December 2004

“What’s a ‘Real Man’?”
India study examines perceptions of masculinity as entry point for addressing HIV

Group session on masculinity, part of the Yari-dosti program in Mumbai, India. Photo credit: CORO, Mumbai

In India, knowledge about HIV/AIDS is low, and few people see themselves as vulnerable to infection. Yet it is estimated that 4.6 million people are infected with HIV, making India the country with the second highest number of infected people in the world.

A key factor contributing to new HIV cases in India is societal norms that keep women’s status low in the home and community and foster men’s greater control over resources and decision-making. This includes decisions that affect sexual behavior and HIV risk, such as whether to be monogamous or use a condom.

Both women and men pay a price for norms that encourage gender inequitable relationships and men’s risk-taking behavior. In a study conducted among Indian men, those who reported extramarital sex were six times more likely to report wife abuse—an extreme manifestation of gender inequity and male power. The study also found a strong relationship between men’s self-reports of STI symptoms—an important risk factor for HIV infection—and their perpetration of partner violence.¹

In India, as in other countries, norms that influence how young males are socialized to become men are particularly relevant to HIV prevention efforts. But is it possible to change these deeply rooted social norms to foster support for gender equitable relationships among young men, who already yield greater power than young women and who stand to gain more as they enter into marriage? And if so, to what extent would this protect them and their partners from HIV infection?

Horizons and the Indian NGO Committee for Resource Organization (CORO), with funding from USAID and the European Commission, explored these questions, similar to those in the Brazil study (see Brazil study), through a series of research and program activities.

The research began with a qualitative investigation about how young men construct their gender identities. This information informed the development of a group-based intervention that has been piloted in three large slum communities in Mumbai (Bombay). Using exercises and materials that were adapted from Brazil’s Program H, the India program aims to change negative aspects of masculinity and reduce risky sexual behavior among young men.

Construction of Masculinity

The study began in the three Mumbai communities with interviews of 22 male key informants, including NGO representatives, doctors, and community leaders, to examine their perceptions of young men’s attitudes and behaviors related to masculinity and HIV/AIDS. Based on leads from the key informants, the interviewers, who came from the study communities, interviewed 23 young men, aged 16 to 24, about their views and experiences. The findings draw on both sets of interviews.

When asked about masculinity, respondents described physical and social attributes of a “real man,” or asli mard in Hindi. Overall, a real man was described as handsome, strong, and one who takes care of family members. He also is courageous and confident and commands respect. According to one young man, “[A real man] is a person who takes on any calamity, is not afraid of anybody.”

Being dominant and aggressive were other qualities associated with being a real man. Respondents often highlighted physical and verbal abuse as important proof of masculinity. The types of violence respondents associated with masculinity were carried out against wives, girlfriends, and men, either individually or as part of a group. As one respondent noted, “Real men lead and win fights and quarrels.”

Data from the interviews indicate that notions of masculinity often are linked to sexual health and performance. According to the young men, a real man is sexually powerful and therefore able to satisfy women and produce children, particularly male children. Sexual potency is seen as an important way for men to establish superiority and control over women.

But the young men in the study had many anatomical and physiological concerns related to sexual performance that they feared would undermine their masculinity. These concerns focused on penis size, semen quality, and early ejaculation.

Respondents described a variety of sexually aggressive behaviors directed at girls, women, and occasionally at men perceived to be feminine, that they and their peers engaged in to prove their masculinity. These ranged from sexual harassment to verbal sexual coercion to forced sex. According to one respondent, “…unless a woman cries while having sex, your masculinity is not proven.”

While most men ridiculed homosexual men, some, after regular contact with the interviewers, narrated their own homosexual experiences. Often a homosexual encounter was their first sexual experience. For a few, their sexual relationships with men continued, even after marriage. Some justified their homosexual activity as an expression of masculinity because they penetrated their partner rather than being penetrated. In their narratives of male-to-male oral and anal sex, condoms were rarely used.

On the other hand, condom use was common with sex workers. However, respondents did not see condoms as appropriate with girlfriends, unless the women are perceived to have multiple partners. But they did not see their own behavior as a reason to use condoms with their female partners.

¹Martin, S.L. et al. 1999. “Sexual behaviors and reproductive health outcomes.” JAMA 287(20): 1967-1972.

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This page updated
19 October 2007