Hesperian Health Guides

Gender roles and STIs

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HealthWiki > Health Actions for Women > Chapter 5: Preventing Sexually Transmitted Infections (STIs) > Gender roles and STIs

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.

For more information and discussion about gender roles, sexuality, and health, see Chapter 3: Gender and Health and Chapter 4: Sexuality and Sexual Health.

3 women thinking while they watch a presentation about condom use.
Jorge would accuse me of having another man...
My partner and I tried using condoms, but sex didn’t feel the same, so we stopped.
Let sex workers use condoms. I only have one partner, so I don’t have to worry about STIs.

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.)

ActivityAn STI drama

Before this activity, create a drama. It should have several situations that connect different characters to each other through sexual relationships.

  1. 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.
  2. 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.
  3. 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.
  4. 3 women speaking in a small group.
    What do you think the characters in the drama should do now?
    I think Roopa could decide to ask Rajiv to use a condom. After all, she knows he has sex with other women.
    I want to know what Gita does with the condom to make Rajiv like it.
  5. 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?

ActivityAn 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.
See more instructions about how to make the board game and how to play.

illustration of the below: a stack of health fact cards, with a check mark on the back of each.

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.)

sample health fact questions.
Kissing will NOT pass HIV from one person to another. True or False?
(correct answer: True)
HAW Ch5 Page 124-2.png
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)
HAW Ch5 Page 124-2.png
A person with chlamydia always has signs of illness. True or False?
(correct answer: False)
HAW Ch5 Page 124-2.png
Name 2 STIs that can cause infertility in a woman if not treated with medicines.
(correct answer, any 2 of these: chlamydia, gonorrhea, trichomoniasis)
a stack of discussion cards, with a question mark on the back of each.

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:

sample discussion cards.
Clara and Esteban have been married for 6 years and they have 3 children. Esteban went to the city to work as a bricklayer to make extra money. Not long after he returned, Clara started having a yellow discharge from her vagina. She is too ashamed to say anything to Esteban, and too embarrassed to tell a health worker.

What should Clara do? What do you think Esteban would do if she told him? Why?
HAW Ch5 Page 125-2.png
Anisha has had HIV since she was born. The government provides free medicines, and she is a healthy young woman. A few years ago, a man she loved asked her to marry him, but when she told him she had HIV, he was very upset and went away. Later she met Milan. They are very happy, and he says he wants to marry her and have a family. Anisha is afraid to tell him she has HIV for fear he will abandon her too.

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.