African Journal of Reproductive Health Women's Health and Action Research Centre ISSN: 1118-4841 Vol. 7, Num. 1, 2003, pp. 49-62

African Journal of Reproductive Health, Vol. 7, No. 1, April, 2003 pp. 49-62

“I Am Happy that God Made Me a Boy”: Zambian Adolescent Boys' Perceptions about Growing into Manhood

Dahlbäck Elisabeth^1,2, Makelele Patrick³, Ndubani Phillimon⁴, Yamba Bawa⁵, Bergström Staffan¹and Ransjö-Arvidson Anna-Berit^1,6

¹Division of International Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. ²Department of Nursing, Karolinska Institutet, Stockholm, Sweden. ³Kitwe District Health Management Board. ⁴Institute of Economic and Social Research, University of Zambia, Lusaka. ⁵The Nordic Africa Institute, Uppsala, Sweden. ⁶Division of Reproductive and Perinatal Health, Department of Women and Child Health, Karolinska Institutet, Stockholm, Sweden.
Correspondence: Elisabeth Dahlbäck, Department of Nursing, Karolinska Institutet, Box 286, 171 77 Stockholm, Sweden. E-mail: elisabeth.dahlback@omv.ki.se

Code Number: rh03008

ABSTRACT

Adolescence is a period of transition during which a person is neither considered a child nor an adult. As little is known about adolescent boys' perceptions, norms, role models and gender relations that influence their male identity and behaviour, this qualitative study was conducted. Data were drawn from seven FGDs and twelve mails of adolescent boys (15–19 years old) residing in two townships outside Lusaka and Kitwe in Zambia. Findings show that growing up to a man entails a certain level of ambiguity and contradictory perceptions in terms of supposedly appropriate social and sexual behaviour but indicates a few alternatives. Based on the findings, we recommend that the information gap, misconceptions and anxiety among boys regarding their male identity should be addressed. The respondents suggested that an educational programme that will pay due attention to their needs and answer their questions should be designed and implemented with active involvement of male adolescent peers. (Afr J Reprod Health 2003; 7[1]: 49–62)

RÉSUMÉ

“Je suis content que le bon Dieu m'ait créé un garçon”: les perceptions des adolescents mâles zambiens sur le procès d'atteindre l'âge l'homme. L'adolescence est une période de transition pendant laquelle l'on n'est considéré ni comme un enfant ni comme un adulte.  Nous avons entrepris cette étude parce qu'on connaît très peu de choses sur les perceptions des adolescents mâles, leurs normes, leurs modèles et les rapports entre les sexes qui influent sur leur identité et comportement masculins. Nous avons reculli des données des 7 DGCs et de douze courriers des garçons adolescents (15–19) qui habitaient dans deux municipalités hors de Lusaka et Kituve en Zambie. Les résultats ont montré que le procès d'atteindre l'âge d'homme implique une certaine ambiguité et des perceptions contradictoires sur le plan du comportement sexuel et social soi-disant approprié. L'étude a proposé des alternatifs. En nous fondant sur les résultats, nous proposons que les problèmes du manque d'information, des idées fausses et de l'inquiétude chez les garçons à l'égard de leur identité masculine soient abordés. Les interrogés ont proposé qu'un programme éducatif qui s'occuperait de leurs besoins et qui répondrait à leurs questions soit conçu et réalisé avec la participation active des pairs adolescents mâles. (Rev Afr Santé Reprod 2003; 7[1]: 49–62)

KEY WORDS: Adolescents, gender, male identity, role models, sexuality, Zambia

INTRODUCTION

Adolescents^a in general, and boys in particular, have been a neglected category in the context of sexual and reproductive health and rights, specifically regarding their psychosexual development.^1,2 Adolescent boys experience significant physical, emotional and social changes accompanied by curiosity and challenges during their development into manhood. Boys, more than girls, are often under pressure to initiate and become sexually active even while they often still lack adequate knowledge of sexual matters.^3,4 During the last decades, the concept of adolescence and the period it covers are phenomena that have begun to receive more attention. This is due to the increasing recognition that adolescents have concerning their own specific health related needs. Such is the case in Zambia. There has been a growing interest in trying to understand what kind of perceptions adolescent boys have about their development into manhood, and what role models, knowledge, attitudes, expectations, joys and worries are involved in constructing their male identity.^5-7

^aThe World Health Organization (WHO) defines person within 10-19 years old as adolescents and those within 15-24 years old as youth.

Research on adolescents has mainly been conducted as if adolescents constitute one homogenous group, without taking into account gender^8b differences. They are taught to act in accordance with expectations, beliefs and values assigned to their gender in a specific society with its specific culture.⁴  Studies and research carried out on adolescents have mainly focused on girls, while adolescent boys' questions, needs and perceptions have rarely been taken into consideration. Few studies have explored adolescent boys' awareness of and their role in unwanted pregnancies.⁹ Campbell¹⁰ and Varga² point out that the existing body of knowledge about men and boys is often fragmented and unclear, and that the focus on males quickly shifts to the precarious situation of women and girls. Sex desegregated data on adolescents are rarely available in low income countries.¹¹ Researchers and policymakers have given very little attention to the role of boys behind adolescent pregnancies they are responsible for.

^bGender and sex are distinct phenomena. Sex refers to biological differences while gender is the cultural interpretation based on the logical differences between men and women. Thus, gender roles are socially constructed from culture to culture, vary within one culture, and vary as well over time.⁸

In Zambia, male dominance in all aspects of life is rooted in cultural and social values. These cultural and social values continue to promote male supremacy and male sexual potency into the younger generations.^12,13 Gender inequality, bred by stereotypical cultural norms and expectations that are difficult to change, strongly influence heterosexual relationships in an unhealthy way.¹⁴ A change in the experience of a male-dominated gender identity has to start early in the socialisation process if a more equal gender relation in adulthood is to be achieved. One encouraging thing about young people is that they have the potential to change attitudes and practices if given appropriate education, e.g., on HIV transmission. In Zambia, observations comparing the 1994 and 1998 sentinel surveillance have shown a downward trend in HIV prevalence in the 15–19-year-old age group.¹⁵ 

Here, early sexual activities with multiple partners place many young people of both sexes at severe health risks, resulting in unplanned pregnancies, unsafe abortions, sexually transmitted infections (STIs) and HIV/AIDS. Other consequences such as school dropout and unemployment are common.¹⁶ Boys in Zambia are usually under social pressure to control, succeed with and have power over girls. These expectations include acquiring early pre-marital sexual experiences. Parents, health providers, teachers and the society at large have grossly underestimated the level of adolescent sexual activity and thus ignored adolescents' needs for education, counselling and guidance.^17,18 As a result, adult denial, prohibition and silence around adolescent development pose  major obstacles to the dissemination of adequate information, education and services to adolescents.⁴  Boys and girls are thus left to cope on their own. This situation is influenced by a process of rapid social and economic change in Zambia, combined with increasing poverty, urbanisation and westernisation.

The population of Zambia is predominantly young. In the census of 2000 the population amounted to 10.4 million, of which approximately 20% are 10–19 years old. Sexual and reproductive health problems in this group are well known. Young people in Zambia are severely affected by STIs and about 50% of all new HIV infections occur in persons between ages 15 and 29 years. Current HIV infection in persons aged 15–49 years in the country was estimated to be 19.7%. HIV-1 seroprevalence in Lusaka and Kitwe Districts was among the highest in the country in 1999; it was 27.2% and 28.7% respectively.¹⁵ Such factors have contributed to a drop in life expectancy from around 52 years in 1982 to 40 years in the late 1990s.¹⁵ It is also known that 20% of all deliveries in Zambia are of teenage mothers and that 60% would have given birth to their first child by the age of 19 years.^19,20 The situation regarding abortions among schoolgirls is alarming. A study at the University Teaching Hospital in Lusaka²¹ indicated that death from abortions has increased from 13% to 30% during the period 1988 to 1993. A recent study in the Western Province of Zambia indicates that on average one in every 100 schoolgirls, an annual average of 15, dies from abortion related complications within the study area.⁶

The fact that sexually and pregnancy related morbidity and mortality among adolescents have become recognised by the scientific community has brought the issue of adolescent reproductive health and rights high up on the international agenda. There has been an increasing awareness of adolescent reproductive health and rights since the last decade. There is also an increased demand to include adolescent males' views in research in order to gain more insight into their “cosmology”, beliefs and practices in legal, social, sexual and reproductive health matters.^3,22

This study was carried out to explore the awareness and perceptions among Zambian adolescent boys' and their transition into manhood from a gender perspective.

MATERIALS AND METHODS

Study Settings

This study was carried out in Zambia between November 2000 and May 2001. The population of Zambia consists of 73 different ethnic groups with as many languages. English is the official language of the country and the predominant religion is Christianity.

Two townships were selected for the study. One was George Compound in Lusaka, the capital of Zambia and Chimwemwe Compound in Kitwe. George Compound is situated about seven kilometres from the centre of Lusaka and has approximately 42,000 inhabitants. There are no higher secondary schools in George Compound apart from basic schools up to grade nine. Chimwemwe Compound is located three kilometres outside Kitwe centre in the Copperbelt Province. Kitwe is about 350km north of Lusaka. Chimwemwe has a population of about 14,000 people and hosts several governmental and private secondary schools.²³

The inhabitants of George and Chimwemwe Compounds belong to different ethnic groups. The predominant language in George Compound is Nyanja and in Chimwemwe it is Bemba. People in the two compounds are mainly engaged in low income generating activities and unemployment is high. Both George and Chimwemwe Compounds have youth friendly corners at the health centres with specially trained nurses and peer educators/counsellors. Peer educators are young people trained to promote safer sex behaviours and to provide accurate sexual and reproductive health information to their age mates living in the area.

Subjects and Selection

The study population consists of adolescent boys between 15 and 19 years old. The years spent in school range from 5 to 12 years. The adolescents were residents of George and Chimwemwe Compounds. We selected boys who were willing to discuss issues related to male identity, sexuality and reproductive health and rights.

The research team recruited participants for focus group discussion (FGD)²⁴ using non-probability sampling²⁵, e.g., during ongoing activities such as sporting events, church meetings in school yards, anti-AIDS clubs and among school dropouts. Another strategy was to recruit through a gate-keeper, a person who has good knowledge of the desired target group. A third method was the snowball sampling, whereby already recruited participants recommend other persons with suitable backgrounds to participate in the FGD. The aspiration was to capture as broad a range as possible of the perceptions, opinions, attitudes, knowledge and practices of adolescent boys with different ethnic and socioeconomic backgrounds within the study area.

Another research tool used in the study was letter writing.^26,27  This was to allow the adolescent boy to express his opinion on given topics and to correspond directly with the research team. The criteria for recruitment of letter writers were similar to those used for the FGDs, in addition to being able to write in English. A further criterion was that letter writers should not have participated in any of the FGDs. Instructions about letter writing were given to midwives and peer educators at different health centres and youth friendly corners in the two compounds who then recruited interested respondents. When a boy accepted to participate, an envelope with questions, a notebook and a pen were handed over to him. A total of twelve boys were recruited. They were given two days to answer the letter before bringing it back, sealed, to the addresses given in their respective areas.

Focus Group Discussion

Seven FGDs were held, two in George Compound and five in Chimwemwe Compound. Fifty three boys participated in the FGDs and each FGD consisted of seven to nine participants. Homogenous focus groups were formed, e.g., groups of out-of-school boys, peer educators, mixed in-school boys and one group of orphans. The sessions were held in privacy at different health centres. Male Zambian team members with experiences and skills in conducting FGDs were moderators during the sessions. They also spoke the local languages of the boys. The principal researcher and local facilitators observed and took field notes.

Interview guides were used to assist the moderator during the FGD. The frames of the guide were kept deliberately wide, allowing respondents to associate freely. The main focus included boys' perception and understanding of male identity, gender, role models, psychosexual development, differences between boys and girls, sexuality, and what kind of man the boys would like to be in future.

Each FGD lasted between 90 and 120 minutes. Local languages, Bemba and Nyanja, were used for three FGDs while the rest were conducted in English. Each FGD was tape-recorded after obtaining informed consent from the participants. Immediately after each session, the tapes were transcribed verbatim and translated into English where necessary.

Significant and recurrent concepts, categories and areas of agreement and disagreement were identified in order to detect new important areas that had not been explored or were insufficiently explored in previous FGDs. New ideas were added to the interview guide and discussed in the subsequent FGD. After conducting seven FGDs, we decided to stop, as very little new information emerged. Before the end of each session, participants were given opportunity to ask questions or seek clarification on any issue.

Letter Writing

Twelve boys, between 16 and 19 years old who had nine to twelve years of schooling, participated as letter writers. The idea behind the letter writing was to combine the method of immediate verbal dialogue in the FGDs with time for more individual reflections on the topic, expressed with less inhibition and subject to less influence from a moderator or group members. The individual thoughts and reflections expressed in the letters, separate from the group, would not necessarily coincide with their social and sexual behaviour. The interview guide and questions for the letter writing were pre-tested in different groups for clarity, i.e., their adequacy to fulfill the desired purpose. Adolescent boys who participated in the pre-tests were excluded from the main study.

Analysis

The ambition of this presentation is to reflect the voices of Zambian adolescent boys of today. The aim is to strive towards an open-minded and non-judgemental attitude towards the perceptions of the boys. Furthermore, the life situation of male adolescents in Zambia has to be looked at from a particular social context; that of a Zambia in transition due to increasing poverty and the HIV/AIDS infection.

First, after each FGD, we listened to the tapes and transcribed them verbatim to get a first impression of the contents. Second, the contents of each FGD were marked with different colours, coded, and concepts were highlighted by the research team. A similar procedure was used for coding the letters. Then, when all FGDs and letters were sorted by concepts, a cut and paste method was used to select, compare and compile all answers under each question. Furthermore, identified and interrelated concepts were summarised under each question and organised into categories. Lastly, identified and interrelated categories were merged into three central themes.

In this paper, we sought to retain the local English idioms, thus, statements in the direct quotes have been highlighted in italics in the text without corrections.

During analysis, several meetings were conducted with members of the research team to discuss inconsistencies, adequacy and to reach a consensus about emerging concepts, categories and themes. The process of analysis is illustrated in Table 1.

The study was approved by the ethics committees at the Karolinska Institutet, Stockholm, and at the School of Medicine, University of Zambia, Lusaka.

RESULTS

The results show that transition into manhood starts early in boys. Acquiring manliness and culturally expected masculine behaviours require steps of active and passive learning, observation and imitation. In this study, we found three central themes emerging through the discussions with the boys and from the letters. These themes were male identity and gender issues, advantages and challenges of being a boy, possibilities and difficulties that adolescent boys face today (Table 1).

Male Identity and Gender Issues

The Contradictory Role of Man

The captured views of the boys, in positive terms, were that a `real man' possesses power, status and position in the society. “His position makes it possible to get what he wants. It is difficult for a man to fail to get what he wants …” Other attributes mentioned were: “A man should be self-reliant, respectful, trusted and loyal to others.” He is also evaluated according to his ability to relate to and handle other people. A common view was that “a `real man' should be physically strong, bold and brave. He should be the head of the household”.

A man “ought to be married and have children. He should be knowledgeable, hardworking and take responsibility for the family by providing money for food, health and education and, in general, be a good leader of his family, set a good example”.

“A caring husband sits down to ask the family about their needs, and he should be able to provide food for his wife and his children and pay school fees and health services for his family. A man should also be faithful to his wife and `stop jumping' (stop having girlfriends) … show a good sexual behaviour.”

Certain tasks were considered inappropriate for a man and a head of the household; they were `taboos'. The boys pointed out that a man should not cook, sweep or wash up napkins, and he should not behave like a woman, i.e., be a talkative and a gossip, and he should be able to stay aloof from quarrels. His role is to use a spade, a shovel and a hoe, work in the fields or garden and do jobs that only men can do. According to the boys, traditionally a woman cannot be head of the household, but if the husband is working far away from home, the wife could take full responsibility. However, the husband remains the head of the home and requires to be respected by her.

Disturbing threats to the traditional gender roles emerge when women start to earn money and become economically independent. Some boys expressed worries that women who earn their own money may start to see men as useless.

“She may chase me out of the house or become rude and start talking about `equal rights' … some women become cruel, stupid, gossiping and talking bad about the husband in bed or talking about the man as `he is just a pair of trousers' … then the man has the right to discipline his wife.” (A `pair of trousers' connotes men who are not really men.)

Examples of negative views were given, e.g., on `stupid and misbehaving men'. The boys said they had witnessed irresponsible or abusive male behaviour towards women and girls, often within their own families. Some have seen their mothers being beaten up by their father in their presence. One boy said he cannot feel good when watching such things. Other examples of men's bad conduct were discussed such as men who get drunk and have sex with other women outside and later come home expecting their wives to be waiting with food for them. When the husband then wants to have sex with her, she refuses and gets beaten up.

In contrast, the boys also discussed positive relations between couples such as involving women who are educated and working. In such families, both couples contribute in harmony and share their family responsibilities. The boys gave examples of tendencies that could contribute to a greater degree of gender equity between the sexes such as the right of girls to higher education, to make their own decisions, and to marry the man they love.

Sexuality and Fertility – The Core of Manhood

Evidence from the FGDs and letters suggest that sexuality and fertility are seen as the core of manhood. A real man is heterosexual. The participants stated that heterosexuality is innate and natural while homosexuality is perceived as a threat to masculine sexuality and identity. Many of the boys expressed worries about not being able to respond to the traditional male roles. To eliminate these worries they saw sexual abstinence as the alternative. Anyhow, for many boys across the FGDs it was considered very important for a man to demonstrate his fertility. Some respondents opined that a man should be married, be faithful to his wife, care for his children and not indulge in casual sex. Others felt that a `real man' needs sex and should have many girlfriends who he should be able to satisfy sexually.

“A man should be fertile and able to impregnate a woman and feel proud when doing so. He has also the right to have as many children as he wants.”

“But … men like sex with many girls and do not think about the risk of HIV/AIDS, they just enjoy themselves.”

However, many boys perceived such men as irresponsible, as they would be transmitting HIV/ AIDS to girls and women in the community.

The boys were aware of living in a changing society with changing attitudes and traditional practices. A process of changing family structure from the old extended family system towards the nuclear family was seen as a reality. Many of the boys expressed a negative attitude to polygamy. Men who have three wives were considered abnormal and thought to have inherited a bad tradition from their forefathers. Other reasons for preferring small families are primarily economic due to unemployment and increasing poverty.

When the issue of girls' virginity was brought up, participants said most boys and men do not expect brides to be virgins any longer, although the older generations still do. In the old traditional system it was a `taboo' to have a boy or girlfriend before marriage. Today pre-marital sexual relationships are a very common phenomenon.

Acquiring Manliness

Adolescence itself is a contradiction; a time of opportunity and risk. It is a period when self-image is built upon feelings of omnipotence and invulnerability on the one hand and dependency and uniformity on the other, i.e., the desire to fit into a group but not without a large portion of ambivalence.

Regarding the issue of how to acquire manliness, several factors influenced the boys and their self-image and development. They said they are victims of conflicting messages given from home, school, peers and the churches, which do not facilitate their choice of how to think or act in an appropriate way. The processes involved are in the psychosocial environment as well as the physical transformation of the adolescent boy, which they felt started early in childhood and could not be concealed or stopped.

The variety of common physical body changes were easier to discuss. Growing beards, experiencing voice change, growing muscles, having wet dreams, producing sperm, having sexual feelings, finding sex enjoyable and realising the ability to impregnate a girl were reported as significant experiences. Experiences of psychological signs including behavioural changes were also vividly illustrated with examples by the boys.

“Behavioural changes … we have it with us. One automatically becomes more mature in body and mind, one changes the behaviour and conduct, one stops childish behaviour, you keep your self clean, you put on Adidas when playing football and you get increased tolerance and in general you look at life differently, more critically … you also realise the danger of `playing' with girls.”

The boys gave other examples of what they considered as characteristics of psychological and moral maturity, e.g., ability to keep secrets, differentiate good from bad, and take increasing responsibility and consequences for their own behaviour in general. With these assets, they got a feeling of becoming more self-confident. On the contrary, the self-confidence was used to revolt against established adult society in order to create their own norms and rules. The self-confidence was challenging for them, they provoked and insulted people in public places ``just to show off''. They had a feeling that they had become strong, invulnerable, independent, and that their parents could not control them any longer.

Peers were the primary influence on the boys' identity building. Television, videos and the media were other important sources of sharpening male identity role models. Peer pressure and the need to conform to each other strongly affected their behaviour. It was considered difficult to deviate from the group norm. Whenever boys meet, it is common for them to narrate experiences they had with girls and describe in detail how they had sex with different girls. Sexual activities and experimentation play a major role in identity building to become a man. A shared opinion was:

“… you need to have a girlfriend as the others to show off. Other boys have girlfriends and you have to do the same, if not to be a fool … to fit in the group. You have to `play with girls' (have sex) imitating the pleasure other people talk about.”

Other boys agreed to that and contributed as follows:

“Well, you see … during adolescence you are brought up like … one needs sexual practice to know his sexual ability. We want to taste what friends have tasted, `practice makes perfect' … you watch, think and practice.”

“Yes, you need to have girlfriends. If you abstain from sex for a long time, sperms can accumulate and you get sick.”

The boys said a common way of acquiring self-image is to imitate the hair style, appearance or dressing style, or other aspects of behaviour, attitudes, language, taste of music, manner of walking and body image of celebrities. The most frequently mentioned role models are famous footballers in Zambia because they earn a lot of money and are able to live a good life. Dissociation from prevalent teenage behaviour was mentioned more as an exception than as a rule, as it required much of psychological strength to deviate from the group.

In the absence of parental or adult guidance, the boys said TV, radio, video and magazines to a certain extent play an important role in their education on identity building, or taught them about risks and signs of STDs and HIV/AIDS. Above that, the media also more or less provide them with idea of how to act sexually, take precautions, or about how young people enjoy themselves. The media also give them ideas of how to treat a girl with respect, how to kiss, make love, etc — behaviours and feelings that, according to them, one cannot simply read about.

Advantages and Challenges of Being a Boy  

The Privileged Sex

This study reveals that gender inequality is established at home, reinforced at school and in the society at large. Already in their early childhood the boys realised that they enjoyed more privileges and freedom in comparison to the girls. One boy expressed himself thus:

“I am happy that God made me to a boy.”

This statement was shared by majority of the boys in the study.

Spontaneously, the boys mentioned advantages regarding education, responsibilities and respect that they have as male adolescents in their families. They said that they are guaranteed better education than their sisters, and younger children are taught to address them respectfully by using the prefix `Ba Sydney', not just `Sydney'. The boys believed that educating boys would contribute to the development of the country because boys are clever, while girls are thought to be weaker intellectually. From early childhood, boys and girls are fostered into stereotyped gender roles.

The boys gave several examples at home and at school:

“Girls think different from boys. Girls are weaker in thinking. In the school when teachers ask questions they point at the boys, as they know that girls don't know anything. Girls have little time for studying … they are so playful. They do not think about their future as we boys do, only on being married. Boys have to think about where to go years from now … parents emphasise boys' education `you boys will look after us when we get old'.”

Freedom and Choice

The boys' views on the differences between girls and boys were illustrated by many other examples. Boys were aware of having access to the `official arena' in ways that girls cannot. They also highly appreciated their ability to spend their freedom as they want and their time as they like when compared to girls. Boys could decide for themselves what to do, when and where to go, and they could just play around without being questioned or restricted by anyone.

According to the boys, division of labour between the sexes is gender specific. Girls do what is considered inappropriate for boys to do, e.g., staying at home, doing household work, helping their mothers to cook, washing and sweeping, and preparing food for the family. The boys just get up in the morning and leave the house without any notice. Typical work for boys includes digging, garden work and slashing the grass, although these are rarely done by them. A feature of good character for girls, according to the boys, is cleanliness. Girls bath three times daily while the boys do so only once.

Another very important difference between boys and girls as revealed by the boys is that parents could force a girl to marry a man against her will while boys have the freedom to refuse to marry a girl they do not like. Regarding marriage, the boys discussed two alternative ways to choosing a wife, comparing the pros and cons, depending on whether the wife comes from the village or town.

“… when I grow up, I intend to go to the village, get a woman, educate her … (laughter). She will respect you and you respect her, she wants to have many children, she is not demanding or complaining, she would reject contraceptive pills … I tell you, you'll have no problem and you will have a happy life! But girls from town, they are not taught by elders, they do not have respect for the elders. After having two kids she starts complaining to the kids; `Your father is so and so, I can't do or get this and this, all my friends are driving a car'. She don't appreciate what you did for her! If she was properly taught by the elders she would not even talk about cars … she would not even know thinking about that.”

This statement was not uncontroversial to other boys in the group. Some of the boys were of the opinion that men do not always have to win in a relationship. They argued that if the woman is educated, it is easier to discuss problems with her and solve problems together. During these discussions, the boys realised and agreed that they lack respect for girls and that men have a tendency to make decisions for girls, be it in the domestic domain, at school, or in private relationships. However, there were risks boys have to be aware of:

“If she starts deciding for you, you end up as a fool. Don't let her rule you, discuss, give her a chance, but then … you conclude nicely.”

Ultimately, the consensus in the group was that it is better to marry an educated girl from town because you could discuss your problems as equals.

Sexual Attraction and Desire

One boy stated thus:

“… you feel the nerves when you see a girl … it is only a question of self-control …”

The period of adolescence was said to be a period of conflicting challenges and the need for self-control. According to the boys, sexual activity starts at an early age and peer influence was identified as the major reason for having sex for the first time. Girls in their miniskirts or tights and their way of walking arouse curiosity and sexual desire in boys. This was mentioned as yet another reason for early sexual relations. To test and gain sexual experience is important, but love and sex are not the same thing. This is how one boy explained his overwhelming emotions:

“Our sex desire … it starts ringing in your mind that you need to have sex, it goes from your mind to the heart, then to the brain and lastly to your self – that is the flesh desire! You need self-control to not fulfil your desire … but indulging in sex may also be false conceptions about love. Another thing, boys don't understand love, what is in their mind is infatuation … they want girls only for sex and there is very little respect towards girls' bodies. Girls' `No' means `Yes'. It is not respected by boys.”

Regarding relationships with girls, there was agreement that boys go after girls for sex, to have sexual experience and gratification. `Practice makes perfect' was a proverb often heard among the boys. Girls on the other hand are after money. The game is twofold; boys want sex and girls need money. Girls need money for food, books, clothing, confectioneries, etc. Life is not always easy for boys, as they pointed out. Life is a challenge in many ways. A boy has to struggle to get anything he wants while girls just go out with `sugar daddies' to get money. For girls to find boys attractive they should be equipped with the “4C's” — have cell phones, cash, clothes and cars.

If the girl refuses sex when a boy wants to `play with her' she might be beaten up. Sexual violence and lack of respect for girls were brought up several times in all the focus groups and among the letter writers. It is a common phenomenon in the compounds although many of the boys looked at sexual violence with shame.

Possibilities and Difficulties Faced by Adolescent Boys Today

Social and Cultural Changes versus Visions and Dreams

The poor socioeconomic and health situation in Zambia as well as broken family ties frightened the boys deeply. As a result of these factors they could foresee, in the near future, less educational opportunities followed by unemployment and socioeconomic disaster. The boys also found themselves caught up at crossroads between conflicting traditional norms and modern values with minimal adult guidance. The parents, the school, the churches and foreign cultures have exposed them to contradictory and confusing messages and expectations.²⁸ They were left with the question of how to act socially and sexually in the most appropriate way.

Different kinds of fears, threats and dangers were a reality among the adolescent boys. One concern was how negative peer pressure and influence could affect their future. Other worries brought up were HIV/AIDS and the fact that elderly men marry or `play around' with girls, competing with the young men and leaving the girls HIV infected. HIV/AIDS and its effect on their health was a predominant and recurrent threat during the FGDs and among the letter writers. Others said that sexual satisfaction, which could be an exciting source of joy and pleasure, leads to HIV infection, suffering and death. For these reasons, many of them felt that they might never grow into future leaders; only their grandparents would survive and grow old. Many of their dreams for the future seemed shattered. In their own words:

“Today, in my life, I only fear HIV/AIDS, which kills people like grass and ants. Parents die and I get guardians who mistreat me or … I might become a street child – confusion.”

Many of the boys wanted their parents to be more involved. Parents were considered by many boys as the most suitable primary source of education and guidance for children. Many of the boys were disappointed that they could not talk to their parents about sexual and reproductive matters. The boys stated that parents are not able to, some do not want to, while others do not have the appropriate knowledge to discuss or advise the younger generation. Some do not care about what their children are doing.

“Parents don't care whatever the children are watching, whether it is pornographic films or crime. Moreover, the parents say it is a modern world … The children have lost the respect for their parents, and as a result of this the children tell their parents that they are old-fashioned. Parents don't have a say.”

Peer Pressure

Peers are one of the most influential role models during adolescence. During adolescence and the process of identity building, the boys test various roles and behaviours, overcome different challenges and have to find a way to resist a lot of negative peer pressure. They said they know how negative peer pressure, idleness, poverty and bad movies/videos, like gangster movies from the US, could corrupt adolescents' morals and attitudes. They vividly discussed common patterns of progressive decline into problems that result in a vicious circle socially and legally.

“One get money problem, girls need boyfriends for money, one end up stealing, gambling, etc, when parents cannot afford giving enough money … Yes, if one join bad groups … you start experimenting drugs, drinking, smoking, sleeping around, come into prostitution, rape, unwanted pregnancies, abortions, and end up contracting STDs/HIV/AIDS. … young men are tempted and want to practice what they see, hear and observe on the TV and pornographic videos, these so called x-bass video^c films and music. Many cannot differentiate good behaviour from bad. Government should control films and videos shown in the compounds as well as stop people walking in the streets at night … create dressing codes and propose age limits for pornographic videos.”

^c'X-bass videos' or 'blue movies' are code words that young people use for pornographic videos to keep their parents from knowing what they are talking about.

A Brighter Future

The boys gave their views of adolescence as a period full of ambiguity and conflicting attitudes, norms and values, challenges and fears, but nevertheless also confidence in their approaching adulthood. Some of the boys said the confusing situations could also initiate a turning point, pave way for something else or something new. In order to avoid `bad' behaviour and maintain `good' morals, boys use various strategies. They try to (re)design a positive future lifestyle based on self control, self confidence and self-reliance, and foster the ability to differentiate good from bad. Many quotations from the Bible were given and built upon. They discussed recommendations such as not being hot tempered, rude, jealous or selfish. From experience, education and observations, they had already learnt that lack of self control and self respect creates disrespect to others, and that loss of sexual control contributes to the spread of STIs/HIV, rape, unintended pregnancies, illegal abortions, criminality, etc. A few said that it is better to totally abstain from sex and pornographic films during adolescence as they lead young people to having pre-marital sex and thus contacting HIV/AIDS at a young age. During the discussion, one boy commented thus: “you need personal strength to withstand peer pressure …”. A requirement that was seen as difficult to maintain in the long run but worth the trouble.

However, despite negative influences, the boys also expressed what is universal among young people — an innate positive view of and curiosity about life, a desire to build a brighter future including many positive dreams and visions. Despite all their fears, they saw themselves as getting good education; well-paid jobs; taking responsibilities for their families, wives and children; and having a nice house and a car. For many boys, it meant aspiring to become a man who is understanding, loving and a caring husband and father, a very successful and positive picture.

DISCUSSION

One major finding in this study is the lack of good male role models. A role model is a person who a child would want to identify him or herself with. It is a person who they look up to, admire and try to imitate to acquire his/her characteristics in the socialisation process in order to sharpen their own identity.^29,30  The boys did not unanimously agree to the conventional and oftentimes stereotyped gender role of a `real man' in Zambia. Despite their having gained a complex view of contradictory gender roles, attitudes, desires and conducts among adult men, most of the boys grew up believing, implicitly or explicitly, that their identity as men and as individuals is defined by their sexual prowess. Similar views have been highlighted by Yamba²⁸ and Varga.² The boys looked for alternative male roles but could only rarely find them in their immediate surroundings. In a study from Ghana, Ampofo³¹ emphasised that men are generally perceived as insensitive to women's feelings. Thus, boys are excluded from learning about intimacy, tenderness, caring and vulnerability. In fact, very few adult men, and none of the boys' fathers, were mentioned as good role models in this study. The reasons for that may be multi-faceted. UNFPA³² underlines that the traditional role of men and fathers has eroded in many societies and that it is not clear what could replace it. Data from Silberschmidt⁵ indicate that men's loss of social value due to social and economic changes seem to be compensated for and manifested in macho-sexual behaviour, violence and control over women.

Data from this study suggest that domestic and sexual violence against women and girls are common in homes and compounds where the boys live. One study from Zambia confirmed that approximately 40% of women are physically abused by their partners.³³ Violence is to a great extent a result of lack of respect for the opposite sex (females), and a lack of communication and negotiating skills regarding sexual matters.^12,18 As adolescents are profoundly affected by the gender norms in their community, violence is an issue that has to be recognised in sexual and reproductive health education and services with the goal of preventing such behaviour.

Similar to findings from other studies,^2,9,34 this study indicates that very little attention has been paid to adolescent boys' perceptions of their sexual and reproductive life, attitudes and practice. Adolescent boys are rarely looked at as a particular age group with their peculiar sensations and needs. Boys are assigned highly valued roles by the home, the school and the society at large; they are prepared to become decision-makers.^5,35 Such internalised gender norms affect women's and men's roles, their expectations of each other, their communication patterns, and maintenance of imbalance of power between the sexes. If not addressed very soon, cultural norms and values that teach boys that they are the `privileged sex', and superior to girls, may lead to perpetuation of this gender inequality. The study also manifests the need to address the lack of information as well as misconceptions, prejudice and vulnerability on social, legal, sexual and reproductive health matters among Zambian boys. Findings such as those of  Ndubani³⁶ show that the boys live in a world where they find themselves at crossroads surrounded by a variety of contradicting phenomena, e.g., traditional-modern, rural-urban, educated-uneducated, strong-weak, dependent-independent, free-controlled, vulnerable-invulnerable, respect-non-respect, and violence-non-violence. Here, the ambiguity of the boys may reflect the situation of Zambia as a country in cultural and economic transition. It is also a crossroad where the individual adolescent has to take a lot of decisions, usually with little guidance.

The boys acknowledged the period of adolescence as unpredictable and involving risk-taking behaviours. The findings highlight a gap between existing knowledge and unsafe sexual behaviour. According to Obrist³⁷, there is a risk of de-contextualising and reducing adolescent sexuality to simply a health problem that can then be solved by technical know-how. She believes that unwanted pregnancies and HIV/AIDS infection, not sexuality as such, is the problem. The ability to handle one's sexuality is partly learnt through culture. As behaviour is learnt, it can also be re-learnt and changed by acting responsibly and with caution.³⁸ That means adolescence might be a period of possibilities towards changed gender power relations from what it is today. A minimum requirement for supporting adolescents is a forum where they can discuss their social and sexual behaviours, find alternative lifestyles and make well-informed and responsible decisions.

One finding in this study about gender differences was that the boys, despite the lack of good role models, had ideas about what constitutes an `ideal man'. The man and husband many boys would like to be is one who understands, loves and cares, condemning male sexual and domestic violence. Another interesting finding regarding gender is how the boys tried to put themselves in the `shoes of the girls'. They tried to imagine what it means to be a girl; e.g., to be confined to the home, having few possibilities to make own decisions, being less respected, being subject to more restrictions and having less choices, as opposed to boys' freedom. Indeed, these signs are encouraging, showing the ability and willingness on the part of the boys to at least try to imagine the situation of the opposite less privileged sex. Young people of today have the potential to change their attitudes and behaviour on condition that they get appropriate education and guidance.^15,16,38

The study further indicates that many adolescent boys engage in early sexual activities primarily due to peer pressure. Adolescents are also attracted by manifestations of other cultures, media portrayals, substance abuse and unemployment, which may all contribute to making them vulnerable, becoming easy prey for an unsuccessful start in life.³⁹

Contrary to other studies^6,10,37, majority of the boys no longer expect girls to be virgins at marriage, like the older generation does. From their experiences, it is neither possible nor necessary for a girl to remain a virgin until marriage. A study in Tanzania³⁹ shows that 88.9% of young people had sex with friends and schoolmates of the same age. In the Zambian setting, adolescent boys may have a similar reality in mind regarding their sexual experiences and their views on virginity among Zambian girls.

A new trend found was that the boys expressed desire for their parents to be involved in life skills education. Instead of previous tradition where grandparents, uncles or aunts had the role of preparing adolescents for adulthood¹³, they consider the parents as the ones who should get involved as discussion partners regarding appropriate social and sexual comportment. Making educational investment in parents and providing them with support could contribute to bridging the widening generation gap.

Adolescent boys require comprehensive sexual and reproductive health education and services to understand the value of becoming responsible individuals. Thereby they will become important contributors to reducing sexual and reproductive ill health and unplanned pregnancies, gender inequality, and they will promote good health in the future within their own age groups. This is a challenge at a time when adolescence has become a complex part of life, an extended period in years, and with more educated young people having less possibilities for continued education and are suffering from more unemployment and idleness.

Finally, policymakers, schools, health professionals and church leaders at all levels have the responsibility of obtaining knowledge and gaining an understanding of the perceptions of adolescent boys regarding sexual and reproductive issues as well as their sexual and reproductive health needs and rights, in accordance with the goals of ICPD.^22,40 As reports of Nzioka⁹ and this study suggest, there is no time to lose; there is always a generation of reproductive age with specific reproductive health needs that must be attended to. The challenge remains to meet questions, ignorance and worries of adolescent boys regarding psychosexual development, lifestyle issues, health problems and gender relations. What the adolescent boys now need and deserve is accurate and relevant gender, sexual and reproductive health counselling and health services as well as a positive, polite and respectful attitudes on the part of adults. The attention given to these boys has to start from their vantage point based on their varying needs and perspectives.

Changes in men's gender related and sexual behaviour are expected to have a more significant impact on, e.g., transmission of STIs/HIV/AIDS, unwanted pregnancies, unsafe abortions and sexual violence than changes in women's behaviour.³⁰ This is true for adolescent boys growing into manhood as well.

ACKNOWLEDGMENTS

This study was made possible through financial support from the Swedish International Develop<%5>ment Cooperation Agency, Department for Research Cooperation, (Sida/SAREC) and Forskningsnämnd Vård, Karolinska Institutet, Stockholm, Sweden. We gratefully acknowledge the Lusaka and Kitwe District Health Management Boards. The Zambian adolescent boys are acknowledged for generously sharing their thoughts with the research team.

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