AIDS and Behavior

, Volume 22, Issue 6, pp 1858–1869 | Cite as

Gender Norms, Gender Role Conflict/Stress and HIV Risk Behaviors Among Men in Mpumalanga, South Africa

  • Ann GottertEmail author
  • Clare Barrington
  • Heath Luz McNaughton-Reyes
  • Suzanne Maman
  • Catherine MacPhail
  • Sheri A. Lippman
  • Kathleen Kahn
  • Rhian Twine
  • Audrey Pettifor
Original Paper


Men’s gender role conflict and stress (GRC/S), the psychological strain they experience around fulfilling expectations of themselves as men, has been largely unexplored in HIV prevention research. We examined associations between both men’s gender norms and GRC/S and three HIV risk behaviors using data from a population-based survey of 579 18–35 year-old men in rural northeast South Africa. Prevalence of sexual partner concurrency and intimate partner violence (IPV) perpetration in the last 12 months were 38.0 and 13.4%, respectively; 19.9% abused alcohol. More inequitable gender norms and higher GRC/S were each significantly associated with an increased odds of concurrency (p = 0.01; p < 0.01, respectively), IPV perpetration (p = 0.03; p < 0.01), and alcohol abuse (p = 0.02; p < 0.001), controlling for demographic characteristics. Ancillary analyses demonstrated significant positive associations between: concurrency and the GRC/S sub-dimension subordination to women; IPV perpetration and restrictive emotionality; and alcohol abuse and success, power, competition. Programs to transform gender norms should be coupled with effective strategies to prevent and reduce men’s GRC/S.


Gender role HIV Sexual behavior Violence Alcohol South Africa 



We would like to thank the study participants for sharing their time and perspectives with us. We would also like to thank the staff of the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) for their support of the parent study, including data collection. Amada Selin, Tamu Daniel, Sheree Schwartz and Rushina Cholera also assisted with study coordination and data collection. This study was supported by a Ruth L. Kirschstein National Research Service Institutional STD/HIV Pre-Doctoral Training Award (National Institutes of Health DHHS/NIH/NIAID: 5 T32 AI 07001-35) through the University of North Carolina at Chapel Hill Institute for Global Health and Infectious Diseases. The National Institute of Mental Health provided funding for the parent study for this research (1RO1MH087118, A. Pettifor, PI; 1R21MH090887, S. Lippman, PI).


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Ann Gottert
    • 1
    • 2
    Email author
  • Clare Barrington
    • 1
  • Heath Luz McNaughton-Reyes
    • 1
  • Suzanne Maman
    • 1
  • Catherine MacPhail
    • 3
    • 4
  • Sheri A. Lippman
    • 3
    • 5
  • Kathleen Kahn
    • 3
    • 6
    • 7
  • Rhian Twine
    • 3
    • 6
  • Audrey Pettifor
    • 3
    • 8
  1. 1.Department of Health Behavior, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Population CouncilHIV and AIDS ProgramWashingtonUSA
  3. 3.MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public Health, Faculty of Health Sciences, University of the WitwatersrandJohannesburgSouth Africa
  4. 4.School of HealthUniversity of New EnglandArmidaleAustralia
  5. 5.Center for AIDS Prevention StudiesDepartment of Medicine, University of California at San FranciscoSan FranciscoUSA
  6. 6.Wits Reproductive Health and HIV Institute (WRHI)University of the WitwatersrandJohannesburgSouth Africa
  7. 7.Umeå Centre for Global Health ResearchDivision of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå UniversityUmeåSweden
  8. 8.Department of EpidemiologyGillings School of Global Public Health, University of North Carolina at Chapel HillChapel HillUSA

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