a Department of Public Health , University of Zambia , Lusaka , Zambia.
b Centre for Health Promotion Research, Leeds Beckett University , Leeds , UK.
Glob Public Health. 2018 Jul;13(7):931-943. doi: 10.1080/17441692.2017.1337800. Epub 2017 Jun 12.
Vaginal microbicides are heralded as a woman's HIV prevention method. This study, conducted in a microbicide clinical trial setting in Zambia, explored how the social construction of masculinity and sexual behaviour influenced the acceptability of vaginal microbicides. The data were generated from 18 In-depth Interviews and 8 Focus Group Discussions. The data were analysed thematically. The study found that hegemonic masculinity influenced the use of vaginal microbicides positively and negatively, in multiple ways including: decision to initiate gel use, autonomous use of the gel, and consistent use of the gel. Men were seen as heads of households and decision-makers who approved their partners' intentions to initiate gel use. Autonomous gel use by women was not supported because it challenged men's dominant position in sexual matters and at a family level. The socially accepted notion that men engaged in multiple sexual relationships also influenced women's decision to use the gel. Sustained gel use depended on the perceived effect of the gel on men's sexual desires, sexual performance, fertility, and sexual behaviour. This study suggests that acceptability of microbicides partially lies within the realm of men, with use constrained and dictated by cultural constructs and practice of masculinity and gender.
阴道杀微生物剂被誉为女性预防艾滋病的方法。本研究在赞比亚的杀微生物剂临床试验环境中进行，探讨了男性气质和性行为的社会建构如何影响阴道杀微生物剂的可接受性。数据来自 18 次深入访谈和 8 次焦点小组讨论。数据进行了主题分析。研究发现，霸权男性气质以多种方式积极和消极地影响阴道杀微生物剂的使用，包括：决定开始使用凝胶、自主使用凝胶和持续使用凝胶。男性被视为家庭的顶梁柱和决策者，他们批准伴侣使用凝胶的意图。女性自主使用凝胶不受支持，因为这挑战了男性在性事务和家庭层面上的主导地位。社会普遍认为男性有多个性伴侣，这也影响了女性使用凝胶的决定。持续使用凝胶取决于人们对凝胶对男性性欲、性表现、生育能力和性行为影响的看法。本研究表明，杀微生物剂的可接受性部分取决于男性，其使用受到文化结构和男性气质及性别实践的限制和规定。
