true father of a child, encourage men fighting and callously
dishonor the notions of the bride price.
If she happens to be with very many men, when she goes back to her husband, she
may not satisfy him in love because she is thinking of the others. It is not right for
the lady. – Luwero 18-24 years
The Relationship Between the Gender Norms & Expectations of
Ugandan Men and Their Sexual Practices
The aim of the research was to learn how men in Uganda articulate their role as men
and their attitudes, behaviors and practices about sexual practices. Within that broad
question, the purpose was to identify what masculinity means to men, what are their
common sexual practices, how they view the role of Ugandan women and then
ultimately, discern possible interactions between these elements. The data indicate a
connection between masculinity and male sexual practices in Uganda especially in regard
to the issues of multiple partners and faithfulness. The strength of the connection is
difficult to quantify from this research, but there is indication that masculinity has a
strong influential force on a man’s reasoning, which in turn leads to specific sexual
First, the data suggest that a variety of external factors are influential not only to the
development of a masculine identity, but also to the sexual behaviors and practices of
men (see Figure 4.1). These include the learned gender beliefs and behaviors taught to
boys by family members, friends, role models and leaders; cultural beliefs and traditions
such as the importance of marriage and quantity of children; perceived societal roles for
men and women; religion; mind-altering substances including alcohol and drugs; and
inherent biological pre-dispositions. For example, boys are responsible for caring for
livestock and helping with farming while girls are required to assist with cooking and
cleaning. This is often complemented by the phenomena that families preferentially send
boys to school in deference to girls because it is believed that a boy extends the lineage of
a clan and should be educated enough to financially support this extension. In other
words, boys have a higher realm of responsibility. From an early stage, this thought
process encroaches on the development of masculine identity and encapsulates a
differentiation in the gender roles – that of provider for the male and one of supporter for
the female. This also establishes a power dynamic between boys and girls, which suggest
that boys are stronger, smarter and more important than girls. In cultural terms, men are
expected to get married and produce many children (especially boys) to continue the
lineage of the clan or tribe. This concept reinforces the idea that one becomes a man
when he has achieved these milestones. The man may have sexual relations with other
women in order to accomplish that goal in the event that his wife is unable to produce
children or produces few boys. A third example is the perceived societal/cultural element
that men go to work and earn money and women stay home and take care of the house
and children. This external influence again underpins the belief that having a job and
providing for a family is instrumental to manhood. At the same time, having money is
often referenced as an enabler for taking on multiple partners.
Masculinity or masculine identity is also a powerful, influential mechanism for male
sexual practices and vice versa. The relationship of external influences, masculine
identity and sexual practices can be represented in a triad formation (see Figure 4.1).
According to the data, masculinity is multi-dimensional. In summary, enacting
masculinity can be initiated in the following contexts:
Meeting Cultural Norms
Moral Values
Caring Figure
Sexual Activity
The primary sexual behaviors and practices that emerged from the male focus group
discussions included engaging in multiple partners, remaining faithful or monogamous to
one partner and the use or lack of using condoms. The relationship between masculine
identity and sexual practices can be illustrated via each identified facet of sexual practice.
When asked why some Ugandan men have multiple partners, men recalled a variety of
reasons for this behavior. Each of these reasons for action can be supported by masculine
beliefs they identified (see Figure 4.2). This suggests that some attitudes and beliefs
Figure 4.1: Theoretical Framework of External Influences, Masculinities & Male Sexual Practices
about what it means to be a man contribute to men engaging in sexual relations with
multiple partners. In fact, men may feel propelled or obligated to participate in multiple
sexual encounters in order to enact masculinity.
This can be illustrated with several examples. One reason men said that they have
multiple sexual partners is because they have a natural lust and a high sex
drive with sexual needs that they believe can not be satisfied with one woman. In
addition, men like to explore by learning new sex tricks and being involved with different
types of women (e.g. race, tribe, clan). These behaviors are supported by one of the key
components for enacting masculinity, which indicates that ‘real men’ have sex often and
have satisfying sexual encounters.
Another cause for engaging in multiple partners is when men run into problems with
their wives such as if a wife is barren or has produced only girls, if a man finds his wife
unattractive or old, if the wife no longer maintains her domestic responsibilities, or if a
wife no longer respects her husband and no longer provides sexual satisfaction. A ‘real
man’ is required to be married and have children. Children are signs of sexually virility,
which is a masculine trait. The masculine identity suggests that a man should also be
sexually satisfied and his wife should take care of his home and children properly. So
when these factors are not being met, a man feels he is within his right to look elsewhere
for this satisfaction and continue to prove his masculinity to the outside world.
A final example can be demonstrated with the issue of money. Men explained that
having money enables a man to have multiple sexual partners. Men feel obligated to buy
trinkets, food or beverages for these partners and/or support their living expenses. He
must generate income in order to do so. Making money or having a job is a key trait of
masculinity. Thus, having multiple partners is actually a way of demonstrating your
masculinity, by showing the world that you have money.
Others… when they are drunk they start boasting around that, “Money is
not my problem! I can spend any amount on a woman.” – Soroti 25-35
The fascinating thing about the behavior of having multiple partners is that every
reason men stated for engaging in this action can be supported by masculine attributes.
Figure 4.2: Link Between Masculinities & Multiple Partners
There was no indication in the research that any un-masculine beliefs are tied to this
practice, and therefore, having multiple partners may be an extension and overt
demonstration of manhood.
Utilizing multiple partners is heavily reinforced by masculinity, but the same cannot
be said about faithfulness (see Figure 4.3). The reasons for being faithful (i.e.,
monogamous) are reinforced by a mixture of masculine and un-masculine beliefs. For
example, men stated that a man is faithful because he is poor and is not able to perform
sexually, whether due to impotence or another sexual problem. All of these of these
stated reasons are sustained by very un-masculine qualities. In other words, a man who
does not work hard and make money is not considered a “real man.” The thought of a
man being faithful because he has no money is consequently viewed unfavorably and
unmanly, just as having satisfying sexual experiences frequently is pivotal proof of
manhood. The implication for monogamous men is that they are not having sex often, so
they must have a sexual problem like impotence, which is clearly not masculine. Men
also proclaim that men are faithful when their wife is controlling or bewitches them and
yet, a man is supposed to be the powerful, dominant force in a relationship and retain
control of his wife, as well as his sexual needs. The mere appearance that the opposite is
true proves a man to be feeble because he lacks capability and masculinity.
There are a few reasons for faithfulness that are supported by masculine beliefs. Men
say they are faithful in order to abide by their religious beliefs or marriage vows and
having good morals is widely respected in men. Other men state that they remain faithful
because they love their wives and they fulfill the men’s sexual needs and take good care
of the households. Again, this reasoning is influenced by the importance placed on a man
having sexual satisfaction, perceived control of his household and being married.
Finally, some men believe that faithful men are of good character and worthy of their
respect. A man who is considered well mannered and is admired in the community
epitomizes a true man.
The research clearly demonstrates that the strong impetus of masculinity fortifies
men’s reasons for having multiple partners, but a combination of masculine and unmasculine beliefs underline the reasoning for faithfulness. Thus, if a man is eager to
Figure 4.3: Link Between Masculinities & Faithfulness
prove his masculinity, it is likely that he may be more easily persuaded to engage in
having multiple partners, since the behavior itself is literally built upon the defining
foundation of manhood. On the other hand, remaining faithful or monogamous in a
relationship is conflicted with both masculine and un-masculine supports. A man
engaging in faithfulness might be more likely to face negative feedback for his actions
and attacks on his masculinity, since the behavior is not 100% supported by masculine
attributes. A man who is faithful may find that he must defend or justify his masculinity
in other ways.
The connection between masculinity and Ugandan men’s use or non-use of condoms
is more tenuous relationship. Men noted that they use condoms primarily when they are
planning their family, don’t trust their partner, fear HIV/AIDS or other diseases and if
they have money available to purchase condoms. The last three items are supported by
the masculine beliefs that “real men” should have money, they must have lots of
satisfying sexual encounters and it is important that they remain in control of a sexual
situation and execute power. On the other hand, family planning is certainly not
supported by a critical element of a masculine identity, which is to have many children.
This is decidedly un-masculine (see Figure 4.4).
A more convoluted situation can be found in the illustration for men who do not use
condoms (see Figure 4.5). Men explained that they don’t use condoms because they want
children, trust their wife or partner, don’t believe that AIDS exists or believe death is
inevitable in any case, so why worry. These four reasons for not using condoms are
endemic of the masculine beliefs that: men should have many children; men should be
sexually satisfied; men should have control over their wives and families and men are
powerful and fearless. On the other hand, men also claim that they don’t use condoms
because the condoms prevent them from having pleasure, they lack the money to
purchase condoms or alcohol or drugs cause them to lose control and forget about this
measure. These reasons for not using a condom are supported by traits considered unmasculine: not being sexually satisfied, not having money and lack of power or control.
It is not as easy to see a prominent connection between the enactment of a man’s
masculinity and whether or not he uses a condom. But in fact, this could be one
Figure 4.4: Link between Masculinities and Condom Use
Figure 4.5: Link Between Masculinities & Not Using a Condom
explanation for why there are inconsistencies in condom use with Ugandan men. Condom
use or not using a condom can not be equivocally linked to masculine beliefs. If condom
use was identified by men as a masculine practice there might be larger proportion
participating in the behavior. This action may also be confounded by other environmental
or situational considerations.
Study Limitations
There were two study limitations worth noting. First, the focus group guide contained
too many questions. A total of 26 questions were used (see Appendix 1), however, many
of the main questions contained a subset of additional follow up questions. The objective
was to ensure that a wealth of information was captured; however, these layers of
questions complicated the facilitation process and tired the research assistants. An
examination of the transcripts revealed that some research assistants moved quickly and
haphazardly through the last few questions. In addition, due to the size of the study and
the number of languages involved, a multitude of translators and transcribers were used.
The final transcripts exposed some inconsistencies with the translation. Despite, pretesting and many levels of checking translation and back translation, inevitably there was
some fluctuation in the final wording used by the research assistants, which amounted to
some data reduction.
Second, the research assistants utilized for the project could have benefited from
additional training. The original training was conducted over a 3-day period in English
and five vernacular languages. One supervisor per region was hired to monitor the
regional team, advise on facilitation techniques and prevent or correct language
difficulties in the discussion guide and on-site meetings. Utilizing five supervisors
created some inconsistency in the level of monitoring. Transcripts revealed that probing
in some groups was limited, other times participation from all group members was not
achieved and occasionally, research assistants subtly injected their own opinion into the
facilitation. That being said, it is difficult to ascertain the precise extent of the problem
since there were other players (i.e. transcribers and translators) instrumental in the data
collection, which could have also impacted the results.
Future Implications
The link between masculinity and health warrants further research. Closer
examination of the link between manhood and individual health behaviors, as well a
better understanding about why men sometimes do not take initiative to protect their own
health or that of their partners could be instructive. The knowledge of changing gender
dynamics could be better informed by understanding how men form masculine beliefs
and how those beliefs change over time in a given cultural context and examination of
why certain men are more inclined to accept changing gender norms versus other men
who feel inclined to resist. It would also be interesting to explore men’s beliefs in context
with their marital status. In other words, do single men regard sexual relationships in a
different manner or practice different sexual behavior than married men and if so, how?
Future health interventions targeting men should integrate elements of gender norms
and expectations. Enacting masculinity is a critical mechanism of manhood, and utilizing
masculine attributes may be a pivotal instrument for behavior change in men. It is
important not to carelessly lump all elements of a masculine identity together because
there are conflicting notions of masculinity and its impact is variable on different
practices. It is critical – via research with men - to understand how masculinity is tied to
individual behaviors. Additionally, many health promotion approaches are based on the
assumption that individuals will respond or change their behavior once they have the
‘correct’ knowledge. These approaches suggest that individuals have complete control
over their own health and can simply make a change, and in fact, this is not the case.
Future methodologies must consider the interaction between the environment, gender
dynamics, masculinities and the impact on sexual behaviors (Silberschmidt, 2001).
As one of the men from the focus groups aptly stated, “…sensitize in a way that shows
if you do this one thing, it won’t change the man. He is still a man.” This is a pivotal
insight into how future health interventions targeting men should be constructed. If
interventions are meant to be influential, they should be fashioned in a way that
encourages male involvement and male behavior change without emasculating the man
himself. Alternatively, initiatives that are traditionally considered unmanly or unmasculine, might be reconstructed to appeal to men with a more masculine pretense.
Gender roles are grounded in deep-seated cultural and historical context. Change in
these dynamics only occurs over a long period of time. Interventions should make a
concerted effort to initiate discussions within a community, small groups and even the
individual level in order to bring attention to this topic. Men need to be given the
opportunity, in a safe and comfortable forum, to talk about their roles as men in the
society, the pressures and expectations they face, the problems they experience and the
possible coping mechanisms or solutions to these problems. In addition, men seem
particularly influenced by role models, such as family members or leaders in the
community. A mixed approach of discussion and role-modeling might begin to allow
men the opportunity to critically think about their own, the impact of their behavior on
family members and friends, how to make improvements or changes in behavior, as well
as to challenge many presumed cultural or societal assumptions of what it means to be a
man or a woman in Uganda.
At the same time, interventions about women’s personal and economic empowerment
should continue. There should be a balanced approach that addresses both genders and
allows the genders, separately and together, to critically examine assumptions about
gender roles and cultural traditions. More interventions should emphasize, encourage and
instigate communication between couples and the sexes. There is a cultural divide that
often keeps men and women separate. It would be interesting to explore approaches that
foster an environment for men and women to discuss various gender and sexual issues,
whether it is directly through couple counseling or small groups.
Women in Sub-Saharan Africa would clearly benefit from more equality between the
sexes (i.e., education, social-economic status). However, it is important to consider how
this elevation or change in the role of women in a society impacts the men. Men are a
fundamental, permanent part of the equation, and without their support, instituting any
change is difficult. Therefore, it is imperative to have their input, understand their fears
and concerns and help them to adjust and participate with changing gender roles.
Barker, G. (2000). Gender equitable boys in a gender inequitable world: Reflections from
qualitative research and program development with young men in Rio de Janeiro,
Brazil. Sexual and Relationship Therapy, 15(3), 263-282.
Barker, G. & Ricardo, C. (2005). Social Development Papers. Young men and the
construction of masculinity in Sub-Saharan Africa: Implications for HIV/AIDS,
conflict, and violence. Washington, DC: The World Bank
Campbell, C. (1997). Migrancy, masculine identities and AIDS: The psychosocial
context of HIV transmission on the South African gold mines. Social Science &
Medicine, 45(2), 273-281.
Cohen, S. & Burger, M. (2000). Partnering: A new approach to sexual and reproductive
health: Technical Paper No. 5. New York, NY: UNFPA.
Connell, R.W. (2003). Masculinities, change, and conflict in global society: Thinking
about the future of men’s studies. Journal of Men’s Studies, 11(3), 249.
Deaux, K. & Major, B. (2004). A social-psychological model of gender. In Kimmel &
Aronson (Eds.), The gendered society reader, (pp. 72-81). Oxford: Oxford
University Press.
Dey, I. (1999). Grounding grounded theory: Guidelines for qualitative inquiry. San
Diego, CA: Academic Press.
Eckman, A., Huntly, B., & Bhuyan, A. (2004). How to integrate gender into HIV/AIDS
programs: Using lessons learned from USAID and partner organizations.
Gender and HIV/AIDS Task Force, Integrated Gender Working Group, USAID.
Epstein, H. (2004, June 13). The fidelity fix. The New York Times. Retrieved March 5,
2005 from
Garbus, L. & Marseille, E. (2003). HIV/AIDS in Uganda. Country AIDS Policy Analysis
Project, San Francisco, CA: University of California – SF.
Family Health International. (2004). Involving men. Retrieved April 10, 2005, from PrinterFriendly.asp.
Family Health International. (2002). Gender stereotypes compromise sexual health.
Retrieved April 10, 2005, from
Fleshman, M. (2004. Women: the face of AIDS in Africa. Africa Renewal, (18)3.
Retrieved March 5, 2005 from
Goldman, N. (2005). Masculinity in the 21st century: Another dark continent? The
American Journal of Psychoanalysis, 65(4), 405-407.
Gupta, G.R. (2000). Gender, sexuality, and HIV/AIDS: The what, the why, and the how.
Plenary address XIIIth International AIDS Conference. International Center for
Research on Women. Retrieved April 23, 2005 from
Gupta, G.R. (2002). Cross-generational and transactional sex: A public health crisis and a
moral dilemma. A keynote address at a conference entitled “Innovations for
adolescent girls and HIV/AIDS. Retrieved April 23, 2005 from
Gupta, N. & Mahy, M. (2003). Sexual initiation among adolescent girls and boys: Trends
and differentials in Sub-Saharan Africa. Archives of Sexual Behavior, 32(1), 4153.
Hearn, J., & Morgan D. (1990). Men, masculinities & social theory. London: Unwin
Hyman Ltd.
Hogle, J., Edward, E., Green, E., Nantulya, V., Stoneburner, R., & Stover, J. (2002).
Project lessons learned case study: What happened in Uganda? Declining HIV
prevalence, behavior change, and the national response. Washington, DC:
Synergy Project, USAID.
Index Mundi. Uganda demographics profile 2004. Retrieved May 9, 2005 from
Jack, L. (2005). A candid conversation about men, sexual health, and diabetes. The
Diabetes Educator, 31(6), 810-817.
Katende, C., Bessinger, R., Gupta, N. Knight, R., Lettenmaier, C. (2000). Uganda
Delivery of Improved Services for Health (DISH) Evaluation Surveys 1999.
North Carolina: University of North Carolina.
Kimmel, M. S. (2004). Introduction. In Kimmel & Aronson (Eds.), The gendered society
reader, (pp. 1-6). Oxford: Oxford University Press.
Living for Tomorrow Project. Questionnaire on views about relationships between men
and women. Retrieved April 19, 2005 from
Luke, N. & Kurz, K.M. (2002). Cross-generational and transactional sexual relations in
Sub-Saharan Africa: Prevalence of behavior and implications for negotiating
safer sexual practices. AIDSMark.
Marinova, J. (2003). Gender stereotypes and the socialization process. Brazil: Expert
Group Meeting, United Nations Development Programme.
Ministry of Gender and Sports, Uganda. (2003/4). ESAPR. Retrieved April 6, 2005 from
Montgomery, C.M., Hosegood, V., Busza, J., & Timaeus, I.M. (2006). Men’s
involvement in the South African family: Engendering change in the AIDS era.
Social Science & Medicine, 62, 2411-2419.
O’Brien, R., Hunt, K., & Hart G. (2005). ‘It’s caveman stuff, but that is to a certain extent
how guys still operate’: men’s accounts of masculinity and help seeking. Social
Science & Medicine, 61, 503-516.
Ostlin, P., Sen G. & George, A. (2004). Paying attention to gender and poverty in health
research: content and process issues. Bulletin of the World Health Organization,
82(10), 740-745.
Pan American Health Organization. (n.d.) Fact sheet: Gender and child development.
Retrieved March 5, 2005 from
Peacock, D. & Levack, A. (2004). The men as partners program in South Africa:
Reaching men to end gender-based violence and promote sexual and
reproductive health. International Journal of Men’s Health, 3(3), 173-188.
Phillips, D.A. (2006). Masculinity, Male Development, Gender and Identity: Modern and
Postmodern Meanings. Issues in Mental Health Nursing, 27, 403-423.
Robertson, S. (2006). ‘Not living life in too much of an excess’: lay men understanding
health and well-being. Health: An Interdisciplinary Journal for the Social Study
of Health, Illness and Medicine, 10(2), 175-189.
Sabo, D. (2004). Masculinities and men’s health: Moving toward post-superman era
prevention. In Kimmel & Aronson (Eds.), The gendered society reader (pp. 327344). Oxford: Oxford University Press.
Silberschmidt, M. (2001). Disempowerment of men in rural and urban East Africa:
Implications for male identity and sexual behavior. World Development, 29(4),
Strauss, A. & Corbin, J. (1998). Basics of qualitative research: Techniques and
procedures for developing grounded theory. London: Sage Publications, Inc.
Theorin, M.B. (2001). Women in the City. Gender Policy Review. Retrieved April 9,
2005 from
Uganda Bureau of Statistics. (2001). Uganda demographic and health survey 2000-2001.
Entebbe, Uganda: Ministry of Health.
UNAIDS. (2004). Focus: HIV and young people – the threat for today’s youth. Retrieved
March 5, 2005 from
UNFPA. (2000). Chapter 4: Men, reproductive rights and gender equality. Retrieved
April 19, 2005 from
UNFPA. (2000). Chapter 5: Counting the cost of gender inequality. Retrieved April 19,
2005 from
WHO. (n.d.). Boys in the picture. Retrieved April 21, 2005 from
WHO. (1999). What about boys? A literature review on the health and development of
adolescent boys. Geneva: WHO Department of Child and Adolescent Health and
Appendix 1: Focus Group Discussion Guide
DISTRICT: __________________
AGE: 18-24 yrs
25-35 yrs
Before we begin, we would like to know a little more about each of you.
Could you please raise your hand to answer the following question?
(Researchers should collect this information, i.e. number of people in each
1. ETHNICITY: How many people are from the (___) tribe? (researchers ask about
specific tribes to the area and note below; assure people that tribe does not affect their
attendance at the focus group. What is important is that they speak the language.)
Tribe: __________________ ________
Tribe:__________________ ________
Tribe:__________________ ________
2. EDUCATION: How many people have:
No education ____________
Some university _________
Some primary ___________
University degree ________
All primary _____________
Masters degree __________
Some secondary _________
Ph.D. __________________
All secondary ___________
Tertiary ________________
3. MARITAL STATUS: How many people:
Single ________
Married _______
Divorced ________
4. CHILDREN: How many people have:
No children ______
1-2 children ______
3-5 children ______
6-10 children _____
More than 10 children _______
5. EMPLOYMENT: How many people work in:
Agriculture ________
Professional/technical ________
Sales/service ________
Other ________
Skilled manual labor ______
Casual manual labor _______
Unemployed _______
1. Think about the men in your community that you admire. Describe them.
Prompt: What are their qualities? How do they interact with other men? How do they
treat women? What do other men think of them? What do women think of them?
2. What are the most highly valued “male” characteristics? Why are these
characteristics highly valued?
Prompt: What types of things about men do people like?
3. What are the least highly valued “male” characteristics? Why are these
characteristics the least valued?
Prompt: What types of things about men do people not like?
4. When and how does a boy become a man? How does a young man acquire
Prompt: Are there specific events/markers that define manhood? If so, what are they
and please describe them.
5. Are there certain expectations for how men should act? What type of
responsibilities do men have?
Prompt: What expectations are there for men about work? Finances? Relationships?
6. What expectations do your families have about you?
Prompt: What do your mother and father expect from you? What does your wife expect
from you? What do your children expect from you?
7. What are the biggest problems that you and other men face in your community?
Prompt: Are there places where men can find support for their problems? If so, where
and what kind of support is provided?
8. Who has been your role model(s) for what it means to be a man? What makes this
person a role model?
9. What does it mean to be a woman in your community?
Prompt: How are women treated in your community? What kinds of problems do they
face? How do they cope with these problems? Do you think it is easy to be a woman?
10. What are the differences in the way boys and girls are raised?
Prompt: Is this a good way to raise children? Should boys and girls be raised in the
same way? Why or why not?
11. What does it mean to be a man? A husband/partner? A father?
12. Are there things that you believe you cannot do or say because it would make you
look less like a man? If so, what?
Prompt: Are there any times when you acted in a certain way or said something and
your friends and family ridiculed you or made fun of you.
13. What makes a man feel vulnerable or ashamed (weak, helpless, defenseless) in his
relationship with his wife? What can be done to overcome these feelings?
14. What does sex mean to men?
15. Do men generally have many sexual partners? If yes, why? Who is more likely to
have multiple sexual partners – single men, married men or both? Why?
16. Is it ok for a woman to have as many partners as men do? Why or why not?
17. Consider a man who has only 1 sexual partner and he remains faithful to her.
What do men think of him? What do women think of him?
Prompt: Is this behaviour respected by men? Women? Why or why not? How does a
man learn to have only 1 partner and be faithful to her?
18. Consider another man who has multiple sexual partners or many casual partners.
What do men think of him? What do women think of him?
Prompt: Is this behaviour respected by men? Women? Why or why not? Who
influences a man to have multiple partners? How does a man learn that it is ok to have
multiple partners?
19. What do you think about situations where young women will date and/or have sex
with older men (“sugar daddies”) in exchange for gifts, money, etc?
Prompt: Are young men engaged in these activities? Is it acceptable behaviour?
Why or why not?
20. How involved should men be in raising their children? What types of things
should men be doing?
Prompt: Why are some men more involved in raising their children (i.e. providing
money and caring for the children) but other men are not involved in their children’s
lives? What or who influences a man to be a more involved father?
21. Do you think men in your community worry about STDs or HIV/AIDS? Why or
why not?
22. Do you think men in your community worry about getting a woman pregnant?
Why or why not?
23. Do men use condoms? Why or why not? In sexual relationships, who usually
decides if the couple uses a condom?
Prompt: Is it ok for a woman to suggest using a condom? Why or why not?
24. Do you believe it is important for men to be involved in the health issues for his
family? (i.e. discuss reproductive health issues with their partners, use
contraception for family planning and to prevent disease, visit the health centre
with their partners) Why or why not?
Prompt: In your opinion, are the majority men involved in health issues with the family
or do the majority leave this up to their partner? Why?
25. Are men in your community violent? If yes, please describe the type and cause of
Prompt: Do men get into fights? Over what? How common? Do men in community
carry weapons? Engage in criminal activities? What is the response of the police to
these acts of violence?
26. Sometimes men are violent with their partners (i.e. sometimes a man hits a
woman). Why does this happen?
Prompt: Why do men act this way? Is this behaviour acceptable? Why or why not?
Are there times when it is ok to act this way and other times when it is not? Have you
seen this kind of violence in your community? In what situation? What would you do
if you saw a man using violence against a woman?
Related flashcards

12 Cards


25 Cards

Create flashcards