Exploring Adolescent Masculinity in an HIV Context Using Participant Autophotography

Abstract

Adolescent boys living with chronic medical conditions face a challenging context for constructing a young masculine identity, conceptualised as an active positioning in relation to hegemonic masculinity. The research question was to identify constructions of masculinity among adolescent boys living with HIV. The purpose of the study was to explore the intersection of masculine identity construction with an HIV positive identity of relevance to policy and programmes for supporting adolescent boys. Dialogical Self Theory and Connell's concept of hegemonic masculinity were used as frameworks for understanding masculine identity construction as positioning. Participatory methods consisted of semi-structured interviews, focus groups, autophotography and biographical drawings. The purposive sample consisted of adolescent boys (N=7) from an HIV support group. The challenging context of chronic illness highlighted the construction of masculine identity through identifications and alignments in relation to hegemonic masculinity. The participants' narratives revealed the complexities of instantiating and sustaining a young masculine identity.

Keywords: autophotography, Dialogical Self Theory, hegemonic masculinity, masculine identity

Introduction

The researchers explored constructions of masculine identity with the participation of seven adolescent boys in the agerange 13 to 16 years who were members of a clinic-based HIV support group in KwaZulu-Natal, South Africa. Multiple research methods were used to engage with participants over approximately six months. Research methods included autophotography, an active participatory method for exploring spatio-temporal contexts of meaning, previously used in young masculinity research (Blackbeard & Lindegger, 2007; Langa, 2008) and youth resilience research (Didkowsky, Ungar, & Liebenberg, 2010).

South African research on men and masculinities has produced varied accounts of gender, power and identity in a diverse socio-cultural landscape. Connell’s concept of ‘hegemonic masculinity’ has informed analyses of masculine identity intersected with a range of social concerns including age, health, education and gender violence (Morrell, Jewkes, & Lindegger, 2012). Local researchers in the past ten years have been especially interested in constructions of young masculinity, with relevance for health risk and prevention, health services provision, gender-responsive education systems and the high rates of gender violence prevalent in South Africa today (Gibbs & Jobson, 2011; Morrell et al., 2012). A model of multiple hegemonic masculinities has been useful for South African researchers in understanding how forms of masculinity are instantiated in relation to perceived ideals and performances of masculinity (Morrell et al., 2012).

Current thinking is that masculine identity is relational, spatialised and embodied, produced and transformed through cultural experience (Messerschmidt, 2012). Masculine identity is produced especially in relation to hegemonic masculinity, alternately conceptualised as a dominant form of masculinity which reproduces gender relations or as a set of masculinity ideals or ‘imperatives’ (Korobov & Bamberg, 2007). The latter conceptualisation was utilised in this study, as a concept for how masculine identity was organised and expressed in a self-society dialectic. As a sophisticated theory of the self-society nexus, Dialogical Self Theory (DST) (Hermans & Hermans-Konopka, 2010) was utilised as a conceptual overlay for understanding the instantiation of masculine identity through masculine ideals and imperatives. The concept of self positioning from DST was particularly applied for understanding how the participants managed a masculine identity against conflicting social ideals and expectations.

South African researchers have highlighted a range of risks produced through gender inequitable masculinities, norms of sexual entitlement, poverty gaps, unemployment and relative levels of disadvantage associated with high prevalence of gendered and interpersonal violence (Jewkes, Sikweyiya, Morrell, & Dunkle, 2011). Local research in young masculinity has identified links between norms of masculinity and HIV risk behaviours (Harrison, O’Sullivan, Hoffman, Dolezal, & Morrell, 2006) and revealed diverse constructions of young masculinity varying from traditional patterns to alternate and emerging masculinities (Lindegger & Maxwell, 2007). Some have argued that a focus only on the negative features of masculinity neglects contestations between versions of masculinity more or less identified with hegemonic ideals or instances of transitions to alternate masculinities (Lindegger & Quayle, 2009). Similarly, structural and instrumental analyses of young men’s behaviours and practices can overlook the instantiation of identities within personal and interpersonal subjectivities, crucial considerations for the transformation of gender-inequitable masculinities (Jewkes et al., 2011; Lindegger & Quayle, 2009).

Problem statement

Our focus was to identify the individual and group of masculinity among adolescent boys living with HIV with

attention given to how masculine identity was constructed in relation to hegemonic masculinity.

Research questions

From an interpretive research paradigm, we were interested in (1) how the boys positioned themselves in relation to

hegemonic masculinity, (2) how having an identity as an HIV positive person influenced positioning of a masculine

identity and (3) what was the influence of masculine identity upon an HIV positive identity.

Purpose of the study

The purpose of the study was to investigate the individual and group constructions of young masculinity in relation tohegemonic masculinity as a set of social ideals and imperatives. The goal was to produce a contextualised, interpretive account of how adolescent boys in an HIV context positioned a masculine identity in a self-society dialectic.

Research Methods

Mixed methods were used within an interpretive qualitative paradigm (Silverman, 2011) in keeping with the purposeof the study and the focus on personal and social subjectivities. The purposive, relatively homogenous sample consisted of seven Black African (Zulu) male participants aged 13 to 16 with a mean age of 14 years 5 months at the start of the study. Following consent and assent processes appropriate for research with adolescent minors (Lasser & Thoringer, 2003), participants were enrolled from a mixed-gender, clinic-based support group for adolescents living with HIV and on antiretroviral therapy. From a research methodology perspective, Kelly (2004) notes that sampling to saturation of 6 to 8 is optimal and credible for qualitative research with a homogenous group, provided that the data has sufficient depth.

Data collection proceeded over a six month period. Interviewers consisted of the researcher and two Zulu-speaking support group facilitators known to the participants. The language of the interviews was Zulu and/or English. In the order used, the data collection used the following methods (1) semi-structured interview, (2) focus groups using a semistructured interview schedule, (3) autophotography (Noland, 2006) and photo-elicitation interviews, (4) reflective writing, and (5) biographical drawing and biographical interviews. Validity and reliability were strengthened through prolonged engagement with participants, triangulation of methods and mixed data sources, reflexive verification with participants and the interviewing team and combining methods of data analysis (Silverman, 2011).

As a familiar qualitative research method, individual semi-structured interviews work best when interviewers engage active listening and allow conversations to develop beyond the question protocol or when there are repeated interviews with the same participant (Joseph & Lindegger, 2007) and when combined with other data sources such as focus groups, (Lindegger & Maxwell, 2007), visual methods (Blackbeard & Lindegger, 2007) or ethnographic fieldwork (Mfecane, 2008). Focus groups have proved useful in young masculinity research, particularly for elucidating group constructions of masculinity (Joseph & Lindegger, 2007, Mfecane, 2008) and differences between collective and individual constructions of masculinity when contrasted with individual semi-structured interviews (Blackbeard & Lindegger, 2007). Question schedules were aimed at eliciting open-ended conversation with rapport-building in an initial phase of data collection.

Participants were invited to record images on single use cameras (autophotography) to represent the statement ‘my life as a young man living in South Africa today’ and to then discuss the photographs as visual prompts in a ‘photoelicitation’ interview (Noland, 2006). In addition to autophotography, the boys were asked to produce and then discuss in an interview, a drawing to represent their lives, past and present. Participatory visual research methods enhance research credibility by giving the youth participant the power over what images are included or excluded (Bolzan & Gale, 2011). Participant visual methods can facilitate collaborative meaning-making between interviewer and interviewee, and can interrupt the power differentials between interviewer and interviewee, privileging the interviewee’s content as represented in the images (Didkowsky, Ungar, & Liebenberg, 2010; Liebenberg, 2009). Autophotography has proved especially useful and appropriate for young masculinity researchers for these reasons, especially with regard to collaborative rapport and contextualising interviewees’ accounts within the time and space of daily life (Blackbeard & Lindegger, 2007; Langa, 2008). As a multiple data source, autophotography lends itself to mixed methods of data analysis which, while potentially complex for the researcher, can considerably enhance research credibility (Blackbeard & Lindegger, 2007). In collecting autophotography data, procedures of ethical consent and assent for the release of participants’ photographic material were

followed, including preserving anonymity and confidentiality of participant and photographic subjects in keeping with established procedures in similar studies (Blackbeard & Lindegger, 2007; Langa, 2008).

The data for analysis were from multiple sources and consisted of audio recordings, interview transcripts, participant-produced photographs, biographical drawings, interviewer process notes and a research journal. Following the approach of coherent and active integration of methods in interpretive research (Babbie & Mouton, 2005), induction of findings proceeded through iterative dialogue between several data analysis strategies applied to multiple forms of data.

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Content analysis of the visual data (80 photographs and 4 drawings) consisted of quantitative content analysis (counting categories of setting and content) and qualitative content analysis of themes following steps of familiarisation, theme identification, dialogue (creating a conversation between visual data themes and emerging themes of the verbal data), elaboration (refining the thematic organisation) and integration. Qualitative thematic analysis utilised familiar iterative steps (Terre Blanche, Durrheim, & Kelly, 2006). In addition, critical narrative analysis of the biographical interviews (Saville-Young & Frosh, 2009) was attempted in which specific, detailed interrogation of the text focused on dissonances, contradictions, coherences, emotional valences and disruptions in the text. Critical narrative analysis was

THEMATIC ANALYSIS

Interview transcripts Audio recordings Process Notes

(Terre Blanche & Durrheim, & Painter, 2006)

relevant to the theoretical orientation of the study (DST) in that there was a deliberate interest in narrator positions, an interest in narrative incongruencies or ruptures in the text and identifications of silences, closed-down narratives and opened-up narratives (Saville-Young & Frosh, 2009). That many of the interviews were translated from Zulu into English presented a problem for this part of the analysis and yielded the critical narrative analysis potentially less valid. With consent of interviewers, post-interview discussion between researcher and interviewers was recorded and included as data for analysis. This additional data produced researcher reflexivity regarding the differing perceptions and expectations within the interviewing team, appropriate for the interpretive research paradigm and a participatory ethos.

Findings

6.1 Hegemonic masculinities

The boys positioned masculine identities in relation to at least two forms of hegemonic masculinity which appeared to have central influence in participant accounts.was closely aligned with peer group validation, was highly ‘visible’ and endorsed in practices of using alcohol and addictive substances, reputation for being sexually active and low school attendance. The time orientation towards ‘living for now’ with the possibility of a sudden rise to fame and material success through luck, or being a soccer ‘star’ or an instant celebrity, as in the extract below:

Participant: you can be a soccer player when you grow up (.) and you (.) could go by (.) those big teams (.)

Interviewer: ja like England and Germany ja you end up there (.) as a star (.)

who is your role model as a young man

Participant: he’s a young boy who plays for Pirates (.) he plays soccer very well (.) ja

Interviewer: and why do you admire him?

Participant: (.) he plays soccer very well (.) ja

Interviewer: and why do you admire him?

Participant: (.) because he’s still a young man (.) he can do whatever he wants

Township hegemonic masculinity located individuals as members of closely bound male peer groups with peer respect as a key marker. Aspirational young masculinity was based on a future orientation of material success in the professional world or in business, accomplished through education and avoiding risks, valued by some of the participants, and had a dominant role as a rival form of masculinity to township young masculinity.

Township masculinity was identified with immediate indicators of influence through visible heterosexual dominance and street gang power and control, whereas aspirational masculinity was configured around a successful future. A ‘hard’ form of aspirational masculinity produced a fantasy future of being both a family provider who also had many girlfriends for entertainment. A ‘softer’ version was focused on various uses of the concept of ‘respect’, by and for family, by and for male peers, and by girls or women. The boys constructed future contexts of visible success as material providers, as illustrated below.

Interviewer: what are you planning for your future (.) do you have any plans already?

Participant: really huge plans

Interviewer: like:?

Participant: like I wish one day to have my own house my own accessories [mm] ja:: a big huge car a

sports car [mm] my own family [ja] (.) my wife my children living all together as a

happy family (.1) I would like to see myself in the health department

Aspirational young masculinity invoked discourses of economic empowerment and occasionally drew on discourses

of constitutional rights and traditional cultural identities and located individuals as the makers of their own destinies.

6.2 Dilemmas and solutions

HIV positivity was positioned as a marginalised identity in relation to hegemonic masculinity, with the boys self-consciously ‘different’ from other boys, who were perceived as being better able to conform to hegemonic standards. The boys sometimes constructed peers as threats and being HIV positive as a protected space experienced with considerable ambivalence. At times, the interviewers themselves appeared to construct ‘protective walls’ in the interviews by prompting responses which reinforced the idea that HIV was an opportunity to not conform to hegemonic imperatives. An alternate position based on principles and values was also apparent but this was not taken up strongly by the boys. More fragile positions were apparent in attempts to co-opt elements of hegemonic masculinity in defending against unattainability, resulting in contradictions such as being tough in order to resist performing toughness through risk-taking. These varying positions were highlighted in discrepant positions taken by participants in focus group discussions and individual interviews and considered as ‘located’ and voiced positions within time and space, following DST.

was a context-bound identity which emerged from the constraints of being HIV positive and was mostly but not exclusively articulated by boys who were more identified with an HIV positive identity. Walled solution masculinity was formed through ways of creating a unified masculine self and identity in a situation where hegemonic masculinity was perceived to be unattainable. For some boys, family contexts provided a ‘protected’ space and although this was experienced with ambivalence, the boundaries of families affected by HIV formed a social ‘wall’ for a modified version of masculinity centred on self-responsibility. For some, the fact of being HIV positive formed a symbolic ‘wall’ in which it was possible to feel acceptably masculine without feeling the need to conform to a hegemonic masculinity. The conditions and constraints of being HIV positive was experienced with considerable ambivalence, given that being HIV positive was not a choice, although becoming part of a group of self-responsible peers was for some a choice or partial choice. This form of masculinity was an emerging version that had some unity and was based in a particular form of positioning in which the boys found ways to maintain a sense of masculine self and identity in the constrained and the ‘protected’ situation of HIV positivity. Walled solution masculinity had a relative stability as the condition of being HIV positive would not foreseeably change in the future, although for some there was a hope for a cure in the future which would demolish the ‘wall’. The ‘wall’ referred to the constrained context of HIV positivity.

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Walls, gates, fences and barriers were recurrent in the photographic data and the biographical drawings, which prompted the idea of the ‘walled solution’. The outsider perspective positioned the viewer outside contexts such as homes, the clinic and commodities. Photographs ‘on the inside’ prompted discussion from an interiorised perspective, facilitating reflections on life as a young man within a family, a school or peer group. 56 of the 80 photographs were of objects and environments rather than people, suggesting a sense of isolation and instrumentality which was also voiced in the interviews and depictions of losses and barriers in the biographical drawings. Displays of objects were frequent, often

relevant to social and interpersonal activities, such as football team posters, displays of personal clothing items, computers and mobile phones. There were no photographs of people playing sport or using computers or mobile phones which suggested instrumentality, isolation and a stark commodification of masculine identity. The photographs also revealed poverty and materially constrained living conditions, at odds with a commodity-based identity.

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The analysis suggested that there were a variety of ways in which boys were positioned in relation to hegemonic masculinity. The boys’ subjectivities were sometimes positioned by collective narratives or hegemonic imperatives. Positions were also influenced by others, for example, by alternate perspectives such as the viewpoint of a traditional grandfather or an innovative experience. The presence or absence of others and changing circumstances made positions available or constrained positions, for example a participant becoming the ‘man of the house’ in his father’s absence or feeling ‘boosted’ when his father encouraged his school effort. The boys were active in positioning themselves in relation to hegemonic imperatives, ideals and practices, for example, participants presenting an autonomous ‘I-position’ in resistance to hegemonic imperatives to use alcohol and drugs. Some of the individual positioning was unstable and unanchored in contexts or collective identities, rendering the counter-hegemonic position fragile. For example, a participant’s individualised appeal to a hegemonic ideal of self-control was inadequate in preventing peer-validated hegemonically-aligned practices (alcohol use with peers). Collective identities appeared more stable and sustainable.

Masculinities were situated both spatially and in time, at various ‘construction sites’, school, home, township streets and in team sport. Masculinities were developed against constructions of girls/women, and it was here that anxieties and emotional experience was most evident, as girls and women were perceived or experienced as being able to ‘unsettle’ the boys and to define their acceptability as young men. Girls/women were represented in very ambivalent ways, and the anxieties of the boys were most about the hegemonic imperative to be or at least appear to be heterosexually active. Girls were portrayed in ambivalent and contrasting ways, with some girls feared or blamed as being untrustworthy and unpredictable while others deemed ‘respectful’, patient and kind. Departing from hegemonic norms in performing household tasks was an area that exemplified conflicts between the situations in which the boys lived, hegemonic imperatives and ways that the boys attempted to maintain some identification with aspects of hegemonic masculinity.

6.3 Mapping the self-in-society

To facilitate interpretation and integration of the data with the theoretical orientation of the study, the ‘Scape Model’

(Hermans & Hermans-Konopka, 2010) was adapted and used as a schematic for organizing the emerging data. In the

terminology of Dialogical Self Theory, the voiced I and Me-positions were mapped into the spatio-temporal domains or ‘self-landscapes’ (Hermans & Hermans-Konopka, 2010). I-positions were an inner ring and Me-positions the periphery. From the perspective of Dialogical Self Theory (DST), based on the notion of an extended self from William James, identity is instantiated through internal or external speech acts in a ‘complex mix’ of self and social (Hermans & Hermans-Konopka, 2010).

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Masculine identity was conceptualised as a function of the dialogue of various masculine I-positions with hegemonic masculinity having the quality of a privileged or dominant voiced position located in a space-time matrix. Broadly, the findings suggested that masculine I-positions could be dialogued and ‘redialogued’ at the self-social nexus. Interactional contexts and drastic changes in personal narratives created opportunities to actualise alternate self-narratives from new or modified I-positions, as described by Hermans (2004). The condition of being HIV positive created a domain of opportunities for self-innovation within constraint both practical and in social subjectivity. An HIV positive identity modified conditions within which hegemonic ideals were possible, facilitating self-innovation opportunities to adapt and shift identity positions in relation to hegemony either as new positions, new perspectives (metapositions) or by linking identities (coalitions) (Hermans & Hermans-Konopka, 2010).

Conclusion

The participatory research process created opportunities for collaborative reflection and dialogue about masculineidentity, working in similar ways to participatory gender-based interventions and programmes. From the findings it is suggested that alternate gender-equitable young masculinities can be accomplished through redialoguing of identifications and positions in relation to contextual hegemonic masculinities. The findings also indicate that masculine identity cannot be considered in discursive contexts only but in the material conditions, opportunities and spatial contexts in which socialization occurs. Of relevance to public health and policy development, the findings supported that masculine identity can be innovated and adapted, especially with resources and gender equitable contexts that innovate and support change. The study supported that many young men are in fact oppressed by hegemonic masculinity expectations, which are associated with anxious distress, health risk behaviours and various psychosocial problems.

The qualitative research methodology was appropriate for addressing the research question with inductive findings that drew on multiple sources and methods. Autophotography and biographical drawings drew attention to the spatial dimensions of masculine self-positioning in which participants exercised agency in depicting contexts and sites of masculinity construction. The biographical drawings and accompanying interviews highlighted the temporal domain in which masculine self and identity was formed in relation to past, present and the future as lived experience. The study was potentially limited by sample size and the challenges of translated texts, which limited more fine-grained analysis of interview texts as attempted with critical narrative analysis.

A key focus of this research was the ‘intersection’ of being HIV positive and ‘young masculinity’. As a set of ideals, imperatives and practices, hegemonic masculinity organises systems of gender power relations and in this research it was evident that hegemonic masculinity was multiple, contextual and relational. Attaining either of the two dominant versions of masculinity available to the young men were constrained both by the challenges of being HIV positive and material resources with limited opportunities. DST was useful in locating masculine identity within a self-society dialectic, considering identity positioning and fluidity. DST provided fresh opportunities for revisioning the concept of hegemonic masculinity, applied here to adolescent masculinity construction in a very challenging context.

Acknowledgements

Funding was provided by the South African Netherlands Partnership for Alternative Development (SANPAD). The Sweden-South Africa Masculinity Research Group provided a valuable peer context for presenting work in progress. A portion of the work in progress was presented at the 30th International Congress of Psychology, Cape Town in 2012.

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