Masculinity, Health, and Human Rights: A Sociocultural Framework

This paper draws upon a sociocultural framework from masculinity studies and applies it to the case of men\u27s health with the goal of providing the legal field with critical considerations that might shape a stronger future research agenda in the area of masculinity, rights, and health. It is well recognized that gender inequality affects women, and that men enjoy numerous cultural and institutional privileges that negatively shape women\u27s health outcome. These commonly understood drivers of women\u27s poor health have led to crucial and much needed linkages between women\u27s rights and health. However, men do not exclusively enjoy cultural and institutional privileges relative to women, and cause harm to women\u27s health. Men are also deeply and negatively affected by gender relations and gender inequality, resulting in harm to their health and access to healthcare. Furthermore, men are not homogenous as a group; there are vast differences and inequalities among men in terms of their health and healthcare access. This means that men do not equally share in the rewards of masculinity; it is marginalized men who in fact disproportionately pay the costs of adhering to narrow definitions of masculinity. Following in-depth coverage of each of these debates, the paper concludes with several questions to inspire further interdisciplinary inquiries related to masculinity, health, and rights

Psychometric Properties of the Adolescent and Young Adult Men – Health Indicators Scale (AYAM-HIS)

The goal of this current study was to evaluate the psychometric properties of the AYAM-HIS among a select sample of AYAMs, a priority population experiencing disparate health outcomes compared to women. These preliminary results indicate that AYAM-HIS yielded reliable and valid data, thus providing a means to measure indicators of health behaviors and possible outcomes within this population. The AYAM-HIS can provide the necessary information to assess current health behaviors so as to provide a foundation from which interventions can be designed. Future research into reducing survey fatigue related to AYAM-HIS and testing with diverse populations are warranted

The promises and limitations of gender-transformative health programming with men: critical reflections from the field

Since the 1994 International Conference on Population and Development, researchers and practitioners have engaged in a series of efforts to shift health programming with men from being gender-neutral to being more gender-sensitive and gender-transformative. Efforts in this latter category have been increasingly utilised, particularly in the last decade, and attempt to transform gender relations to be more equitable in the name of improved health outcomes for both women and men. We begin by assessing the conceptual progression of social science contributions to gender-transformative health programming with men. Next, we briefly assess the empirical evidence from gender-transformative health interventions with men. Finally, we examine some of the challenges and limitations of gender-transformative health programmes and make recommendations for future work in this thriving interdisciplinary area of study

Economic Self-Help Group Programs for Improving Women’s Empowerment: A Systematic Review

Motivation: Self-help groups (SHGs) are implemented around the world to empower women, supported by many developing country governments and agencies. A relatively large number of studies purport to demonstrate the effectiveness of SHGs. This is the first systematic review of that evidence. Approach: We conducted a systematic review of the effectiveness of women’s economic SHG programs, incorporating evidence from quantitative and qualitative studies. We systematically searched for published and unpublished literature, and applied inclusion criteria based on the study protocol. We critically appraised all included studies and used a combination of statistical meta-analysis and meta-ethnography to synthesize the findings based on a theory of change. Findings from quantitative synthesis: Our review suggests that economic SHGs have positive effects on various dimensions of women’s empowerment, including economic, social, and political empowerment. However, we did not find evidence for positive effects of SHGs on psychological empowerment. Our findings further suggest there are important variations in the impacts of SHGs on empowerment that are associated with program design and contextual characteristics. Findings from qualitative synthesis: Women’s perspectives on factors determining their participation in, and benefits from, SHGs suggest various pathways through which SHGs could achieve the identified positive impacts. Evidence suggested that the positive effects of SHGs on economic, social, and political empowerment run through the channels of familiarity with handling money and independence in financial decision making, solidarity, improved social networks, and respect from the household and other community members. In contrast to the quantitative evidence, the qualitative synthesis suggests that women participating in SHGs perceive themselves to be psychologically empowered. Women also perceive low participation of the poorest of the poor in SHGs due to various barriers, which could potentially limit the benefits the poorest could gain from SHG membership. Findings from integrated synthesis: Our integration of the quantitative and qualitative evidence suggests there is no evidence for adverse effects of women’s SHGs on the likelihood of domestic violence. Women’s perspectives in the qualitative research indicate that even if domestic violence occurs in the short term, in the long term the benefits from SHG membership may mitigate the initial adverse consequences of SHGs on domestic violence

“Real Men Don't”: Constructions of Masculinity and Inadvertent Harm in Public Health Interventions

Research shows that constraining aspects of male gender norms negatively influence both women’s and men’s health. Messaging that draws upon norms of masculinity in health programming has been shown improve both women’s and men’s health, but some types of public health messaging (e.g., “Man Up!”) can reify harmful aspects of hegemonic masculinity that programs are working to change. We critically assess the deployment of hegemonic male norms in one particular STD campaign known as “Man Up.” We draw on ethical paradigms in public health to challenge programs that reinforce harmful aspects of gender norms and suggest the use of gender-transformative interventions that challenge constraining masculine norms and have been shown to have a positive effect on health behaviors

Do Abstinence-Plus Interventions Reduce Sexual Risk Behavior among Youth?

The authors discuss the policy questions arising from a new study on "abstinence-plus" interventions for reducing HIV risk behavior among youth in high-income countries

Sexual Relationship Power and Depression among HIV-Infected Women in Rural Uganda

Background: Depression is associated with increased HIV transmission risk, increased morbidity, and higher risk of HIV-related death among HIV-infected women. Low sexual relationship power also contributes to HIV risk, but there is limited understanding of how it relates to mental health among HIV-infected women. Methods: Participants were 270 HIV-infected women from the Uganda AIDS Rural Treatment Outcomes study, a prospective cohort of individuals initiating antiretroviral therapy (ART) in Mbarara, Uganda. Our primary predictor was baseline sexual relationship power as measured by the Sexual Relationship Power Scale (SRPS). The primary outcome was depression severity, measured with the Hopkins Symptom Checklist (HSCL), and a secondary outcome was a functional scale for mental health status (MHS). Adjusted models controlled for socio-demographic factors, CD4 count, alcohol and tobacco use, baseline WHO stage 4 disease, social support, and duration of ART. Results: The mean HSCL score was 1.34 and 23.7% of participants had HSCL scores consistent with probable depression (HSCL>1.75). Compared to participants with low SRPS scores, individuals with both moderate (coefficient b = −0.21; 95%CI, −0.36 to −0.07) and high power (b = −0.21; 95%CI, −0.36 to −0.06) reported decreased depressive symptomology. High SRPS scores halved the likelihood of women meeting criteria for probable depression (adjusted odds ratio = 0.44; 95%CI, 0.20 to 0.93). In lagged models, low SRPS predicted subsequent depression severity, but depression did not predict subsequent changes in SPRS. Results: were similar for MHS, with lagged models showing SRPS predicts subsequent mental health, but not visa versa. Both Decision-Making Dominance and Relationship Control subscales of SRPS were associated with depression symptom severity. Conclusions: HIV-infected women with high sexual relationship power had lower depression and higher mental health status than women with low power. Interventions to improve equity in decision-making and control within dyadic partnerships are critical to prevent HIV transmission and to optimize mental health of HIV-infected women