Construction of Masculinity: The Role of Gender and Incarceration As It Relates to HIV Transmission Among Recently Released South African Inmates and The Communities to Which They Return

Background: In South Africa, risk of HIV transmission is confounded by two factors: 1) historic and social-cultural constructions of masculinity that dictate male/female power roles and 2) the large influx of inmates (up to 300,000 per year) back into the community. The nature of the South African prison system creates an environment conducive to the spread of HIV through various mediums, thus increasing the likelihood of infection among recently released inmates. Associations of power with gender, suggest that the health of the community and the health of the women within that community is directly linked to the health, attitudes, beliefs, and behaviors of men. This paradigm suggests the need for prison based interventions to educate and influence behaviors related to safer sex practices; yet, there has been little research which examines and suggests interventions to impact the HIV related health risk of inmates while incarcerated and/ or upon their release. Methods: Cross-sectional descriptive survey study part of a larger ongoing study designed to assess 357 South African pre-release male inmates participating in a HIV-health education intervention program. ANOVA was used to determine mean differences across groups and Tukey-B for post hoc comparisons. Results: Inmates demonstrated male dominate attitudes regarding women and sexuality. They exhibited HIV behavioral beliefs which included the perception of forced intercourse as a means of curing HIV, obtaining respect, and dominating women. Conclusion: Cultural competent public health efforts should be made to address heightened threats of HIV associated with gender roles and incarceration in South Africa.