Provider love in an informal settlement: Men's relationships with providing women and implications for HIV in Kampala, Uganda

Abstract

Uganda has made progress in controlling the HIV epidemic since it first emerged in the 1980s. While new infections in the country are higher among women, men in urban areas face a higher risk of AIDS-related mortality due to starting treatment later and taking medication inconsistently. While gender analyses have been used to describe women's HIV vulnerability, less is known about how masculinity, and especially different forms of masculinity, affect men's vulnerability. This study reports on data from an ethnography (2016-2019) with low-income men in urban Uganda. This study uses gender and power theory to describe how men's relationships with female sex workers in an informal settlement in urban Kampala, Uganda are characterized by female providers ("provider love") and male dependents. Young men in this sample, largely jobless, rely on their relationships for daily survival. As gender roles reverse, young men find themselves unable to attain masculine ideals as expected of Baganda men. Instead, men in this sample face less power in their relationships, a loss of masculine respectability, and diminished reputations in the community. These intersections of gender, economic struggle, power, and intimacy reconfigure men's HIV vulnerability in this setting. Public health programming on HIV/AIDS for men should consider different patterns of masculinity, power, and economic struggle and how they impact HIV outcomes.

Keywords: Female sex workers; Gender and power; HIV; Informal settlement; Masculinity; Uganda; Vulnerability; Young men.