February 28, 2012
Sub-Saharan African men do not obtain HIV/AIDS treatment as often as women, and they die prematurely because of it, researchers say.
"There are a lot of men at the testing centers, but yet, you don't see them at the clinics for antiretroviral care," said Edward Mills, associate professor and Canada Research Chair of Health Sciences at the University of Ottawa. "Somewhere in between the time of testing and the time of accessing clinical care we're missing out on these men."
Mills supervised HIV/AIDS treatment programs in Africa for several years and questioned this gender disparity. For some men, being HIV-positive carries a stigma of wrongdoing connected to having pre-marital sex, visiting sex workers, or having a relationship outside of their marriage, he said. Disease-related shame drives these men to defer treatment and seek ineffective alternatives.
"Men initially try to treat the HIV themselves," said Mills. "They maybe go to pharmacies and they buy some aspirin or some Tylenol and they don't want to accept that they've got HIV." Men need more education about HIV and the importance of early treatment, he said.
Male circumcision campaigns could be used as an opportunity to encourage testing and counseling, but broader efforts may be needed to address men who are resistant to accessing health care, as well as women in discordant couples, Mills said.
"In any discordant relationship you would expect the person who is HIV-positive to be the male," said Mills. "But when you look at the evidence, actually about 50 percent of the time it's the male and 50 percent of the time it's the female. So, there are several different interpretations of this, but the best one is it appears that both genders go outside of their marriage."