title: 'Semen contains vitality and heredity, not germs': seminal discourse in the AIDS era.
abstract: Perspectives of public health generally ignore culture-bound sexual health concerns, such as semen loss, and primarily attempt to eradicate sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Like in many other countries, sexual health concerns of men in Bangladesh have also received less attention compared to STIs in the era of AIDS. This paper describes the meanings of non-STI sexual health concerns, particularly semen loss, in the masculinity framework. In a qualitative study on male sexuality, 50 men, aged 18-55 years, from diverse sociodemographic backgrounds and 10 healthcare practitioners were interviewed. Men considered semen the most powerful and vital body fluid representing their sexual performance and reproductive ability. Rather than recognizing the vulnerability to transmission of STIs, concerns about semen were grounded in the desire of men to preserve and nourish seminal vitality. Traditional practitioners supported semen loss as a major sexual health concern where male heritage configures male sexuality in a patriarchal society. Currently, operating HIV interventions in the framework of disease and death may not ensure participation of men in reproductive and sexual health programmes and is, therefore, less likely to improve the quality of sexual life of men and women.
authors.affiliation: Social and Behavioural Sciences Unit, Public Health Sciences Division, ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh. sharful@icddrb.org
authors.forename: Sharful Islam
authors.initials: SI
authors.lastname: Khan
authors.forename: Nancy
authors.initials: N
authors.lastname: Hudson-Rodd
authors.forename: Sherry
authors.initials: S
authors.lastname: Saggers
authors.forename: Mahbubul Islam
authors.initials: MI
authors.lastname: Bhuiyan
authors.forename: Abbas
authors.initials: A
authors.lastname: Bhuiya
authors.forename: Syed Afzalul
authors.initials: SA
authors.lastname: Karim
authors.forename: Oratai
authors.initials: O
authors.lastname: Rauyajin
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008571:Men / Q000523:psychology*; D008875:Middle Aged; D012661:Semen / Q000502:physiology*; D012725:Sexual Behavior; D019529:Sexuality; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*