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In this paper, I reflect on the notion of 'African men' as it is employed in global health scholarship and disentangle the way the idea is used as a generative concept. I explore how this notion circulates and gets modified, adapted and reproduced by scholars, on the one hand, and by various groups of men in Africa, on the other. I argue that the use of the idea of African men as an a priori category in scholarly imagination and practice presents us with stereotypes that impede much research. I then briefly connect with what has been analysed as the hegemonic discourse on Africa as the paradigm of difference, and the history of local modes of self-presentation as Africans. In Kenya, among both men and women, the use of the phrase African men as a natural category of sexual agents has been used to explain or justify men's multiple sexual relations. Yet if we look more closely at men's experiences, it becomes clear how men are caught up in conflicting discourses of masculinity. I conclude that we need to analyse gender as a performative quality that is both constructed and meaningful.

Although pastoralists are a significant proportion of the rural population in many African countries, they are often underserved with regard to health-related interventions. This paper presents data on an effort to provide information about HIV prevention and treatment to Afar people living in remote, northeastern Ethiopia. Using an evidence-based approach, we worked together with the National Network of Positive Women Ethiopians to build relations with Afar communities to design and test an intervention to improve HIV awareness. In this study we observed how multi-directional, local level perceptions - of Afar regarding HIV and existing health-related interventions, of staff from organisations regarding Afar and of the researchers conducting this study regarding Afar - shape the ways in which health-related interventions are offered to Afar and how these are understood by them. While the Afar people express a desire for culturally appropriate HIV-related interventions, few such initiatives have reached them to date. Organisations working in the area often believed that Afar people did not want to accept HIV and were therefore not responsive to their interventions. We argue that the specific history of the Afar people and how this affects their understanding of HIV needs to be better understood and integrated into HIV interventions.

This introduction to this special issue of Culture, Health & Sexuality aims to intervene critically in debates in public health about sexual rights and ways of de-stigmatising HIV/AIDS, in which silence and secrets are seen to undermine well-being and perpetuate stigma. It presents key insights from collaborative studies on HIV/AIDS and youth sexual health, arguing that advocates of disclosure and sexual rights need to think more contextually and tactically in promoting truth-telling. The authors aim to enhance current thinking on secrecy, which examines it primarily as a social practice, by emphasising the centrality of the body and the experience of embodiment in the making and unmaking of secrets. To understand secrecy as embodied practice requires understanding how it simultaneously involves the body as subject - as the basis from which we experience the world - and the body as object - that can be actively manipulated, silenced and ‘done’. The authors show how tensions emerge when bodies reveal reproductive mishaps and describe how the dissonances are resolved through a variety of silencing practices. The paper ends by discussing the implications of these insights for sexual-health programmes.

Intravaginal insertion is often associated with the concept of ‘dry’ sex. All HIV-prevention microbicides tested to date have been vaginally applied lubricant-based gels. In this paper, we examine whether the use of intravaginal insertions could be in conflict with the introduction of vaginal microbicide gels. The Africa Centre site was part of the Microbicides Development Programme evaluating PRO2000/5 microbicide gel. We conducted in-depth-interviews and focus-group discussions with women enrolled in the trial as well as women and men from the community. The analysis focused on people's knowledge of intravaginal insertion in the community and trial participants’ experience of using trial gels. Intravaginal use of a variety of products was widely acknowledged. We found that the experience of using trial gels - which made sex ‘hot’, ‘tight’ and ‘dry’ - matched the desired outcomes of intravaginal insertion. We found that vaginal ‘dryness’ described the removal of excessive amounts of unusual discharge, rather than the removal of normal vaginal secretions and that intravaginal insertion is not exclusively associated with a desire for ‘dry’ sex. Study findings provide evidence that vaginal microbicide gels may be more acceptable in communities where intravaginal insertion is practiced than was previously thought.