Taking the anti-AIDS message to the men

Bumbanani Mlotshwa is a regular in the crowded township pubs of Bulawayo, Zimbabwe's second city. Neither a boozer nor a hawker, he's on an altogether different mission. Moving from table to table, Mlotshwa spreads the word to all who will listen: AIDS is real, it's transmitted through unprotected sex, and condoms can save lives. To help the message stick among the knots of mainly men knocking back their beers, he hands out pamphlets and free prophylactics. Mlotshwa is a Medecins Sans Frontiers (MSF) counsellor, part of a new initiative to tackle AIDS head-on in the conviviality of the bars and beer gardens, where alcohol can lower inhibitions, rev up libido, and temporarily suspend common sense. He talks of the need for couples to take joint responsibility for safer sex, deftly whips out condoms to demonstrate correct use, and preaches tolerance for those already infected with the virus. "It's our collective responsibility, as men, to play a part in the fight against AIDS, and that can be done in many ways. The use of condoms is an option, but being faithful to our partners is the best solution to the spread of AIDS," he advises one group of drinkers, who nod in agreement. "Thousands of people are dying daily, and the solution lies in us being responsible husbands." The preponderance of patrons are men, often overlooked in outreach programmes, which tend to focus on women, who are most affected by HIV/AIDS. But MSF recognises the critical role men can play in stemming the virus and has decided to go after this neglected 50 percent of the population. "The reason why we are targeting men is that they are the ones who take the initiative in intimacy, and they have the final word," said MSF Bulawayo spokesperson Fernanda Falero. "We have come to realise that the best way to reach men is to go to where they are found most of the time, and in numbers, and that is in bars and beer halls. We have a team that we dispatch every weekend to visit drinking places and talk to them on how they can play a meaningful role in fighting HIV/AIDS," Falero said. She noted that a recent MSF survey found that men's knowledge of AIDS-related issues was limited compared to their spouses, who more often receive some kind of education and counselling when they visit clinics during pregnancy or to have their children immunised. "We are well received in most places, but there are few instances when some people mock us, especially those who are drunk. But, generally, they appreciate our lectures and agree that they can make a change through responsible behaviour," said Mlotshwa. Besides its prevention efforts, MSF is dispensing antiretrovirals (ARVs), which can help delay the onset of AIDS, to about 2,000 HIV-positive patients at Bulawayo's Mpilo Hospital. The humanitarian agency is also expanding in rural Matabeleland, a vast region in western Zimbabwe, where it assisting about 500 patients, mostly women. Zimbabwe has the world's fourth highest prevalence rate of HIV/AIDS: just under 25 percent of the adult population is HIV-positive, while an estimated 2,500 Zimbabweans die of the disease every week, robbing households of breadwinners, parents and loved ones. Mlotshwa, clutching his pamphlets and condoms as he heads for yet another bar, is determined to do his part in preventing the number of needless tragedies from rising.