February 8, 2012
While a focus on HIV prevention and treatment among women and children has reduced infection rates among these populations, "men have received considerably less attention in the epidemic and receive less targeted HIV prevention and treatment programs," Edward Mills of the University of Ottawa and colleagues write in a PLoS Medicine essay, adding "Targeting men in prevention and treatment ... may have a large impact on mortality, new infections, and the economic impact of HIV/AIDS in Africa." They note that in Africa, fewer men than women access antiretroviral therapy (ART), and men "typically have higher mortality," seek care later in the disease, and "are more likely to be lost to follow-up."
However, "[i]n the wake of the HPTN 052 trial results, demonstrating 96 percent efficacy of prevention in discordant couples with earlier ART treatment initiation, engaging greater numbers of men with HIV in treatment could have important prevention benefits for women and girls, and for primary prevention of vertical transmission," the authors state. "Funding organizations need to recognize the social and health impacts associated with not engaging men in primary and secondary HIV prevention campaigns," they write, concluding, "Programmatic efforts should account for this disparity, and recognize that it may be necessary to seek out men for HIV testing, care, and ART in variety of settings, and through mechanisms that that take into consideration the local culture and gender roles in partnerships, sex, and health" (2/7).