The impact of male sexuality on womens and childrens health.

There is a strong rationale to involve men in supportive roles in issues that impact on sexual and reproductive health. There is also an urgent need for men to use sexual and reproductive health services in a much more active manner than has traditionally been the case. Current data on the impact of disease on morbidity and mortality points to the devastating effect that HIV is having particularly on young women and children. Similarly sexual violence and coercion are having a profound impact. Men have an obvious responsibility to improve the situation but it is noted that they are not escaping the impact of the epidemic. Men may suffer less from HIV than women in their corresponding age cohorts but they inevitably pay for this in the long run. When other causes of death particularly violence and traffic accidents are taken in account men have a shorter life expectancy than women. Current research has emphasised the value of several new areas of innovation which include participatory forms of mens empowerment health and gender education the potential role of circumcision as well as structured engagement with high risk industries such as the transport sector and settings such as prisons. There are numerous international examples of successful mens involvement and also an increasing range of South African case studies of progressive initiatives some national in scope and others more focused at a district level. (authors)