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Nonbinary young adults (who do not identify with a binary male or female identity and may hold diverse gender identities, including genderqueer, nonbinary and agender) may have unique and unmet sexual healthcare needs compared to binary transgender and cisgender people. However, there is limited knowledge about the sexual health and healthcare needs of nonbinary young adults. We conducted 19 semi-structured, in-depth interviews between August and November 2018 with nonbinary people aged 18–30 years in New England. Interview topics included experiences accessing sexual healthcare and engaging in sexual activity. Interviews were transcribed and transcripts were analysed using inductive and deductive thematic analysis. Three main themes were identified. First, participants described barriers to accessing high-quality sexual healthcare at both the interpersonal and institutional level. Second, participants employed strategies to meet their sexual healthcare needs despite encountering barriers. Third, participants articulated the ways nonbinary gender identities affect sexual relationships, with implications for sexual health. These findings underscore the need for research and advocacy – in collaboration with nonbinary persons themselves – to develop best practices to meet the sexual healthcare needs and advance the sexual health of nonbinary young people. [ABSTRACT FROM AUTHOR]

Compelling evidence from three randomised controlled trials, which showed that voluntary medical male circumcision (VMMC) reduces HIV acquisition from women to men by up to 60%, led to WHO recommending that VMMC be implemented in 14 priority countries. As one of the priority countries, Eswatini aimed to reach 80% VMMC coverage among boys and men aged 10–49 years since programme inception in 2009. By the end of 2019, however, the country had reached a modest 40%. VMMC is intrinsically tied to perceptions of masculinity and male gender identity. Comprehending the role of context-specific masculinity as it relates to VMMC may contribute to our understanding of community attitudes towards VMMC and men's decision-making. Drawing on focus group discussion data, this study aimed to explore the linkage between sexuality, masculinity and health interventions within Eswatini. Using critical discourse analysis, the study identified two discourses: sexuality, masculinity and circumcision, and income, masculinity, and circumcision. In the first discourse, participants constructed discursive linkages between circumcision as an adult and loss of penile sensitivity, decreased libido and sexual performance, and adverse events. The second discourse, income, masculinity, and circumcision located circumcision within the social and material realities faced by Swazi men, gender norms and provision within family structures. [ABSTRACT FROM AUTHOR]

This ethnographic study explores the experience of men in long-term relationships with sex workers and their construction of masculine identities in Kampala, Uganda. Data were collected in 2019 and comprise in-depth interviews with 13 male partners and two group discussions of women with long-term male partners. Thematic analysis used an intersectional lens to frame reconfigurations of gender and masculinity in the context of relationships with sex workers. All men had been clients of sex workers before progressing to become long-term partners. We discuss the complex ways in which men participated in value systems of respectability and reputation to (re)configure gender relations that made sense of their long-term relationships with sex workers. Men viewed their relationships with women through the normative lens of traditional masculine roles associated with monopoly over a partner's sexuality, provider and father. However, poverty, HIV, the failure to have exclusive sexual rights over a partner, and the shame associated with sex work intersected and disrupted masculinities. Despite this, men found meaning in these relationships through the woman's commitment to the relationship, her financial support, her help in accessing HIV services, and the children from the relationship, thereby attaining respectability and avoiding a crisis of masculinity. [ABSTRACT FROM AUTHOR]

Youth and adolescence are times when young men negotiate their identity in relation to social and cultural expectations of being a man, with enduring implications for sexual health and wellbeing. This study explored how boys aged 10–14 years living in Korogocho slum in Nairobi, Kenya conceptualised masculinity, their perceptions of how masculinities are performed, and the linkage between conceptualisations of masculinity and sexual development. Three bases of gender socialisation were identified: (1) verbal messaging (mainly from parents and teachers); (2) observing the behaviours of older men in the community; and (3) information received from mainstream and social media. Masculinity conceptualisations focussed on financial stability, family life and responsibility, physical attributes, character and religion. Two contrasting portrayals of masculinity emerged in the form of idealised and dominant masculinities. A close linkage was found between masculinity conceptualisations and sexual development. Findings are important for programmes that aim to transform harmful gender norms and signal the need for longitudinal research exploring how gender beliefs may change over time. [ABSTRACT FROM AUTHOR]

In Vietnam, HIV continues disproportionately to affect men who have sex with men and transgender women, and the increase in HIV prevalence in these populations may be related to a lack of tailoring of current prevention approaches, which often fail to address social diversity within these populations. To effectively respond to HIV in Vietnam, it is imperative to identify sub-populations within the broad category of 'men who have sex with men' (MSM), a term which in Vietnam as in many other sites frequently subsumes transgender women. In this paper, we document the different categories used to describe people who engage in same-sex sexual practices and/or non-normative gender performances drawing on data collected via in-depth interviews and focus groups with a total of 79 participants in Hanoi. We identified over 40 different categories used to describe men who have sex with men and/or transgender women. These categories could be described as behaviourally-based, identity-based, or emic, and each carried different meanings, uses (based on age and geography) and levels of stigma. The categories shine light on the complexity of identities among men who have sex with men and transgender women and have utility for future research and programming to more comprehensively address HIV in Vietnam. [ABSTRACT FROM AUTHOR]

This study explored the intersection of masculinity and HIV care engagement among fishermen and other male fisherfolk on antiretroviral therapy (ART) in Wakiso District, Uganda. We conducted 30 in-depth interviews with men on ART recruited from HIV treatment sites and used a thematic analysis approach. Since HIV diagnosis and ART initiation, men had adopted masculine identities more conducive to HIV care engagement. The masculine roles of worker and provider, husband and sexual partner and the appearance of physical strength were compromised by HIV, but restored by ART's positive effects on health. Peers also emerged as facilitators to HIV care, with men supporting each other to seek testing and treatment. However, structural and occupational barriers to HIV care associated with the masculine role of worker remained a barrier to care engagement. Findings suggest that emphasising the benefits of ART in bolstering men's ability to fulfil the roles important to them may improve the effectiveness of HIV testing and treatment messaging for men. Differentiated care models that address structural-level barriers to care, and community-level gender-transformative programming to help fishermen engage in HIV care, may be beneficial. [ABSTRACT FROM AUTHOR]

While the uptake of voluntary medical male circumcision (VMMC) is increasing, South Africa has only attained 20% of its target to circumcise 80% of adult men by 2015. Understanding the factors influencing uptake is essential to meeting these targets. This qualitative study reports on findings from focus-group discussions with men in rural KwaZulu-Natal, South Africa, about what factors influence their perceptions of VMMC. The study found that VMMC is linked to perceptions of masculinity and male gender identity including sexual health, sexual performance and pleasure, possible risk compensation and self-identity. Findings highlight the need to understand how these perceptions of sexual health and performance affect men's decisions to undergo circumcision and the implications for uptake of VMMC. The study also highlights the need for individualised and contextualised information and counselling that can identify, understand and address the perceptions men have of VMMC, and the impacts they believe it will have on them. [ABSTRACT FROM PUBLISHER]