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The current study examines how gender influenced the health behaviors, health care experiences, and narratives of HIV-positive men initiating antiretroviral treatment in South Africa. In a rural health district in KwaZulu-Natal, eight men enrolled in a public HIV treatment program underwent observation and in-depth, semi-structured interviews. Family members and program staff also were interviewed.
"The study found that men's narratives and experiences of antiretroviral therapy (ART) were complex," the authors wrote. "Descriptions of control and coping juxtaposed with low self-esteem and guilt." While increased optimism about the future was noted following treatment-related health improvements, these feelings "were readily undermined by men's concerns about being unable to meet strongly gendered expectations in relation to family and work."
Alcohol use/abuse - by the men themselves, or family members - was an important issue affecting disclosure, uptake, and adherence. "Given messages discouraging alcohol use during treatment, men reported self-imposed delays to enrollment while they tried to stop or reduce alcohol use, although none had sought advice or professional help in doing so." In addition, the men "felt very threatened by alcohol abuse by family members fearing accidental disclose, insults and violence." The men held strong views regarding appropriate and professional behavior by program staff, especially relating to confidentiality.
"As ART programs in Africa become established and evolve, we not only need to identify barriers to men's access and adherence but monitor their health and treatment experiences," the authors concluded. "These findings suggest that the issue of alcohol and ART warrants further investigation. Additional training for primary health care providers and counselors on health promotion with men may be useful."
The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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