Engaging men in HIV testing and care

While advances in HIV prevention and treatment in recent years have made impressive inroads, new infections and AIDS-related deaths remain unacceptably high. The global community has recently focused on strategies to blanket communities with HIV testing and immediately provide treatment for anyone who tests positive. Called universal test and treat, such strategies hold great promise to reduce new HIV infections and deaths.

The success of universal test and treat strategies depend on large numbers of people voluntarily taking HIV tests and staying in treatment. Men, however, have historically low levels of HIV testing and poor connections to care compared with women, especially in sub-Saharan Africa. In a new study, Bixby researchers examine the factors that influence men’s testing uptake in the SEARCH trial in Kenya and Uganda. They found that:

  • Men’s employment opportunities often required them to be away from home for extended periods of time, meaning that they often missed opportunities for HIV testing in the community.
  • Seeking medical care is often viewed as an activity for women and children, and men see clinics as women’s spaces. These gender norms prevent men from getting HIV tests.
  • Because HIV can be associated with promiscuity, many men worried about the impact of a positive test result on their marriage.

Despite these barriers, the success of antiretroviral therapy is giving more men the courage to get tested. And others openly discussed the need to change gender norms that prevent men from engaging in HIV testing and care. If universal test and treat programs are to succeed, they need to recognize how issues like employment opportunities, shifting gender norms and new biomedical tools impact men’s behavior and identify ways to fully involve men in HIV testing and care.