Often, it is said that ‘€œthe lives of women are in the hands of men’€. Many women might be irked by the statement. But we all know that men are biologically responsible for women getting pregnant. Sadly, though, many men are unwilling to play their role in the pregnancy. Some even reject and abandon the woman and their unborn baby. In the age of AIDS, that behaviour has sworn many mothers-to-be to secrecy about their HIV infection, leading to babies being born with HIV.  

‘€œA lot of women find out their HIV status when they go and do a pregnancy test or are discovered as being pregnant at the clinic. You’€™ll find that there was no conversation between the couple. They just assume they are negative. You will find that a lot of men (this is obviously anecdotal) have a sense of proxy-testing, where they believe if my partner’€™s negative, then it means I’€™m negative. If my child is born negative, then it means I, as a man, am negative. So, what the man will do is that he will sit there. When the woman comes back from the clinic, she will sit there; she doesn’€™t have the power to come back and say: ‘€˜I’€™ve tested and I’€™m positive. Firstly, there is violence involved. Secondly, there is a possibility of being abandoned’€, says Thoko Ngendane, Project Manager of ‘€œYou Can Count on Me, a Pepfar-funded programme in South Africa.

You Can Count on Me aims to change men’€™s behaviour and to educate them that HIV transmission from parent to child, or what is called PMTCT, can be prevented.        

‘€œWe thought we need to make this project about men taking ownership. If you as a man are saying: ‘€˜You can count on me as a man to be supportive to my woman. You can count on me as a man to protect my legacy because I’€™m informed, because I know better’€™, then that way the person is not feeling like there’€™s no negotiation about how they behave or how they respond to things. If you change one person per intervention, it’€™s an achievement. It was about the man saying that: ‘€˜I am taking control and ownership of what it is that I need to do as a man’€™.’€

The programme trains men to understand what HIV is, how it’€™s transmitted, how to prevent it in the general population, to protect babies from getting it and to help their partners along the journey of pregnancy. Model students in these workshops are then selected to train other men across the nine provinces. Approximately 10 000 men have been reached through face-to-face community meetings. Ngendane says the programme wants to deliver a key message.  

‘€œKnow your status’€, she says. ‘€œWe’€™re saying, as a man, go and do it yourself and then you can then have the power’€¦ knowing going forward’€¦ am I positive or am I negative? You have to have information in order for you to protect your children and the people that are around you’€, she adds.

Social scientists and researchers and groups working with men agree that this approach of using men to influence other men to prevent the scourge of parent-to-child HIV infection is a useful strategy. Bafana Khumalo, co-director of Sonke Gender Justice Network, a group working with men and boys to change behavior, says ‘€œin a society where patriarchy still reigns supreme, men are most likely to listen to other men’€.

‘€œThere’€™s a lot that we can do as men by speaking to each other on those issues so that, indeed, we don’€™t look the other way. There’€™s something that I can do in saying to a friend: ‘€˜No, but that is not on’€™. The problem is that so long as men think we can do these things with impunity because nobody will be there to say, but ‘€˜don’€™t do this’€™ or even give that friendly advice and say, ‘€˜look, this is dangerous’€™. So long as there’€™s no one who is that voice, what are the options? It means this continues. It means the dysfunctions that we see in society continue unabated, and we don’€™t think that serves our society well. We want, therefore, to invoke that very spirit that says, ‘€˜yes, these things happen in our presence’€™. We must, therefore, as men be able to hold each other accountable’€, Khumalo says.

‘€œWe want to make sure that men play their role in empowering women. Men need to play a positive role. Men need not feel women empowerment is not about them because at the end of the day it is also about them. Men have a big role to play when it comes to an empowered society and we need, as men, to go out there and say: ‘€˜We are going to play our role’€™,’€ adds Mandla Ndlovu, Communications Programme Manager for Johns Hopkins Health and Education in South Africa, which supports a number of health communications projects working with men’€™s health issues.    

Until recently, about 70 000 babies were born with HIV every year in South Africa. HIV is also one of the main causes of infant mortality, which has risen considerably in the last 10 years when most countries show a decline. Government’€™s implementation of new guidelines to protect babies and infants will considerably cut the number of babies born with HIV. However, much still depends on men learning new behaviours to empower women to access prevention services to save their babies.