Hesperian Health Guides
Gender roles and STIs
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- Chapter 5: Preventing Sexually Transmitted Infections (STIs)
- Start where people are at
- Learn how STIs spread to help prevent them
- Women's equality prevents STIs
- Gender roles and STIs
- Men share responsibility for STI prevention
- Safer sex requires good communication
- Community strategies for STI prevention
One of the reasons STIs spread so easily is that unhealthy gender roles prevent women from being able to protect themselves.
Gender roles include expectations about what women and men do in sexual relationships. When men are expected to control how and when they and their partners have sex, they may not consider how women feel, and women often believe that their feelings about sex do not matter. But to prevent STIs, women and men need to be able to talk honestly with their partners about safer sex and to agree to make safer sex part of their relationship.
Use drama to discuss gender roles and STIs
Creating a drama and acting it out with a group is a good way to look at the way gender roles create barriers to preventing STIs. People enjoy radio and television dramas because the characters are always getting into trouble and the stories include many surprises. A drama can show characters doing things no one talks about, such as a man paying a sex worker or having a sexual relationship with another man. You can use a drama to discuss changes that would help more women and men take care of their sexual health. You can also use a drama to have a deeper discussion about how gender roles influence people’s sexual relationships.
The sample drama below shows how to combine a drama with discussion. You can also adapt the sample drama using characters and situations that fit your community.
These are some ways to make the drama interesting and useful for discussion:
- Give characters realistic emotions, and understandable reasons for their actions.
- Show characters making mistakes and also making healthy choices.
- Think about ways to include problems with consenting to have sex, power differences between characters, and how people of different ages make sexual choices.
A sample STI drama
Nina: 18 years old, religious, married to Rajiv with 3 children
Rajiv: truck driver, married to Nina, often drives to the city, has a girlfriend named Roopa in another village
Roopa: Rajiv’s girlfriend, mother of Rajiv’s baby
Mohan: married and faithful to Maya, has HIV but does not know it
Maya: village health worker, married to Mohan
Gita: sex worker in the city
Roopa takes her sick baby to see Maya, the health worker. Maya treats the baby and then talks to Roopa about HIV. Asked if her boyfriend uses condoms, Roopa says no. (You can stop here to discuss STI prevention in Roopa’s situation.)
Maya tells Roopa that although her husband Mohan is faithful, they always use condoms because they had sex with others in the past. At first Mohan did not want to use them but now he is used to them. (Another place to stop and discuss.)
Meanwhile, Rajiv is driving his truck to the city. That night, he arranges to have sex with Gita, a sex worker. (Stop and discuss again.)
To Rajiv’s surprise, Gita insists on using condoms! Her sex workers’ union taught about HIV, and they agreed to demand that all their customers use condoms. Rajiv has had sex with many women, but Gita is the first to make him use protection. He objects at first, but she makes using a condom so sexy that he does not mind. (Stop and discuss again.)
In the morning, Rajiv returns to Nina. He remembers what Gita said about HIV. Rajiv considers talking to his wife about condoms but decides she would suspect he is unfaithful. That evening, Rajiv and Nina have sex without a condom.
(The story could continue with more scenes, but this is a good place to stop. Discuss what has happened and what people think will happen next. See the questions in step 4 of the activity below.)
Activity An STI drama
Before this activity, create a drama. It should have several situations that connect different characters to each other through sexual relationships.
- To begin the activity, make sure the participants understand how STIs spread. If the group has not done the Handshake game, it may be a good idea to do that first.
- When the group is ready, ask different people to be characters in the drama you have created. Tell them the story and give them a few minutes to work out how they will act out the scenes.
- As the actors perform the drama, stop it at certain points to ask how their actions help spread or help prevent STIs. You might also ask at each point what a character could do differently to protect her own or her partner’s health.
- At the end of the drama, ask the actors to leave their roles and join the group to discuss how the characters’ gender roles influenced their ability to protect themselves or their partners from STIs.
You might ask people to consider the ways each character fits gender expectations about being a man or woman. How does gender inequality make it more difficult for the women in the drama to protect themselves from STIs?
What would happen if the characters were more honest with each other about their sexual relationships and how they can give each other pleasure? What makes this difficult?
Activity An STI board game
You can adapt A family planning board game to discuss the facts about STIs and how to prevent STIs from spreading. The discussion during the STI board game will help your group:
- test what they know about different STIs.
- explore the reasons why women may have difficulty preventing STIs.
- practice explaining why preventing STIs is important for women’s health.
- find out what they want to learn more about.
To prepare: Make STI health fact questions. The STI chart has information about STIs that you can use to make health fact questions such as the ones here. (The answers are included for you here, but do not put them on the cards. Make a separate answer sheet instead.)
Kissing will NOT pass HIV from one person to another. True or False?
(correct answer: True)
Name 3 STIs that can pass from a woman to her baby during pregnancy or birth.
(correct answer, any 3 of these: syphilis, HIV, hepatitis B, gonorrhea, chlamydia)
A person with chlamydia always has signs of illness. True or False?
(correct answer: False)
Name 2 STIs that can cause infertility in a woman if not treated with medicines.
(correct answer, any 2 of these: chlamydia, gonorrhea, trichomoniasis)
STI discussion questions. To make discussion questions, think about real-life situations and reasons why it may be difficult for women in the community to protect themselves from STIs. There are no right or wrong answers to these questions. The purpose is to discuss the situation as a group. Here are some examples:
What should Clara do? What do you think Esteban would do if she told him? Why?
What should Anisha do? What should Milan do? Why?
To play: When a team or player lands on a discussion question, ask them to think about different solutions and then explain to the whole group why they think one solution may be better than others. Invite others in the group to make suggestions too.
When the game is finished, invite the players to talk about something they learned from the activity. Ask if there are other issues or information related to STIs that the group would like to discuss or learn more about. Use their responses to plan other activities.