Tsha Tsha entertainment-education series challenges masculinity among HIV-positive men in Soweto

By Frederick Oduor Ogenga.

I am currently working as an independent media consultant, freelancer and lecturer. I am also pursuing a PHD in Media Studies at the University of Witwatersrand, South Africa.

Abstract
This article is an excerpt from a study that aimed to examine the production of HIV/AIDS lessons on Tsha Tsha Entertainment-Education and their reception by HIV-positive men in Soweto, and to find out whether this response impacted on their perception of their roles and responsibilities in HIV/AIDS. The rationale behind this study was that gender and HIV/AIDS has been critical in interventions aimed at combating the disease. Studies in South Africa on gender have revealed that versions of masculinity can be implicated in the increasing infection rates of HIV/AIDS making efforts to combat the disease problematic. A qualitative methodology was used. This method included interviews and focus group discussions. Five interviews were done with programme producers and researchers of Tsha Tsha to find out the major considerations in production. An average of seven HIV-positive men were exposed to 12 episodes of Tsha Tsha to find out their responses in six focus group discussions, and whether these indicated a changed perceptions in their roles and responsibilities in HIV/AIDS. Their responses were then examined under Bandura’s (1971) social learning theory and Hall’s (1977) encoding-decoding theory .This theories explain the considerations in the production of lessons in Tsha Tsha and how audiences respond to those lessons respectively. The findings revealed that audiences (HIV-positive) men identified with lessons around HIV-testing, disclosure, support and those that challenge stigma and masculinity in HIV/AIDS. Disclosure emerged as a major theme and was compared with sub themes of testing, stigma, masculinity and social support to form categories that were presented as the findings. While HIV-disclosure is seen as challenging HIV/AIDS stigma and masculinity, where men accept their condition, and take responsibility to continue occupying their space as men, E-E production is seen can reinforce lessons around disclosure and other coping strategies to combat HIV/AIDS.

Key words: HIV/AIDS, testing, disclosure, support, gender, masculinity, South Africa, Entertainment –Education

I have spent many years as part of the media audience about different forms of HIV/AIDS campaign and messages but one really got my attention. However, this was when I used to work in Nairobi, Kenya, for a Non Governmental organization Known as Population Communication International (PCI). At our PCI menu, we offered an Entertainment–Education (E-E) Programme called Ushikwapo Shikamana which translates to “if assisted, assist yourself”. Although this was a series appearing on radio and broadcasted in Kenya and Tanzania, it had a remarkable impact on the audiences based on the characters (models) that embodied HIV/AIDS and other lessons. I was therefore curious to find out to what extent, in terms of audience effect, can a similar TV programme elicit. I therefore began my research by studying (E-E) as a genre for addressing HIV/AIDS but realised that I needed to have a holistic knowledge of the complexity of HIV/AIDS which goes beyond a simplistic media (television E-E) intervention.

Masculinity
During the process, I found out that the study of gender and HIV/AIDS has been critical in interventions aimed at combating the disease. In South Africa, studies have been done under African sexuality in the area of HIV/AIDS. These studies have revealed that masculinity around sex and sexuality depicted women as more vulnerable to HIV/AIDS than men, and men as the drivers of the epidemic (Kometsi, 2004). Masculinity is visible around issues such as having multiple partner, fear of testing, fear of disclosure, men’s ‘Macho’ attitude that ensures they don’t seek treatment, and rejection of their partners when they realize they are positive. According to anthropologists, masculinity is a core set of activities or traits which are transculturally associated with men (Morell, 1991. p. 5)

The perception towards traditional gender roles partially constructed by culture, where notions of masculinity thrive, ensures that men don’t take responsibility in HIV/AIDS. These notions have disempowered men, leaving them vulnerable and making it difficult for them to cope with the epidemic. The perceived vulnerability of women has led to several efforts to empower women with little efforts focusing on men’s vulnerability (Kometsi, 2004; Gupta, 2000; Mane & Aggleton, 2001). The empowerment of women in South Africa on gender equality has perhaps threatened and disempowered men. The ‘New Gender Order’ amidst traditional masculinity has left men confused. They have lost their traditional roles dictated by power positions in the society. This is evident in the increase of domestic violence and sexual abuse of women and children including baby rape (Morell, 2001; Reid &Walker, 2005)

However, as my research is now indicating, there is a changing masculinity particularly in HIV/AIDS that is now penetrating the spaces of traditional masculinity, especially around men’s roles and responsibilities in HIV/AIDS. (Reid & Walker, 2001; Morell, 2004; Garson, 2004). I found out how masculinity crumbles in the face of the epidemic, by the fact that men become weakened by the disease and they lose their dignity due to the association of the disease with ‘bad sex’ that leads to ‘bad death’ (Posel, 2003). These men are forced to forge a new masculinity especially around their roles and responsibilities, through taking certain actions at a post infection level. These are the decisions and roles they play following the disclosure of their status to significant others to ensure their well being and those of their partners. These are actions such as testing for HIV, living positively with HIV disclosure, Stigma and opening up for support for themselves and their partners at different levels (partner, family and community level).

Change, seldom happens in a vacuum, there has to be social forces that drive the change. One of the possibilities of bringing about change is through the media. Entertainment- Education (E-E), has been used as one of the most effective vehicle for social change. This is evident through the evaluation of audience response of E-E programmes like Soul City and evaluation of the first 26 episodes of Tsha Tsha which contributed in the change of the audience member’s perception in HIV/AIDS (Kelly et al, 2005). I conducted this research in Soweto and therefore I looked at the production of HIV/AIDS lessons on the Entertainment-Education television programme Tsha Tsha and their reception by HIV-positive men in Soweto.

The objectives of this research were two fold: Firstly, I wanted to assess the production of HIV/AIDS lessons on Tsha Tsha Entertainment-Education and their reception by HIV positive men in Soweto and secondly, to find out whether this response impacts on HIV-positive men’s perception of their roles and responsibilities in HIV/AIDS.

The questions I was addressing in this research were; what lessons in HIV/AIDS did producers encode in Tsha Tsha? How did HIV-positive men respond to these lessons? And whether these lessons helped them change their perceptions on their roles and responsibilities in HIV/AIDS?

While reviewing the background literature in the field of African sexuality studies, I realized that most scholars agree that there are different forms of masculinities. From a historical perspective, masculinity as a key concept in gender studies has impacted on HIV/AIDS in several ways. This is because masculinity has defined and shaped the nature of heterosexual relationships and has also impacted on HIV/AIDS in South Africa. Masculinity is seen as heterogeneous and there is nothing like a single version of masculinity practiced by all men. There are different masculinities and an increased awareness, by some men, of their identity as a gendered construction which is open to change (changing men).


The nature of relationships between men and women in South Africa and their general perception of their roles and responsibilities within those relationships should be contextualised. They have partly been shaped by notions of masculinity and they include culturally defined gender roles in heterosexual interactions between partners in South Africa. These roles are partially defined by culture; they are patriarchal and legitimate men to exclude themselves in certain critical aspects of HIV prevention, testing, disclosure, care and support (Kometsi, 2004. p. 31-32). Culture constructs certain traditional gender roles which shape the way men and women interact. The major reason why there is a perceived lack of participation in HIV/AIDS interventions by men can be linked to how men perceive their roles and responsibilities in their relationship with their partners and in HIV/AIDS. Some traditional constructions of masculinity creates negative power over women and other sexual partners, acting as a setback when looked at in terms of combating HIV/AIDS (Kometsi, 2004. p. 37).


Gender plays a big role in the relationships between men and women. In the literature scholars have pointed to “a crisis of masculinity” characterised by instability and uncertainty over social roles and identities, sexuality, work and personal relationships (Frosh et al in Reid &Walker, 2005. p.161). Bob Conell, an Australian sociologist argues that men enjoyed the “patriarchal dividend” the advantage men in general gain from the subordination of women. Being a man, Conell argues, conferred power but not all men shared this power equally and not all were individually exploitative (Conell in Morell, 1991: p. 5). He cites men who are exploitative to other men, driven by the force of hegemonic masculinity. This is a form of masculinity that dominates other masculinities. It succeeds in creating prescriptions of masculinity which are binding (or at least partially so), and which create cultural images of what it meant to be a “real man” (Ibid). This masculinity is dominant in the society exercising its power over other rival masculinities and regulates male power over women and distributes this power differently amongst men. Hegemonic masculinity does not rely on brute force for its efficacy, but on a range of mechanisms which create a gender consensus that legitimates the power of men (Morell, 1991. p.7).

However, Morrell argues that even though most men profit from hegemonic masculinity, not every man holds this kind of masculinity. Hegemonic masculinity therefore tends to exclude marginalized groups in the society. Women hardly benefit from this form of masculinity. Donaldson (in Zlotnik 2000.p.12) notes that “a fundamental element of hegemonic masculinity is that women exist as potential sexual objects for men”. Men gain sexual validation not only by pursuing women but also competing for them. This is where hegemonic masculinity is associated with sexual conquest and having many sexual partners partially accounting for the rising infection rates of HIV in South Africa.

Masculinity socializes men to be macho risk takers and to crave for social power. Campbell (in Kometsi 2004. p. 84) claims that “frequent and unprotected sex with multiple partners may often be one of the few ways in which men can act on their hegemonic masculinity”. The active and conscious pursuit of real manhood or prescriptions of masculinity create anxiety precisely because of the shifting nature of the boundaries and its instability over time and place. The socialization described earlier creates men and women as opponents. It creates the perception that masculine power and status are under threat from those who are not masculine (Hooks in Kometsi, 2004. p. 85)

The effects of this hegemonic masculinity are severely felt in relationships between partners. Their sexual health is severely affected especially when they are HIV/positive. For example, one participant mentioned that he did not use condoms despite the fact that he was infected for fear that his manhood will be questioned by the partner, something that led to re-infection. In other cases, this situation is often characterized by men’s negligence in parental roles and their negligence of other roles and responsibilities such as HIV testing, disclosure, care and support. All participants found these issues problematic

Considering the fact that men are the ones that make many decisions in the family, it is imperative to ensure that they contribute wisely in decisions concerning their health and that of their partners. The burden that couples face due to HIV/AIDS is associated with the feeling of social rejection and stigma is difficult to deal with. This is the moment when men and women are required to work jointly, to support each other psychologically, emotionally and financially. It is likely that the kind of relationship existing between partners can influence the choices they make regarding their health.

With sex being central to the self-imaging of men as real men, which is men with power especially over women, women’s insistence on practicing safer sex might be seen as a challenge to the power of men (Kometsi, 2004.p.83). Therefore, in looking at men’s perception of their partners in their relationships and within the broader aspect of HIV/AIDS, it is clear that some decision regarding sex for instance decisions about condom use are problematic (Kometsi, 2004. p. 12). Nevertheless, both men and women (the society) participate in ensuring certain masculinities are privileged and not others. Both men and women are active participants in the perpetuation of some forms of masculinity depending on whether they are favoring them or not.

Changing masculinity
However, masculinities are fluid and should not be considered as belonging in a fixed way to any group of men. They are socially and historically constructed in a process which involves contestation between rival understandings of what being a man should involve. Masculinities are constantly being protected and defended, are constantly breaking down and being recreated.

Deaux (in Zlotnik, 2002. p. 9) observes that masculinity is socially constructed and changes as relationships between societies do, rather than being a natural attribute. Masculinity as a construct or set of attributes does not apply only to men. Rather, it is a construct that may constitute part of the identity of both men and women to some extent.

“Unreal” Aids review (2004) research done by Kometsi on masculinity and HIV/AIDS in South Africa, University of Pretoria indicates that men’s perceptions on masculinity influence their relations with others especially their partners. There is a link between some of men’s practices and the spread of HIV (Kometsi, 2004. p. 81). Power as an operational concept is essential in examining how some men relate to themselves, and more importantly to women. Traditional masculinity therefore becomes some men’s practices in such relationships. This are practices that dominant images of manhood are associated with (Kometsi, 2004. p. 81).

Connell (in Kometsi, 2004. p. 82) suggest the importance of looking at how men and women lead gendered lives as a lead into what the concept of masculinity means.
Masculinity represents not just an idea in the head, or a personality identity. It is also extended in the world, merged in organized social relations. Concepts of masculinity and femininity therefore become useful instruments in looking at men, women and their gender experiences in the context of HIV/AIDS. Considering that some men are rendered more powerful than women in patriarchal societies, it is important to look at the gender power dynamics. This can help us understand men’s perception in their relationships with their partners and their roles in HIV/AIDS especially in testing, stigma support and care.


Furthermore, the socio-economic and political context of HIV/AIDS in South Africa, where HIV/AIDS testing, stigma, disclosure, support and how they relate to masculinity have contributed greatly in the shaping and reshaping of these masculinities. In the political context, there have been debates about the casual link between HIV and AIDS and the crossfire between the government, pharmaceutical companies, civil societies and people living with HIV/AIDS about treatment options, and safety and efficacy of the drugs used for treatment. Within such a complexity, Tsha Tsha as an entertainment-education is used as a case study. Tsha Tsha strives to highlight on issues related to sexuality facing South Africans within a broader framework of addressing the problematic issue of HIV/AIDS.

Men are centrally implicated in the shifting sexual landscape in South Africa. There is a perception that the HIV/AIDS epidemic is driven by men, and men are blamed for the prevalence of domestic violence and child sexual abuse (Reid & Walker, 2005. p. 9; Mane & Aggleton, 2001). The recognition that it is men who spread the epidemic to women was ignored until the late 1990s. This is when it was recognised that since men have some power in sexual relationships they should shoulder the responsibility of preventing the transmission of HIV, protecting their own health as well as that of their female partners. Tsha Tsha presents new ways of targeting and addressing men that are not simply reinforcing traditional stereotypes of gender roles and masculine identities.

In the five interviews that I conducted with the producers of Tsha Tsha, there was an indication that they encode messages based on the assumption that human beings learn from their social environment through modeling (Bandura,1977). They use models that audience can identify with and learn from. While the producers come up with TV messeges in form of lessons through the programme, audiences (HIV-positive men) on the other side respond to such messages in a similar fashion. This explains the relationship between production and reception of such messages in the programme

After being exposed to 12 episodes of Tsha Tsha that had HIV/AIDS lessons purposely designed by programme producers about testing, disclosure and social support (encoding), the HIV-positive men indicated in the six focus grouped discussions, that followed the viewing, that they have learnt lessons about HIV-AIDS disclosure, testing social support through models in the programme. However, disclosure was the dominant theme as they explain in the following excerpts.

There is no any other way, you just have to disclose to the person you are concerned with and see what’s happening. Then you will get the support or you will get the negative response, it will depend. But it is better to stick to disclosure, you just have to disclose. Wellington. W. FGD.

Yah it’s good to talk to avoid thinking too much. WI. FGD.

This indicated that there is a level of success in changing audience perceptions if entertainment-education programmes are purposely designed with HIV/AIDS themes. Other lessons that they indicated to have learnt through the programme were the need to discourage multiple partners, living positively with HIV/AIDS disclosure and stigma, and having a better relationship.


Tsha Tsha therefore followed a theoretical approach that allows us to understand and partly explain production of lessons in Tsha Tsha, and largely explain the responses of HIV-positive men (audience) to the lessons presented. In this theoretical approach encoding is done within the genre of E-E, determining the product that appears in form of lessons. This genre (E-E) is defined by certain professional rules and regulations that define it. Therefore, the intention of the producers was for the audiences to share their version of meaning to the lessons they present when decoding these lessons.

Encoding-decoding theoretical approach therefore helps us understand how Tsha Tsha programme producers design lessons that encourage shared reading. It also explains how HIV-positive men respond to these lessons depending on several other factors. These factors include for instance, their HIV- positive condition. They identified with the lessons about HIV testing, disclosure and stigma out of the fact that they were already infected. Morley (1980), Fiske (1978) and Ang (in Downing et al 1990). Tsha Tsha audiences (HIV-positive) men had a preferred reading (shared reading; according to producers’ intentions) of lessons around HIV-disclosure, testing and stigma, and opening up for support and supporting others (their partners) in HIV/AIDS.

Disclosure
HIV-disclosure is seen as challenging HIV/AIDS stigma and traditional masculinity, where men accept their condition, and take responsibility to continue occupying their space as men. This they do through actions that promote their health and well being as well as those of their partners. The line between gender roles thus becomes invisible when it comes to HIV/AIDS.

Disclosure was repeatedly shown in the episodes through different characters at different contexts. Disclosure of HIV/AIDS in the programme was presented across many episodes as a necessary step towards coping with HIV/AIDS for those infected.

Most participants emphasized the need for HIV disclosure as a way of opening up for support and of helping infected people to cope with the physical and psychological stressors that come with the virus as they explained:

Disclosure has helped us to be strong… in such a way that we are getting the support that we need in the support groups. W.FGD

After knowing my status, I told myself I am like that and I will never change and I must give others the word…. S1. FGD.







The Focus Group Discussions by seven HIV-positive men indicated that they had a changed perception on various problematic issues in HIV/AIDS like testing, stigma, disclosure and social support. The HIV-positive men identified much with the character Viwe (model) due to her courage to test and disclose openly to her family and community, as well as starting a support group to help others. They saw Viwe as their hero because she was strong and, therefore, gave them hope as one of them noted:

Yah for me according to the role that they play I think Viwe is the hero because she is the one who talks about disclosure she is not afraid. W.FGD.

Tsha Tsha encouraged HIV-positive men to talk about certain important issues in HIV/AIDS such as reduction of sexual partners, using safety measures, seeking treatment and the need to live humanly with those infected. The HIV-positive men saw the programme as very encouraging because it teaches people and gives them information about HIV/AIDS.

I see only one thing that this cassette is very good to show people […people must] go and check their status, maybe this cassette can be used to teach to change that disclosure is normal. S2. FGD.

In line with supporting their partners (their roles and responsibilities), most of them were abandoned and were no longer in a relationship because their partners had ‘ran away’ after they disclosed, and perhaps Tsha Tsha should have addressed the issue of partners being abandoned after they disclosed. However, out of watching Tsha Tsha they indicated a changed perception of their roles in a relationship. Most importantly, the findings in this research indicated that masculinity is changing with some men taking responsibility of themselves and ‘partners’ (others), through disclosure after testing. It has also indicated Tsha Tsha’s contribution in providing lessons that brings about a change in perception in men’s roles and responsibilities in HIV/AIDS.













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