SA AIDS Conference 2019:  Tweetchat 2

Men Matter. How can we better involve men in the HIV response?

Moderator:                         Vanessa Carter (Health Care Social Media and Communications South Africa)

Date:                                     Wednesday, 12 June 2019

Time:                                     13:30 – 14:30 (SAST)

Hashtags:                             #TBHIVCare #MenMatter

How to participate:

Start your answers with T1, T2, T3, T4 or CT for transcript purposes. Answer only after the moderator prompts. Questions will be prompted every 10 minutes, but keep answers coming using the relevant T and number. Anyone can participate! Use the #TBHIVCare or #MenMatter hashtag in all your tweets so that you are visible to others in the chat and on the transcript.

Chat Overview

Join us for a 60-minute Twitter with TB HIV Care – live from the 2019 SA AIDS Conference in Durban. Everyone is welcome to join the chat, including those at the conference and those not, doctors, nurses, entrepreneurs, policymakers, advocates, academics, pharma, educators, students, IT developers, journalists, data scientists, civil society, NPOs, researchers, etc. both locally and internationally.

Our topic for this session focuses on men – and more specifically, how we can better involve them in efforts to end HIV.

The transcript will be recorded by Symplur Analytics (https://www.symplur.com). 

Questions

T1: What factors affect gender disparity in terms of access to healthcare and health outcomes (in South Africa or globally)?

T2: What is the biggest challenge when it comes to addressing HIV prevention, treatment and care with South African men?

T3: What does the health system need to do differently in order to engage men in the HIV response?

T4: How can digital technologies or other innovations help overcome the challenges faced when involving men in the HIV response?

Closing: What other thoughts would you like to add?

Blog: Men Matter. How can we better involve men in the HIV response?

In many societies, men generally enjoy more opportunities, privileges and power than women, yet these multiple advantages do not translate into better health outcomes. What explains this gender disparity? According to the WHO European Region’s review of the social determinants of health, chaired by Sir Michael Marmot, men’s poorer survival rates “reflect several factors – greater levels of occupational exposure to physical and chemical hazards, behaviours associated with male norms of risk-taking and adventure, health behaviour paradigms related to masculinity and the fact that men are less likely to visit a doctor when they are ill and, when they see a doctor, are less likely to report on the symptoms of disease or illness” (Source: https://www.who.int/bulletin/volumes/92/8/13-132795/en/).

In South Africa, we see similar patterns at play. UNAIDS reports that men are less likely than women to use health services and tend to be sicker when seeking medical help. They are also less likely to take an HIV test (for example, in 2016 an estimated 45% of men tested for HIV compared to 59% of women) and this means they are less likely to know whether they are HIV positive. As a result, fewer South African men living with HIV start and remain on HIV treatment, and men are more likely to die of AIDS-related causes, as well as tuberculosis (Source: PDF: A snapshot of men and HIV in South Africa – UNAids).

A recent Community Rights and Gender Assessment undertaken by TB HIV Care for the Stop TB Partnership shows that Gender impacts on vulnerability to infection, access to TB diagnosis and treatment, quality of care and treatment completion. Men are markedly more vulnerable to TB infection and disease and have higher mortality than women. National mortality rates for 2016 indicate that TB was the leading cause of death in men in South Africa, accounting for 7.6% (18 153/240 001) of deaths. TB was only the fifth leading cause of death in women, accounting for 5,2% (11 246/214 988) of deaths. Structural barriers to accessing TB services for men include cultural attitudes towards health-seeking (incl. cultural expressions and notions of strength and masculinity undermining engagement in care) and insufficiently tailored healthcare services (e.g. male-only spaces in healthcare facilities or after hours services).

Several recent studies in Malawi, South Africa, Uganda and Zimbabwe suggest that notions of masculinity not only increase the risk of infection with HIV, but they also inhibit men from getting tested for HIV, coming to terms with their HIV-positive status, taking instructions from nurses, and engaging in health-enabling behaviours. Cornell et al. have argued that we have a “blind spot” when it comes to men and antiretroviral therapy (ART) in Africa. These researchers note, for example, that disproportionately fewer men than women access ART across Africa, that men start ART later in the disease course than women, and that men are more likely than women to interrupt treatment and be lost to follow-up. (Source: https://www.who.int/bulletin/volumes/92/8/13-132795/en/)

Men are critical in the HIV response, but they are being left behind. What needs to change? How do we change the conversation with men? How do we involve them more in the HIV response? Examples include creating male-friendly spaces within facilities, creating more men-only support groups and structural programmes and tailoring e-health solutions and innovations to meet men’s needs. During this 60-minute session, we explore the challenges involved in reaching men, and what we can do differently. This session is hosted by TB HIV Care as part of their SA AIDS Conference 2019 conversations.