Men, masculinity, and engagement with treatment as prevention in KwaZulu-Natal, South Africa.
Identifieur interne : 000A12 ( PubMed/Checkpoint ); précédent : 000A11; suivant : 000A13Men, masculinity, and engagement with treatment as prevention in KwaZulu-Natal, South Africa.
Auteurs : Jeremiah Chikovore [Afrique du Sud] ; Natasha Gillespie [Afrique du Sud] ; Nuala Mcgrath [Royaume-Uni] ; Joanna Orne-Gliemann [France] ; Thembelihle Zuma [Afrique du Sud]Source :
- AIDS care [ 1360-0451 ] ; 2016.
Descripteurs français
- KwdFr :
- Acceptation des soins par le patient (ethnologie), Acceptation des soins par le patient (psychologie), Accessibilité des services de santé, Adulte, Agents antiVIH (usage thérapeutique), Attitude envers la santé, Comportement sexuel, Divulgation, Dépistage systématique, Facteurs socioéconomiques, Femelle, Groupes focalisés, Hommes (psychologie), Humains, Infections à VIH (), Infections à VIH (diagnostic), Infections à VIH (psychologie), Masculinité, Mâle, Recherche qualitative, République d'Afrique du Sud, Services de santé (utilisation), Stigmate social.
- MESH :
- diagnostic : Infections à VIH.
- ethnologie : Acceptation des soins par le patient.
- psychologie : Acceptation des soins par le patient, Hommes, Infections à VIH.
- usage thérapeutique : Agents antiVIH.
- utilisation : Services de santé.
- Accessibilité des services de santé, Adulte, Attitude envers la santé, Comportement sexuel, Divulgation, Dépistage systématique, Facteurs socioéconomiques, Femelle, Groupes focalisés, Humains, Infections à VIH, Masculinité, Mâle, Recherche qualitative, République d'Afrique du Sud, Stigmate social.
English descriptors
- KwdEn :
- Adult, Anti-HIV Agents (therapeutic use), Attitude to Health, Disclosure, Female, Focus Groups, HIV Infections (diagnosis), HIV Infections (prevention & control), HIV Infections (psychology), Health Services (utilization), Health Services Accessibility, Humans, Male, Masculinity, Mass Screening, Men (psychology), Patient Acceptance of Health Care (ethnology), Patient Acceptance of Health Care (psychology), Qualitative Research, Sexual Behavior, Social Stigma, Socioeconomic Factors, South Africa.
- MESH :
- chemical , therapeutic use : Anti-HIV Agents.
- diagnosis : HIV Infections.
- ethnology : Patient Acceptance of Health Care.
- prevention & control : HIV Infections.
- psychology : HIV Infections, Men, Patient Acceptance of Health Care.
- utilization : Health Services.
- Adult, Attitude to Health, Disclosure, Female, Focus Groups, Health Services Accessibility, Humans, Male, Masculinity, Mass Screening, Qualitative Research, Sexual Behavior, Social Stigma, Socioeconomic Factors, South Africa.
Abstract
Men's poorer engagement with healthcare generally and HIV care specifically, compared to women, is well-described. Within the HIV public health domain, interest is growing in universal test and treat (UTT) strategies. UTT strategies refer to the expansion of antiretroviral therapy (ART) in order to reduce onward transmission and incidence of HIV in a population, through a "treatment as prevention" (TasP). This paper focuses on how masculinity influences engagement with HIV care in the context of an on-going TasP trial. Data were collected in January-November 2013 using 20 in-depth interviews, 10 of them repeated thrice, and 4 focus group discussions, each repeated four times. Analysis combined inductive and deductive approaches for coding and the review and consolidation of emerging themes. The accounts detailed men's unwillingness to engage with HIV testing and care, seemingly tied to their pursuit of valued masculinity constructs such as having strength and control, being sexually competent, and earning income. Articulated through fears regarding getting an HIV-positive diagnosis, observations that men preferred traditional medicine and that primary health centres were not welcoming to men, descriptions that men used lay measures to ascertain HIV status, and insinuations by men that they were removed from HIV risk, the indisposition to HIV care contrasted markedly with an apparent readiness to test among women. Gendered tensions thus emerged which were amplified in the context where valued masculinity representations were constantly threatened. Amid the tensions, men struggled with disclosing their HIV status, and used various strategies to avoid or postpone disclosing, or disclose indirectly, while women's ability to access care readily, use condoms, or communicate about HIV appeared similarly curtailed. UTT and TasP promotion should heed and incorporate into policy and health service delivery models the intrapersonal tensions, and the conflict, and poor and indirect communication at the micro-relational levels of couples and families.
DOI: 10.1080/09540121.2016.1178953
PubMed: 27421054
Affiliations:
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pubmed:27421054Le document en format XML
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<front><div type="abstract" xml:lang="en">Men's poorer engagement with healthcare generally and HIV care specifically, compared to women, is well-described. Within the HIV public health domain, interest is growing in universal test and treat (UTT) strategies. UTT strategies refer to the expansion of antiretroviral therapy (ART) in order to reduce onward transmission and incidence of HIV in a population, through a "treatment as prevention" (TasP). This paper focuses on how masculinity influences engagement with HIV care in the context of an on-going TasP trial. Data were collected in January-November 2013 using 20 in-depth interviews, 10 of them repeated thrice, and 4 focus group discussions, each repeated four times. Analysis combined inductive and deductive approaches for coding and the review and consolidation of emerging themes. The accounts detailed men's unwillingness to engage with HIV testing and care, seemingly tied to their pursuit of valued masculinity constructs such as having strength and control, being sexually competent, and earning income. Articulated through fears regarding getting an HIV-positive diagnosis, observations that men preferred traditional medicine and that primary health centres were not welcoming to men, descriptions that men used lay measures to ascertain HIV status, and insinuations by men that they were removed from HIV risk, the indisposition to HIV care contrasted markedly with an apparent readiness to test among women. Gendered tensions thus emerged which were amplified in the context where valued masculinity representations were constantly threatened. Amid the tensions, men struggled with disclosing their HIV status, and used various strategies to avoid or postpone disclosing, or disclose indirectly, while women's ability to access care readily, use condoms, or communicate about HIV appeared similarly curtailed. UTT and TasP promotion should heed and incorporate into policy and health service delivery models the intrapersonal tensions, and the conflict, and poor and indirect communication at the micro-relational levels of couples and families.</div>
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<Abstract><AbstractText>Men's poorer engagement with healthcare generally and HIV care specifically, compared to women, is well-described. Within the HIV public health domain, interest is growing in universal test and treat (UTT) strategies. UTT strategies refer to the expansion of antiretroviral therapy (ART) in order to reduce onward transmission and incidence of HIV in a population, through a "treatment as prevention" (TasP). This paper focuses on how masculinity influences engagement with HIV care in the context of an on-going TasP trial. Data were collected in January-November 2013 using 20 in-depth interviews, 10 of them repeated thrice, and 4 focus group discussions, each repeated four times. Analysis combined inductive and deductive approaches for coding and the review and consolidation of emerging themes. The accounts detailed men's unwillingness to engage with HIV testing and care, seemingly tied to their pursuit of valued masculinity constructs such as having strength and control, being sexually competent, and earning income. Articulated through fears regarding getting an HIV-positive diagnosis, observations that men preferred traditional medicine and that primary health centres were not welcoming to men, descriptions that men used lay measures to ascertain HIV status, and insinuations by men that they were removed from HIV risk, the indisposition to HIV care contrasted markedly with an apparent readiness to test among women. Gendered tensions thus emerged which were amplified in the context where valued masculinity representations were constantly threatened. Amid the tensions, men struggled with disclosing their HIV status, and used various strategies to avoid or postpone disclosing, or disclose indirectly, while women's ability to access care readily, use condoms, or communicate about HIV appeared similarly curtailed. UTT and TasP promotion should heed and incorporate into policy and health service delivery models the intrapersonal tensions, and the conflict, and poor and indirect communication at the micro-relational levels of couples and families.</AbstractText>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019380" MajorTopicYN="N">Anti-HIV Agents</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001294" MajorTopicYN="N">Attitude to Health</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D030881" MajorTopicYN="N">Disclosure</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017144" MajorTopicYN="N">Focus Groups</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006296" MajorTopicYN="N">Health Services</DescriptorName>
<QualifierName UI="Q000656" MajorTopicYN="Y">utilization</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006297" MajorTopicYN="N">Health Services Accessibility</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D057228" MajorTopicYN="Y">Masculinity</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008403" MajorTopicYN="Y">Mass Screening</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008571" MajorTopicYN="N">Men</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D010342" MajorTopicYN="N">Patient Acceptance of Health Care</DescriptorName>
<QualifierName UI="Q000208" MajorTopicYN="N">ethnology</QualifierName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D036301" MajorTopicYN="N">Qualitative Research</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012725" MajorTopicYN="N">Sexual Behavior</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D057545" MajorTopicYN="N">Social Stigma</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012959" MajorTopicYN="N">Socioeconomic Factors</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D013019" MajorTopicYN="N">South Africa</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">HIV</Keyword>
<Keyword MajorTopicYN="N">Masculinity</Keyword>
<Keyword MajorTopicYN="N">South Africa</Keyword>
<Keyword MajorTopicYN="N">qualitative</Keyword>
<Keyword MajorTopicYN="N">treatment as prevention</Keyword>
</KeywordList>
<CoiStatement>statement No potential conflict of interest was reported by the authors.</CoiStatement>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2016</Year>
<Month>7</Month>
<Day>16</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="pubmed"><Year>2016</Year>
<Month>7</Month>
<Day>16</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="medline"><Year>2017</Year>
<Month>7</Month>
<Day>18</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">27421054</ArticleId>
<ArticleId IdType="doi">10.1080/09540121.2016.1178953</ArticleId>
<ArticleId IdType="pmc">PMC5096677</ArticleId>
<ArticleId IdType="mid">EMS70180</ArticleId>
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<affiliations><list><country><li>Afrique du Sud</li>
<li>France</li>
<li>Royaume-Uni</li>
</country>
</list>
<tree><country name="Afrique du Sud"><noRegion><name sortKey="Chikovore, Jeremiah" sort="Chikovore, Jeremiah" uniqKey="Chikovore J" first="Jeremiah" last="Chikovore">Jeremiah Chikovore</name>
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<name sortKey="Gillespie, Natasha" sort="Gillespie, Natasha" uniqKey="Gillespie N" first="Natasha" last="Gillespie">Natasha Gillespie</name>
<name sortKey="Zuma, Thembelihle" sort="Zuma, Thembelihle" uniqKey="Zuma T" first="Thembelihle" last="Zuma">Thembelihle Zuma</name>
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<country name="Royaume-Uni"><noRegion><name sortKey="Mcgrath, Nuala" sort="Mcgrath, Nuala" uniqKey="Mcgrath N" first="Nuala" last="Mcgrath">Nuala Mcgrath</name>
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<country name="France"><noRegion><name sortKey="Orne Gliemann, Joanna" sort="Orne Gliemann, Joanna" uniqKey="Orne Gliemann J" first="Joanna" last="Orne-Gliemann">Joanna Orne-Gliemann</name>
</noRegion>
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</affiliations>
</record>
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