Академический Документы
Профессиональный Документы
Культура Документы
211]
On: 12 April 2014, At: 19:00
Publisher: Routledge
Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office:
Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
To cite this article: Sakhumzi Mfecane (2011) To drink or not to drink? Identity dilemmas of men living with
HIV, Agenda: Empowering women for gender equity, 25:4, 8-17
To link to this article: http://dx.doi.org/10.1080/10130950.2011.630520
article
abstract
For centuries the consumption of alcohol in African societies has been reserved mainly for men. Alcohol use
symbolised status, cultural identity, masculine virility and other virtues of manhood. Recently, these ideas have
been promoted by media advertisements of alcohol as a way to achieve sociability and status, and as part of
African tradition and heritage. During my 14-month ethnographic fieldwork with men living with HIV, I realised
that some of them still drank or aspired to drink despite being ill; but the majority had stopped drinking. This
Article explores the ways that an HIV diagnosis reshapes perceptions of masculinity among men, and therefore
also consumption patterns linked to performances of masculinity. My findings indicate that the diagnosis with
HIV significantly changed the ways men construct their masculinity; but some found it particularly difficult to
stop alcohol consumption. This raises challenges for interventions aimed at curbing alcohol use among the ill:
entrenched notions of excessive alcohol consumption being a feature of African tradition and media portrayals
of drinking as a mark of real manhood can often undermine effective interventions.
keywords
Alcohol consumption, African tradition, gender performance and masculinity, sociability, HIV and ARVs
Introduction
Globally, men consume greater amounts of
alcohol compared to women, and they also
suffer more from the harmful effects of
drinking, like poor health, injuries, disabilities, and deaths (WHO, 2011). For centuries
African societies have treated alcohol
mainly as a drink for men, in particular
adult males (Akeampong, 1996; La Hausse,
1988; Hunter, 1936). Although women consumed alcohol, they did so under different
conditions from men (see Suggs, 1996), and
they have often been condemned for their
drinking behaviour (West, 1997; Pattman,
2001). Research has shown that alcohol
consumption among African men has numerous meanings, including masculine
virility (La Hausse, 1988; Carlson, 1990);
pp. 817
article
article
Downloaded by [187.156.37.211] at 19:00 12 April 2014
10
Findings
From February 2006 until May 2007, I interacted regularly with 25 men aged between
25 and 50 years, who shared their life
stories with me. Furthermore I gained rich
and detailed data on living with HIV by
attending gender-mixed support groups of
people living with HIV (PLHIV) at the HIV
clinic for 14 months. The support groups are
a platform for HIV positive patients to give
testimonies about their experiences of
using ARVs and how treatment has changed their lives (Robins, 2005). My observations were that these testimonies were
predominantly biased towards painting a
positive picture of ARVs and support
groups. In this context, drinking remained
a taboo topic, even for men who
were struggling to abandon alcohol. The
11
article
article
Downloaded by [187.156.37.211] at 19:00 12 April 2014
12
also to avoid his friends: I dont socialise with them any longer; Im always
with my wife. Someone calls and says
come lets have a drink and I say no I
dont drink. I dont want. Where I now
stay I dont have friends. I dont want
friends because I can see that abangani
bakufaka ngentloko (friends are misleading) (Interview, June 26 2006).
article
13
article
Most of them were just drinking buddies. I didnt have close relationships
with them. I still talk to them, like if we
are walking towards the same direction.
One of them asked manje awusaphuzi
vele (do you no longer drink?) I said No,
I have asthma; the doctor said I must
stop drinking (Interview, November 15
2006).
In describing the experiences of men who
abstained from drinking alcohol, I have
argued that abstinence reflects their positive responses to support group messages
to change and be different men. Among
men who continued drinking, the stories of
two participants, Bob and Vusi, exemplify a
rejection of these messages to change. Bob,
a 31 year-old man, has a long history of
resisting HIV messages. First he refused to
do an HIV test while he was sick, until his
family pressured him to test and then enroll
for treatment. Later he stopped using ARVs
saying they made him ill. He also returned
to drinking as soon as he stopped ARVs. He
had plans to abandon his HIV positive
girlfriend and commit to a new girlfriend
that he met from a shebeen near his home.
These reactions attest to Bobs refusal to
embrace support group messages to
change. He still wanted to live according
to his previous life-style.
Vusi, a 32 year-old man, also continued
drinking despite using ARVs. Vusi got ill in
2004 while working as a security officer in
Johannesburg. He returned to Bushbuckridge to receive help, and was immediately
taken to the hospital. He was diagnosed with
TB and then later HIV. Vusi abstained from
alcohol while he was on TB treatment, but
he soon returned to drinking after finishing
his TB treatment and starting ARVs. He
insisted that drinking does not affect his
health: They say we shouldnt mix drugs
with alcohol. I hear them, but I have done it
and nothing happened. By continuing to
drink, Vusi positioned himself as a resister of
support group messages to change. This
resistance is also manifested in other facets
of his life. For example, he rejected support
group messages that encouraged men and
14
Conclusions
I have described various ways that HIV
positive men responded to messages to
abstain from alcohol after enrolling for the
ARV treatment programme. Alcohol is regarded as a risk factor for adherence to
ARVs (Christian et al., 2009; Simbayi et al.,
2004). I have shown that alcohol has been
an important cultural commodity in African
societies, used by most people to perform
rituals; strengthen social ties; and recently,
with the impact of media advertising and
large-scale marketing and sale of different
types of liquor, to achieve a revered status
of being a real man (auty). The latter
meanings assigned to drinking have recast
the teetotalers as antisocial, priestly and
somewhat inferior to drinkers. Most HIV
positive men in my research consumed
large amounts of alcohol before they got
ill, and they viewed it as an important
aspect of their performance of manhood.
But the majority abandoned it after testing
positive, and few men continued drinking or
sought to drink once they recovered from
an AIDS illness. These different responses
have been attributed to the ways men
respond to messages from support groups
to transform their lives and adapt after
testing and enrolling for treatment. Men
who stopped drinking have embraced these
messages compared to men who continued
drinking.
15
article
article
Downloaded by [187.156.37.211] at 19:00 12 April 2014
Acknowledgements
Thanks to Deborah Posel and Steven Robins for
organising seminars for me to present the first
drafts of this paper at University of Cape Town
and Stellenbosch University respectively, and to
the audience for their constructive comments.
Notes
1.
2.
3.
16
References
Akeampong E (1996) Drink, Power and Cultural
Heritage: A Social History of Alcohol in Ghana, c
1800 to Recent Times, Portsmouth: Heinemann.
Baker J (1992) Prohibition and Illicit Liquor on the
Witwatersrand, 19021932 in J Crush & J Ambler (eds) Liquor and Labour in Southern Africa,
Anthens: Ohio University Press.
Biehl J (2007) Will to Live: AIDS Therapies and Politics
of survival, Princeton and Oxford: Princeton
University Press.
Brothers for Life (nd) http://www.brothersforlife.org/,
Accessed September 17, 2011.
Cataldo F (2008) New forms of citizenship and sociopolitical inclusion: Accessing antiretroviral therapy in Rio de Janeiro favela Sociology of Health
& Illness, 30 (6): 900912.
Carlson RG (1990) Banana Beer, reciprocity, and
ancestor propitiation among the Haya of Bukoba,
Tanzania Ethnology, 29: 297311.
Christian SH, Stoner SA, Pantalone DW & Simoni JM
(2009) Alcohol use and antiretroviral adherence:
Review and meta-analysis Acquir Immune Defic
Syndr, 52 (2): 180202.
Colvin C & Robins S (2010) Positive men in hard,
Neoliberal times: Engendering health citizenship
in South Africa in J Boesten & NK Poku (eds)
Gender and HIV/AIDS: Critical Perspectives from
the Developing World, Bradford: Ashgate.
Crush J & Ambler J (1992) Introduction in J Crush &
J Ambler (eds) Liquor and Labour in Southern
Africa, Anthens: Ohio University Press.
Hunter M (1936) Reaction to Conquest: Effects of
Contact with Europeans on the Pondo of South
Africa, London: Oxford University Press.
Karp I (1980) Beer drinking and social experience in
an African society: An essay in formal sociology
in I Karp & C Bird (eds) Explorations in African
Systems of Thought (p. 90), Washington DC:
Smithsonian Institution Press.
Kuzwayo E (1996) Call Me a Woman, Northlands:
Picador Africa.
La Hausse P (1988) Brewers, Beerhalls and Boycotts:
History of Liquor in South Africa, Johannesburg:
Ravan Press.
Mager AK (2005) One Beer, One Nation, One Soul:
South African breweries, heritage, masculinity
and nationalism 19601999 Past and Present,
188: 163194.
Mager AK (2010) Beer, Sociality and Masculinity in
South Africa, Bloomington and Indianapolis: Indiana University Press.
Mc Allister P (1987) Beer Drinking and the unit of
study: Notes on the history of Xhosa beer drinking and on combining cultural analysis and
political economy approaches in anthropology,
paper presented at Conference of South African
Anthropology, University of Cape Town.
Mc Allister P (2006) Xhosa Beer Drinking Rituals:
Power, Practice and Performance in the South
African Rural Periphery, Durham and North Carolina: Carolina Academic Press.
17
article