The influence of social constructs of hegemonic masculinity and sexual behaviour on acceptability of vaginal microbicides in Zambia

Vaginal microbicides are heralded as a woman’s HIV prevention method. This ethnographic study, conducted in a trial setting in Zambia, explored how the social construction of masculinity and sexual behaviour influenced the acceptability of vaginal microbicides from the man’s perspective. The data was generated from 18 In-depth Interviews (IDIs), and 8 Focus Group Discussions (FGDs). The data was analysed thematically. The study found that hegemonic masculinity influenced the use of gel use among women in multiple ways: 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 position in sexual matters and at 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.