XVIII International AIDS Conference

Abstract

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Promoting gender equity for HIV and violence prevention: the male norms initiative in Ethiopia

J. Pulerwitz1, S. Martin1, M. Mehta2, T. Castillo2, A. Kidanu3, F. Verani4, S. Tewolde5

1PATH, Washington DC, United States, 2EngenderHealth, New York, United States, 3Miz-Hasab Research Center, Addis Ababa, Ethiopia, 4PROMUNDO, Rio de Janeiro, Brazil, 5HIWOT Ethiopia, Addis Ababa, Ethiopia

Background: Certain male gender norms have been shown to facilitate HIV risk and support for partner violence. This abstract highlights key findings from the Male Norms Initiative in Ethiopia - implemented by EngenderHealth, PATH, PROMUNDO, and local partners HIWOT Ethiopia and Miz-Hasab - focused on promoting gender equity for HIV and violence prevention.
Methods: Set in three low-income subcities in Addis Ababa, this quasi-experimental study focused on young men in youth clubs aged 15 - 24 and their partners. It compared the impact of:
(1) participatory group education (n = 19 one hour sessions) and community-based activities (e.g., theater and music, marches),
(2) community-based activities only, or
(3) a delayed intervention/comparison. Surveys were conducted (n = 729 at baseline, 645 at endline); loss-to-follow-up was 11%. Surveys measured support for (in)equitable gender norms via the 24-item Gender Equitable Men (GEM) Scale (alpha = .88), HIV risk behaviors and partner violence. In-depth interviews were conducted with a subsample of young men and their sexual partners (n = 25 couples).
Results: At baseline, 36% of young men with partners reported being physically violent against their partners over the past six months. Support for inequitable gender norms was substantial, with, for example, 58% agreeing that 'a woman should tolerate violence in order to keep her family together.' At endline, both intervention groups reported significantly more equitable norms and decreased physical violence, with no change in the comparison group. The majority of participants and their female partners reported positive change after the program, including better communication about HIV prevention, increased condom use skills, and acknowledgement of the importance of monogamy and/or delaying sex.
Conclusions: Findings highlight the importance of incorporating gender into HIV prevention programs, and suggest that both interventions were successful in leading to improved attitudes towards gender norms and reduced HIV and violence risk.


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