Increasing attention to the role of gender inequalities in driving the HIV/AIDS epidemic has resulted in a growing interest in the possibilities and difficulties of HIV prevention work with men. The primary challenge of this work, as identified by Rao Gupta above, is to correct the “imbalance of power” that creates vulnerability to HIV/AIDS. Framing the challenge in this way poses the question: what are men’s interests in maintaining or altering the current arrangements of power between men and women which, it is argued, have such a bearing on the course and pace of the epidemic? What’s in it for men?

This paper proposes four emphases for HIV prevention work with men in order to address the issues at the heart of this question. It looks at the importance of working with men as both agents and victims of patriarchy, and of creating spaces in which men can heal from and take accountability for patriarchal oppression. The second section explores the need to clarify the analytical distinctions between gender and sexuality in order to more clearly focus on the extent to which they shape each other. Creating this conceptual space not only clarifies their mutual interactions but also allows for much greater attention to be given to the problems and possibilities of men’s sexualities in ways that are not over-determined by a gender analysis.

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