amigos amistades: male their role in hiv prevention ... · amigos y amistades: male friendships and...

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A MIGOS Y A MISTADES : M ALE FRIENDSHIPS AND THEIR ROLE IN HIV PREVENTION IN THE D OMINICAN R EPUBLIC Fleming P 1 , Barrington C 1 , Moya M 2 , S. Rosario 2 , Kerrigan D 3 1 University of North Carolina, Dept. of Health Behavior, Chapel Hill, USA, 2 Centro de Orientación e Investigación Integral (COIN), Santo Domingo, Dominican Republic, 3 Johns Hopkins Bloomberg School of Public Health, Baltimore, USA Abstract Research in the Dominican Republic suggests male peer groups may influence men’s sexual behaviors, in particular condom use and engaging in sex with female sex workers. The purpose of this study is to explore types of friendships among men and their role in encouraging or discouraging HIV-protective behaviors. We analyzed qualitative data from two studies in Santo Domingo, one with male peer educators (n=17) and the other with regular male partners of sex workers (n=20). We found that men often consider that friends encourage risky behavior and that few men feel they have friends they can trust. HIV prevention efforts seeking to engage with men should explore how to cultivate and promote more supportive male friendships. The men interviewed often described a difference between social drinking buddies who cannot be trusted, and close friends who generally are trustworthy and can provide support. Un amigo es alguien que uno se cuentan cosaslas amistades son las que tu comparten con ello por un trago, porque te dan 20 pesos y que te dan la espalda“A friend [amigo] is someone who you share things with… friendships [amistades] are those which you share a drink because they give you 20 pesos and then they turn their back on you” -Regular Partner 6 Friends are described as becoming decreasingly important, and even a burden, as men get older. Several participants emphasized that they prefer to andar solo, or go out alone, rather than in a group of friends to avoid problems, including excessive alcohol use and engaging in sexual risk behaviors. Siempre me gusta andar solo…uno con los amigos siempre encuentra problemas “I always like to go out by myself…when you’re with friends you always find problems-Regular Partner 4 Trusted friends usually did not encourage risky behaviors, and sometimes even provided an opportunity for healthy communication around relationship dynamics, sexual behavior and general life processes. En coro, uno tiene más comunicación…trata de avisarlo, a veces si te ha pasado igual“In a [close] group of friends, there’s more communication… you try to tell them stuff, see if the same things have happened to them” -Peer Educator 6 The challenge identified by most participants was that they lacked trusted friends to play this supportive role Un amigo es alguien que uno se cuentan cosas buenas cosas malas, ve, no hablan de esa persona y esa persona no habla de ti...no tengo amigos” A friend is someone you can tell good things and bad things, you don’t gossip about that person and they don’t gossip about you…I don’t have any friends” -Regular Partner 4 Paul J. Fleming Doctoral Student Department of Health Behavior Gillings School of Global Public Health University of North Carolina Chapel Hill [email protected] Contact We analyzed qualitative data from two studies in Santo Domingo. The first study population was male peer educators (n=17) who were trained to promote HIV prevention. They were interviewed to better understand their social networks and experience as peer educators The second population was regular male partners of sex workers (n=20). These men were referred by their female sex worker partners. Participants were asked about their relationship history, friendships, and recommendations for promoting HIV prevention among men. Data passages where men described their friendships and male peers were coded, analyzed and compared to their relationship narratives to determine the role that friends and peers played in the men’s lives. The coded sections on friendships were then analyzed for recurring themes. Methods Conversations among trusted male friends have the potential to create a safe space for exploring alternative versions of masculinity not tied to encouraging excessive alcohol use and sexual risk behaviors. Because few men have these trusted friends, they have few opportunities to experiment with breaking traditional masculine molds. HIV prevention efforts seeking to engage with men should explore how to cultivate and promote supportive male friendships so that men can feel comfortable expressing non-normative ideas about sexual relationships and performing HIV-protective behaviors.. Conclusions Introduction Throughout men’s lives, male peer groups play an important role in delineating men’s roles and responsibilities in a society. Research in the Dominican Republic suggests male peer groups may influence men’s sexual behaviors, in particular condom use, engaging in sex with female sex workers, and alcohol use. Since men sometimes talk about women or seek out sex workers with friends, it is important to better understand this dynamic. Friendships, like romantic relationships, involve varying degrees of trust, social influence, and emotional intimacy. The purpose of this study is to explore different types of friendships among men in the Dominican Republic and their potential role in supporting or discouraging HIV-protective behaviors. CHART or PICTURE CHART or PICTURE Results The study was implemented by USAID | Project SEARCH, Task Order No.2, which is funded by the U.S. Agency for International Development under Contract No. GHH-I-00-07-00032-00, beginning September 30, 2008, and supported by the President’s Emergency Plan for AIDS Relief. The Research to Prevention (R2P) Project is led by the Johns Hopkins Center for Global Health and managed by the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (CCP). www.jhsph.edu/R2P

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Page 1: AMIGOS AMISTADES: MALE THEIR ROLE IN HIV PREVENTION ... · AMIGOS Y AMISTADES: MALE FRIENDSHIPS AND THEIR ROLE IN HIV PREVENTION IN THE DOMINICAN REPUBLIC Fleming P1, Barrington C1,

AMIGOS Y AMISTADES: MALE FRIENDSHIPS AND THEIR ROLE IN

HIV PREVENTION IN THE DOMINICAN REPUBLIC

Fleming P1, Barrington C1, Moya M2, S. Rosario2, Kerrigan D3 1University of North Carolina, Dept. of Health Behavior, Chapel Hill, USA, 2Centro de Orientación e Investigación Integral (COIN),

Santo Domingo, Dominican Republic, 3Johns Hopkins Bloomberg School of Public Health, Baltimore, USA

Abstract

Research in the Dominican Republic suggests male peer

groups may influence men’s sexual behaviors, in particular

condom use and engaging in sex with female sex workers.

The purpose of this study is to explore types of friendships

among men and their role in encouraging or discouraging

HIV-protective behaviors. We analyzed qualitative data from

two studies in Santo Domingo, one with male peer educators

(n=17) and the other with regular male partners of sex

workers (n=20). We found that men often consider that

friends encourage risky behavior and that few men feel they

have friends they can trust. HIV prevention efforts seeking to

engage with men should explore how to cultivate and

promote more supportive male friendships.

The men interviewed often described a difference

between social drinking buddies who cannot be trusted,

and close friends who generally are trustworthy and can

provide support.

“Un amigo es alguien que uno se cuentan cosas…las

amistades son las que tu comparten con ello por un trago,

porque te dan 20 pesos y que te dan la espalda”

“A friend [amigo] is someone who you share things with…

friendships [amistades] are those which you share a drink

because they give you 20 pesos and then they turn their

back on you”

-Regular Partner 6

Friends are described as becoming decreasingly

important, and even a burden, as men get older. Several

participants emphasized that they prefer to andar solo, or

go out alone, rather than in a group of friends to avoid

problems, including excessive alcohol use and engaging

in sexual risk behaviors.

“Siempre me gusta andar solo…uno con los amigos

siempre encuentra problemas ”

“I always like to go out by myself…when you’re with

friends you always find problems”

-Regular Partner 4

Trusted friends usually did not encourage risky behaviors,

and sometimes even provided an opportunity for healthy

communication around relationship dynamics, sexual

behavior and general life processes. “En coro, uno tiene más comunicación…trata de

avisarlo, a veces si te ha pasado igual”

“In a [close] group of friends, there’s more communication…

you try to tell them stuff, see if the same things have

happened to them”

-Peer Educator 6

The challenge identified by most participants was that

they lacked trusted friends to play this supportive role

“Un amigo es alguien que uno se cuentan cosas buenas

cosas malas, ve, no hablan de esa persona y esa persona

no habla de ti...no tengo amigos”

“A friend is someone you can tell good things and bad

things, you don’t gossip about that person and they don’t

gossip about you…I don’t have any friends”

-Regular Partner 4

Paul J. Fleming

Doctoral Student

Department of Health Behavior

Gillings School of Global Public Health

University of North Carolina – Chapel Hill

[email protected]

Contact

We analyzed qualitative data from two studies in Santo

Domingo.

• The first study population was male peer educators

(n=17) who were trained to promote HIV prevention.

They were interviewed to better understand their social

networks and experience as peer educators

• The second population was regular male partners of

sex workers (n=20). These men were referred by their

female sex worker partners. Participants were asked

about their relationship history, friendships, and

recommendations for promoting HIV prevention among

men.

Data passages where men described their friendships and

male peers were coded, analyzed and compared to their

relationship narratives to determine the role that friends

and peers played in the men’s lives. The coded sections on

friendships were then analyzed for recurring themes.

Methods

Conversations among trusted male friends have the potential

to create a safe space for exploring alternative versions of

masculinity not tied to encouraging excessive alcohol use and

sexual risk behaviors. Because few men have these trusted

friends, they have few opportunities to experiment with

breaking traditional masculine molds. HIV prevention efforts

seeking to engage with men should explore how to cultivate

and promote supportive male friendships so that men can feel

comfortable expressing non-normative ideas about sexual

relationships and performing HIV-protective behaviors..

Conclusions

Introduction

Throughout men’s lives, male peer groups play an important

role in delineating men’s roles and responsibilities in a

society. Research in the Dominican Republic suggests male

peer groups may influence men’s sexual behaviors, in

particular condom use, engaging in sex with female sex

workers, and alcohol use. Since men sometimes talk about

women or seek out sex workers with friends, it is important to

better understand this dynamic. Friendships, like romantic

relationships, involve varying degrees of trust, social

influence, and emotional intimacy. The purpose of this study

is to explore different types of friendships among men in the

Dominican Republic and their potential role in supporting or

discouraging HIV-protective behaviors.

CHART or

PICTURE

CHART or

PICTURE

Results

The study was implemented by USAID | Project SEARCH, Task Order No.2, which is funded by the U.S. Agency for

International Development under Contract No. GHH-I-00-07-00032-00, beginning September 30, 2008, and supported

by the President’s Emergency Plan for AIDS Relief. The Research to Prevention (R2P) Project is led by the Johns

Hopkins Center for Global Health and managed by the Johns Hopkins Bloomberg School of Public Health Center for

Communication Programs (CCP).

www.jhsph.edu/R2P