Remaking Masculinity in Bwaise

Crammed into the back of a stuffy matatu, one of Kampala's ubiquitous white minivan buses, I strained to see my stop. I was making my first visit to Bwaise, a densely populated slum community that became the focus of my fieldwork in Uganda. Our matatu had begun its journey in Kampala's city center, near the office towers, government buildings, and large hotels that were the pulsing core of this vibrant capital city. In twenty minutes, after many jarring stops to disgorge and ingest passengers, we had passed the main university campus, a nearby slum with mushrooming student hostels, a long stretch of carpentry workshops displaying overstuffed couches, and a Pentecostal megachurch that resembled an airplane hangar. I knew I was now close to my destination, and when I spotted Bwaise's main landmark, a three-story furniture showroom, I shouted, "Siteegi!" (Bus stop!), and clambered out of the matatu.

I had come to Bwaise to visit the home of Christine, a forty-four-year-old widow who had lived in Bwaise for over two decades. Christine and I met a week earlier at a nearby health clinic when I attended a support group for HIV-positive people. Christine was the treasurer of the Post-Test Club, and she had passionately channeled her own experience living with HIV into educating and counseling residents of Bwaise about AIDS. When she learned I was interested in how AIDS had affected life in Kampala, she extended an invitation to visit her neighborhood.

As the matatu sped away, I felt conspicuous — a white American man standing alone in a neighborhood few Western foreigners ever visited. Even without the many stares, I found the congested strip of storefronts overwhelming as a thick stream of pedestrians, cars, trucks, and motorcycles clogged the sidewalk and road. To my relief, a young man approached me and politely introduced himself as Christine's youngest son, Paul. Stocky and with something of an urban swagger, Paul seemed an ideal escort in a place like Bwaise. He led me through a narrow alley beside the furniture showroom, and in moments we were in the crowded residential interior of Bwaise. The traffic noise and exhaust fumes of the main road were replaced by sounds of children playing and the stench from the shallow streams of raw sewage snaking between the homes.

Although I had visited other Kampala slums, I was surprised by the dirt and trash, and the density of dilapidated housing. Yet on this first visit I also caught glimpses of Bwaise's energy and vitality. Women sat outside their homes laughing with each other, watching their children while preparing snack food to sell. A group of men bantered loudly as they grilled the chapatti bread sold in the night market, teasingly calling out, "muzungu," white person, as I passed. Ugandan hip-hop blared from a tiny yellow stand selling cassette tapes as a man with a wheelbarrow full of bright green matooke (plantains) maneuvered past us on the narrow dirt path. It was this contrast between the undeniable squalor of Bwaise and the vigor, resourcefulness, and resilience of so many of its residents that became a leitmotif of my time in the community.

Paul and I wound through the mazelike housing, passing one- and two-room homes packed cheek by jowl. Some were constructed of only mud and wattle and topped with rusting metal roofs; others were older, more substantial homes long past their prime. Eventually we reached a cluster of three small homes that shared a tiny courtyard. On the right side was Christine's house, a two-hundred-square-foot, two-room rectangle made from brown bricks and covered with an aging corrugated metal roof. It sat on a two-foot concrete foundation that provided some protection from the makeshift sewage canal that encircled the compound.

Christine, a slightly stout woman with a broad nose, almond eyes, and high cheekbones, greeted me warmly and invited me into her home. She was in the middle of her morning ritual, preparing maandazi (sweet fried bread). Rising around six, she spent several hours over a small pot of boiling oil, frying balls of batter to sell. This was her main source of income, and her goal was a dozen batches, each with ten pieces of maandazi. Around ten, she would deliver her product to women at the market and collect the money from the previous day's sales — an effort that yielded about one dollar in profit.

As Christine plopped the batter into the oil, she began telling me about her life, including how she was infected with HIV. At twenty, she married a man with a good job as a medical assistant. They were able to afford both an official Catholic wedding and a traditional ceremony in keeping with their heritage as Baganda, the largest ethnic group in Uganda. Over the next decade they had five children together. But then her husband fell sick and died from AIDS. From that point forward, Christine said she knew she too was infected, and because she was monogamous while her husband had two other long-term relationships during their marriage she felt he was to blame. But Christine was not embittered, saying, "At that time people were not fearing AIDS so much. They were not well informed." She referred to the other women as her cowives, and she was grateful for the financial support they provided after her husband's death. Over the course of the next decade, both of these women also died from AIDS.

As I listened to Christine's story, I came to appreciate the devastating toll AIDS had taken on her family. In addition to her husband and cowives, she had lost a brother to the disease, and she was now sharing her house with her younger sister, Mary, who was in the advanced stages of AIDS. Like Christine, Mary believed her husband had infected her with HIV. Over the next six months I watched as Mary slowly succumbed to the disease, even after gaining access to antiretroviral drugs. Christine was devastated by her death. The disturbing images of Mary's frail body on their couch remain with me still, tempered only by memories of her courage and dry wit in the face of her suffering.

While other women might have remarried, Christine was not interested in a new relationship and had remained alone since her husband's death. "I had a little money, but I had to work for my children," she told me, "so I had no time for those men." Concerned a new relationship would bring more problems than benefits, Christine was resigned to survive on her own. Her income, however, was much too low to cover her family's needs, and she was now burdened by thousands of dollars of debt from microfinance loans. Caring for her sister Mary and Mary's children added to her responsibilities, which were becoming overwhelming. Christine faced the bleak prospect of never getting out of debt. If her health ever started to fail, she said, she would not even be able to continue her modest income-generating activity. She was determined that her children receive an education, hoping that they would eventually find decent employment and, in turn, support her.

Having finished her maandazi, Christine said it was time to make her weekly rounds as an AIDS counselor. Her responsibility was to check on members of her Post-Test Club who lived in Bwaise, to monitor their condition and provide encouragement. She had been doing this volunteer work for three years, compensated by only a trifling stipend from an international nongovernmental organization (NGO). As we headed deeper into residential Bwaise, crossing increasingly large sewage canals, we eventually reached a narrow alley where a woman was scaling fish. She enthusiastically greeted us, and Christine asked her about her health, taking careful notes. In the next two hours, we would make four more similar visits, all with HIV-positive widows like Christine. If there had been more time, Christine told me, there were many more HIV-positive people we could have visited in Bwaise, something I would see firsthand in my many months of fieldwork that followed.

Given her experience with her husband, I was not surprised to learn that Christine was preoccupied with how her two sons were negotiating AIDS and sexual intimacy. She was less concerned about her older son, Peter, who at twenty-two was extremely leery of relationships because of his family's experience with AIDS. In contrast to most of his male peers, Peter decided to forgo girlfriends altogether, never having had sex, and was instead focused on his studies, a strategy that eventually resulted in a government university scholarship. Christine was very worried about her youngest son, Paul, however, who she felt was heading down a risky path. At eighteen, and ostensibly still in secondary school, Paul spent most of his days hanging out with friends and many of his evenings at the local clubs. Paul's style of dress took cues from the American hip-hop culture so influential among Kampala youth: baggy jeans, unlaced Timberland-style boots, white tank tops, and loose short-sleeved shirts. He was fond of thick silver jewelry, and his most cherished accessories were his tattoos — gothic Old English designs in black ink that covered his muscular upper arms and back.

Christine viewed Paul's tattoos, jewelry, and attitude as part of a dangerous teenage rebellion that revolved around Bwaise's rather notorious club scene. As I would see myself, Paul was a frequent club patron, and he had befriended the staff, as well as most of the edgy young men in Bwaise. In contrast to Peter, Paul boasted to me about his girlfriends but also insisted, "I can't have sex with a girl when I don't have a condom. That only happened once, the first time I had sex. And ever since I've never done it without one." Nonetheless, Paul's club crowd worried Christine, and she often complained he was spending too much time with Bwaise's abayaye (thugs). As a mother raising her sons alone, Christine said it was difficult to counteract the influence of his peers. "These surroundings," Christine complained, "when you are a woman only, you get problems with children, because they mostly fear men. They fear their fathers." Without such a man in Paul's life, Christine remained concerned that she could not stop him from getting pulled deeper into the world of Bwaise's abayaye.

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This glimpse into Christine's life encapsulates what motivates me to write about how AIDS has shaped gender and sexuality in Uganda. Christine's story reveals the ubiquity of AIDS in a place like Bwaise and shows how the disease has become a pervasive aspect of everyday life. From my visits with Christine, it was obvious that AIDS had not only ravaged her family but her community as well. Christine's story is also emblematic of the many Ugandans who take action to address the disease, whether by being part of an AIDS support group, or helping those afflicted with the disease, or simply by discussing AIDS in a frank and open manner.

Most centrally for this book, Christine's life also illustrates the role that gender relations have played in the epidemic. Both she and Mary claimed to be monogamous wives and believed they were infected with HIV by their husbands. While not resentful of her deceased husband, Christine's experiences made her concerned about her sons and how they would negotiate their intimate relationships now that the dangers of AIDS were well known. Paul and Peter were exploring very different strategies for navigating masculinity, sexuality, and AIDS, each with consequences not only for their sexual health but for their transitions into male adulthood as well.

Finally, Christine's life underscores how the challenges of AIDS were further complicated by Bwaise's grinding poverty. For Christine and her son Peter, poverty made intimate relationships too fraught with conflict and suspicion, something to be avoided altogether. This same poverty, in Christine's eyes, provided her son Paul with easy access to perilous forms of escapism and exposure to far too many male peers who reveled in the more decadent side of life. Most obviously and sadly, poverty also impeded Christine's sister, Mary, from receiving the health care she needed, hastening her death from AIDS.

The ways that Christine and her family grappled with AIDS are not unique to life in Bwaise. Their struggles are repeated in similar communities across Kampala and illustrate how AIDS shapes everyday life in many urban African settings (figure 1.1). I chose to locate this study in Uganda because the country holds a special place in the history of the global AIDS pandemic. During the late 1980s and early 1990s, HIV infection rates dropped rapidly in Uganda, in sharp contrast to skyrocketing rates in much of southern Africa. Uganda was, in fact, the first country on the continent to document a drop in HIV prevalence. Given that the country had just emerged from over a decade of civil war, this was a remarkable achievement — one that earned Uganda the label of Africa's great AIDS success story.

This success has been attributed in part to political leadership but also to the attitudes and perceptions of Ugandans from all walks of life. There was an openness in talking about AIDS in the country and a flowering of grassroots responses to the crisis. A forthrightness about how sexual behavior was tied to AIDS also emerged, including emphasis on men reducing the number of their sexual partners to mitigate the spread of HIV. This in turn helped disrupt dense networks of sexual relationships, a factor now seen as important to Uganda's success (Thornton 2008). By the early 1990s, Uganda was also emerging as an African leader in women's rights, propelled by both the government's promotion of a rights agenda and the more far-reaching work of a vibrant women's movement. It has been suggested that this institutionalization of women's rights also played a role in how Ugandans, especially Ugandan women, were able to respond to the epidemic (Epstein 2007; Epstein and Kim 2007).

It was this success story that drew me to Uganda. I wanted to understand how the AIDS epidemic — a tragic event of historic proportions — had shaped gender and sexuality in Africa, especially conceptions of masculinity. Modifying sexual behavior — including promoting abstinence, condom use, and limiting sexual partnerships — has figured prominently in the public health response to AIDS in Africa. There is, therefore, good reason to suspect that the AIDS crisis may have altered normative discourses of sexuality, especially in those countries where the epidemic has been intense. In addition, because sexuality and gender are deeply intertwined, it is reasonable to presume that pressure on normative notions of sexuality would have reverberations for gender relations, especially in contexts where other forces are destabilizing the gender status quo.

If AIDS had shaped these social relations anywhere in Africa, Uganda seemed the best place to find evidence for it. Prior research on AIDS in Uganda, and sub-Saharan Africa more generally, however, has largely focused on the factors that fueled the spread of HIV on the continent, including economic and gender inequalities (Kalipeni et al. 2004; Kim et al. 2007; Pronyk et al. 2006). Far less attention has been paid to how the prolonged AIDS epidemic may have altered gender relations and intimate relationships — an issue at the heart of this book. While I could have explored these issues by examining the impact of a particular government AIDS program or a specific public health AIDS intervention, I instead focused on everyday life in Bwaise (figure 1.2). As one poor community among very many in Kampala, Bwaise gave me a view into the lives of typical Kampalans and a way of tracing the deeper cultural implications of the AIDS epidemic in urban Uganda.

My fieldwork in Bwaise paid particular, but not exclusive, attention to men and masculinity. Over the past two decades, a great deal of research has shown how normative notions of masculinity have contributed to the spread of HIV across Africa (Barker and Ricardo 2005; Bujra 2000; Dworkin 2015; Foreman 1999; Gibson and Hardon 2005; Hunter 2010; Lindegger and Quayle 2009; Parikh 2009; Rivers and Aggleton 1999; Setel 1999; Smith 2009a, 2014). In this book I examine the reciprocal nature of this dynamic — how AIDS has shaped masculinity, especially male sexuality. Throughout I develop a core theme that emerged from my fieldwork: the central role of what I refer to as masculine sexual privilege, both in everyday responses to AIDS and in the reproduction of gender inequality. In the urban Ugandan context, I use masculine sexual privilege to refer to both men's authority to dictate the terms of sex and a man's right to multiple sexual partners if he so chooses, whether they are wives, girlfriends, or shorter-term partners.