Masculinity and vulnerability to HIV among heterosexual men in São Paulo, Brazil

To identify aspects of masculinity that could be associated with vulnerability to HIV among heterosexual men. A qualitative survey was conducted among bus drivers and members of the Work Accident Prevention Committee of a public transportation company in São Paulo city, Brazil. Ten individual interviews and four safe sex workshops were tape-recorded and transcribed, and their contents were categorized and discussed in thematic blocks: sexuality, infidelity, condom use, and sexually transmitted diseases and Aids. Aspects that make heterosexual men more vulnerable to HIV are as follows: feeling strong and immune to disease; engaging in impetuous, risky behaviors; inability of refusing a woman; belief that men need sex more than women do and that their sexual desire cannot be controlled. Men's infidelity is considered a natural behavior while women's infidelity is a result of to her partner's inaptitude. It's up to men to make the decision of using or not condom and women can only ask them to use it in order to avoid pregnancy. The refusal to use condoms is related to: aesthetical and economical reasons, fear of failing erection, loss of sensibility for both men and women. Interviewees do not consider themselves vulnerable to either HIV or STDs and have little knowledge about the modes of infection. An aspect that favors prevention in this population men are expected to be responsible and good providers for their families. Thus condom use could be advocated as a contraceptive method and to avoid "bringing diseases home". It is important to know the different conceptions of masculinity to be able to intervene as they are related to increased vulnerability to HIV and could lead a way to better promoting prevention in this population.