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Chapter 5HIV, AIDS and GenderThe Social Construction of SexualityHIV and AIDS, apart from a medical and epidemiologicalquestion, are also a phenomenon with asocio-cultural dimension, and a development question.They therefore require an approach and understandingthat should include their social and culturaldimension, the institutionalised patterns of behaviour,the symbolic systems, the structures of productionand distribution of goods and services, and therelations of power.The progression of the epidemic is deeplyconnected to the sexuality of individuals, as well as tothe sexual behaviour they adopt. Indeed, the way inwhich individuals construct and express theirsexuality is influenced, not only by processes of anindividual nature, but also ones that are social,cultural, psychological, economic and political.Phenomena such as initiation rites, polygamous andtraditional marriages, rites of passage, taboos,traditional medicine, among others, are stronglythreaded by components of sexuality (PEN II 2005-2009).The concept of sexualityThe treatment of matters dealing with sex and sexualitycannot be dissociated from the body and fromindividual instincts and emotions. These elementsoften belong to the language of intimacy and/or ofsymbolism constructed in the mind, but it is veryembarrassing for many people to talk about it.For many Mozambican social strata, sex and sexualitylie in the realm of taboo, and thus are remittedto an area of shame and of the forbidden. Since sexualityis one of the pillars of traditional family moralities,mastery of its language is still an enormouschallenge, because it is different from day-to-day languages,and imposes a psychological order beyondthe contexts in which our socialisation evolves.In a multicultural and multilingual mosaic suchas Mozambique, sexuality and its expressions occurwithin the pattern of values that guide the way inwhich each community unit is structured anddefined.The structure of social organisation and the symbolicconventions that determine cultural order andidentity conceive of the man as the one who takes thesexual initiative. It is he who has the right to pleasure,while the woman has the duty to bear childrenand to satisfy the male biological instinct. This behaviouralorder, which is learnt at various moments ofsocialisation, whether through initiation rites, orthrough languages and rituals that are ever present inthe family and community, determines the socialexpectations of both men and women in the sphereof sexuality.Thus, in strongly patriarchal societies, socialisationbrings the language that instigates and encouragesmen to be “macho”, with their minds turnedtowards risk and to the use of social and sexualpower. It is common that they express their masculinitythrough scattered relations with multiple sexualpartners. Meanwhile, the same patterns of sexualsocialisation tend to inhibit women from taking careof their sexual health, particularly in contexts wheretheir economic power and psychological influence isreduced or nil. Thus sexuality is a resource of powerand of force.The symbolism that clothes the social constructionof sexuality is the result of knowledge of traditionalroutine, which goes beyond considerationsabout sex, and brings to the surface ideas and interpretationsabout diseases that are conventionallyassociated with sexuality.It is thus interesting to note, for example, thattuberculosis is often interpreted as resulting from theviolation of certain norms, including failure to “purify”the widow whose husband has just died.Furthermore, and particularly in the sphere ofpainful practices, the same interpretation of sexualityhas been used as a factor to cure particular diseasesor in the pursuit of easy enrichment. Thus insome societies children or virgins are still physically31