What role can gender-transformative programming for men play in increasing men’s HIV testing and engagement in HIV care and treatment in South Africa?

Abstract

Men are less likely than women to test for HIV and engage in HIV care and treatment. We conducted in-depth interviews with men participating in One Man Can (OMC) – a rights-based gender equality and health program intervention conducted in rural Limpopo and Eastern Cape, South Africa – to explore masculinity-related barriers to HIV testing/care/treatment and how participation in OMC impacted these. Men who participated in OMC reported an increased capability to overcome masculinity-related barriers to testing/care/treatment. They also reported increased ability to express vulnerability and discuss HIV openly with others, which led to greater willingness to be tested for HIV and receive HIV care and treatment for those who were living with HIV. Interventions that challenge masculine norms and promote gender equality (i.e. gender-transformative interventions) represent a promising new approach to address men’s barriers to testing, care, and treatment.

What Role Do Masculine Norms Play in Men’s HIV Testing in Sub-Saharan Africa?: A Scoping Review

“…These types of interventions—often described as ‘gender transformative’—have rarely been applied specifically to increasing HIV testing in Africa, but some recent studies suggest it may be a promising approach. Researchers in South Africa conducted a qualitative evaluation of One Man Can to determine whether it has any impact on men’s HIV testing behaviors even though the program focuses specifically on changing gender norms and does not specifically target a change in HIV testing behaviors [54]. They found that many men reported greater willingness to test for HIV after participating in One Man Can because One Man Can changed their views about gender equity and gender norms.…”

“…Gender norms related to masculinity may play a critical role in men’s relatively low HIV testing rates [10, 11]. Gender norms are “those qualities of femaleness and maleness that develop as a result of socialization rather than biological predisposition” (p. 146) [12].…”

Can a Gender Equity and Family Planning Intervention for Men Change Their Gender Ideology? Results from the CHARM Intervention in Rural India

“…One Man Can, Program H) are typically time and resource intensive and involve many workshops and sessions with participants (G. Barker et al, 2004; Paul J Fleming et al, 2016). In contrast, CHARM was relatively brief: it only included three sessions, each of which was relatively brief.…”

“…CHARM is a relatively brief intervention compared to other gender-transformative interventions that have been evaluated (G. Barker, Nascimento, Segundo, & Pulerwitz, 2004; Paul J Fleming, Colvin, Peacock, & Dworkin, 2016; Jewkes et al, 2008). Brief interventions are particularly attractive because it can be difficult to engage men in time-intensive interventions.…”

Behavioral and Psychosocial Correlates of HIV Testing Among Male Clients of Female Sex Workers in Tijuana, Mexico

“…Third, given the link between HIV testing and misogynistic attitudes, gender-transformative interventions may be particularly useful 55–57 . Gender-transformative interventions aim to democratize the relationship between men and women and have been shown effective at reducing men’s sexual risk behaviors and violence behaviors 56 and one recent study demonstrated that it may be effective at increasing men’s uptake of HIV testing 58 .…”