IT HAS OFTEN been noted that the HIV/AIDS epidemic moves along the faultlines of society, finding its niches in ignorance, poverty, racial discrimination, homophobia, drug addiction, and the dislocations that follow war and famine.
For all its tragic costs, AIDS has, in that way, emerged as a kind of world litmus paper, making visible the global structures of social injustice. But one of those structures has so far received relatively little emphasis, although it is everywhere one of the most deadly vectors of HIV transmission.
I am referring to universally prevailing ideas of human masculinity - a cross-cultural set of assumptions about what manhood means, which, when seen in the light of AIDS, must be understood as nothing less than a world disaster for women, children, and for us men ourselves.
This is not to blame males for the AIDS epidemic. Blame is irrelevant. Nor is it to absolutize generalizations about manhood. But there are patterns of male behavior as such that are recognized as problematic in numerous contexts, and the time has come to explicitly label the role of such patterns in the transmission of HIV, not to scapegoat men but to enlist them at new levels in fighting this disease.
World AIDS Day is Friday and the United Nations is taking the occasion to highlight a worldwide two-year AIDS education and prevention campaign organized around the theme ''Men make a difference.'' The UN reports that 70 percent of HIV infections result from heterosexual contact, 10 percent from gay sex, and 5 percent from needle use, when four out of five needle users are men. ''Engaging men as partners in fighting AIDS,'' the UN concludes, ''is thus the surest way to change the course of the epidemic.''
How do men make a difference? Drawing on UN studies, let us count the ways. Across the globe, the sex partners of men outnumber those of women, making men more common vectors of transmission; men more often than women determine whether safe sex is practiced; men, especially under the influence of alcohol or drugs, are more likely than women to engage in risky behavior, including violence; men are less likely than women to be health conscious.
As dominant care-givers, women are more likely than men to see the effects of AIDS up close. For biological reasons, men are less susceptible to infection from heterosexual sex than women. In affluent nations of the West, sex between men is a main route of HIV transmission. In impoverished nations of Africa and Asia, main sources of infection include marauding soldiers, transient workers, truck drivers, and other males away from home. And the dangers involved in all these instances are exacerbated by notions of manliness that inhibit expression of feelings, as well as open discussion of taboo subjects like homosexuality, substance abuse, and sexual practices.
The World Health Organization reported last week that of the 36 million people living with HIV or AIDS in the world today, about half are women, but the death rate of women exceeds that of men and is rising. Because so much of HIV transmission is tied to gender inequities that show themselves in sexual practices, and even in rituals of needle sharing where female users often follow male users, the AIDS epidemic amounts to a new call for justice for women. ''Only when society as a whole takes steps to support the rights of women to autonomy and equality,'' the UNAIDS organizers argue, ''will larger numbers of women have the chance to protect themselves from HIV.''
This is a struggle that must be waged everywhere - from sub-Saharan refugee camps where women are lured into commercialized sex to American middle schools where boys are learning to expect sexual gratification from girls, with no notion of mutuality. The solution is not to guilt-trip African truck drivers, nor to chastise pre-teen lotharios in the United States, any more than the solution to AIDS two decades ago was to demonize gays. The solution is to recast an outmoded masculinity that punishes women, but that also devastates men and boys.
The true welfare of males is as much at stake in the fight for gender equality as that of females, just as protection of the rights of all people assumes defense of the rights of gay people. These assertions could once have been dismissed as nostrums of a cultural elite, but no longer. HIV and AIDS have put the need for a new masculinity on the mandatory agenda of the earth - and of every man on it. It is in that way that men can make a difference.
James Carroll's column appears regularly in the Globe.
© Copyright 2000 Globe Newspaper Company
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