The transmission of HIV/AIDS in heterosexual marital relationships in Zambian rural communities and HIV/AIDS : a case study of Petauke District

Primarily through a case study of the Petauke District this thesis examines the perceptions of local men and women as a basis for examining the significance of the social construction of masculinity for the transmission of HIV/AIDS in heterosexual marriages in rural Zambia. Further, it explores participants' perceptions regarding two possibly key dimensions to the transmission of HIV/AIDS in heterosexual marital relationships in rural Zambia. These are the interconnections between masculinity and gender based violence as a factor in the risk of infection, and male attitudes to the use or neglect of condoms as a measure of protection against the risk of HIV/AIDS transmission. This case study is set primarily in a postmodern social constructionist theoretical context. This provides a sensitive means of registering the variety of concepts, perceptions, interpersonal interactions and broader social conditions which feed into masculinity as a social construction. It also facilitates a fine-grained analysis of how notions of masculinity are both context-specific and shift across time. While largely focusing on the illustrative significance of stakeholders' accounts in Petauke District, the study also provides an account of wider socio-economic conditions and the spread of HIV/AIDS, as a backdrop, and a critique of salient features of current health promotion responses. The case study uses qualitative methods, involving the use of individual interviews and focus group discussions with a sample of thirty men and thirty women, respectively, who were previously or are currently married. A thematic approach is used to analyse the data collected in the field. The study findings reveal that study participants perceive Petauke district to be undergoing a process of social transformation and it is thus on a 'cultural crossroads'. This is as a result of the growing influence of the media, education, intermarriages and social mobility. This has given birth to new social values which all have an influence on the social construction of masculinity. Challenging traditional and contemporary hegemonic modes of masculinity is perceived as one of the main tools that should be used to address the association between the social construction of masculinity and the risk of HIV/AIDS transmission in heterosexual marital relationships. This includes addressing the intersection between domestic violence and the risk of HIV/AIDS infection and promoting the use of condoms against the risk of infection in marital relationships. The study concludes by drawing out the implications for health promotion policy and practice. It discusses the need for health promotion to work with male and female stakeholders, and undertake programmes that have as a key strategy the deconstruction of harmful beliefs and ideologies associated with masculinity, in order to address male HIV/AIDS risk taking behaviour in marital relationships in rural Zambian communities