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"No one can ask me 'Why do you take that stuff?": Men's experiences of HIV disclosure and antiretroviral treatment in South Africa

"No one can ask me 'Why do you take that stuff?": Men's experiences of HIV disclosure and antiretroviral treatment in South Africa
"No one can ask me 'Why do you take that stuff?": Men's experiences of HIV disclosure and antiretroviral treatment in South Africa
This paper examines the way gender shaped the health behaviours, health care experiences and narratives of HIV-positive men initiating antiretroviral treatment in South Africa. We conducted participant observation and in-depth, semi-structured interviews with eight men enrolled in a public HIV treatment programme in a rural health district in KwaZulu-Natal. We also interviewed their family members and programme staff. The study found that men's narratives and experiences of antiretroviral therapy (ART) were complex. Descriptions of control and coping juxtaposed with low self-esteem and guilt. Improvements in health following treatment increased optimism about the future but were readily undermined by men's concerns about being unable to meet strongly gendered expectations in relation to family and work. Alcohol use and abuse by men themselves or by family members was found to be an important issue influencing disclosure, uptake and adherence. Given messages discouraging alcohol use during treatment, men reported self-imposed delays to enrolment while they tried to stop or reduce alcohol use, although none had sought advice or professional help in doing so. Men also felt very threatened by alcohol abuse by family members fearing accidental disclose, insults and violence. With regards to health providers, men held strong views as to appropriate and professional behaviour by programme staff, particularly regarding confidentiality. As ART programmes in Africa become established and evolve, we not only need to identify barriers to men's access and adherence but monitor their health and treatment experiences. These findings suggest that the issue of alcohol and ART warrants further investigation. Additional training for primary health care providers and counsellors on health promotion with men may be useful
0954-0121
355-360
Fitzgerald, Molly
fdbbac3a-66e6-4c5c-aec9-b12cb38ca63c
Collumbien, Martine
1cec8cbc-4330-4a9f-ae08-b1666456bbb4
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993
Fitzgerald, Molly
fdbbac3a-66e6-4c5c-aec9-b12cb38ca63c
Collumbien, Martine
1cec8cbc-4330-4a9f-ae08-b1666456bbb4
Hosegood, Victoria
c59a89d5-5edc-42dd-b282-f44458fd2993

Fitzgerald, Molly, Collumbien, Martine and Hosegood, Victoria (2010) "No one can ask me 'Why do you take that stuff?": Men's experiences of HIV disclosure and antiretroviral treatment in South Africa. AIDS Care, 22 (3), 355-360. (doi:10.1080/09540120903111536). (PMID:20390516)

Record type: Article

Abstract

This paper examines the way gender shaped the health behaviours, health care experiences and narratives of HIV-positive men initiating antiretroviral treatment in South Africa. We conducted participant observation and in-depth, semi-structured interviews with eight men enrolled in a public HIV treatment programme in a rural health district in KwaZulu-Natal. We also interviewed their family members and programme staff. The study found that men's narratives and experiences of antiretroviral therapy (ART) were complex. Descriptions of control and coping juxtaposed with low self-esteem and guilt. Improvements in health following treatment increased optimism about the future but were readily undermined by men's concerns about being unable to meet strongly gendered expectations in relation to family and work. Alcohol use and abuse by men themselves or by family members was found to be an important issue influencing disclosure, uptake and adherence. Given messages discouraging alcohol use during treatment, men reported self-imposed delays to enrolment while they tried to stop or reduce alcohol use, although none had sought advice or professional help in doing so. Men also felt very threatened by alcohol abuse by family members fearing accidental disclose, insults and violence. With regards to health providers, men held strong views as to appropriate and professional behaviour by programme staff, particularly regarding confidentiality. As ART programmes in Africa become established and evolve, we not only need to identify barriers to men's access and adherence but monitor their health and treatment experiences. These findings suggest that the issue of alcohol and ART warrants further investigation. Additional training for primary health care providers and counsellors on health promotion with men may be useful

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Published date: 2010

Identifiers

Local EPrints ID: 181369
URI: http://eprints.soton.ac.uk/id/eprint/181369
ISSN: 0954-0121
PURE UUID: dcc23bea-5e3f-46b5-a904-e42e7a5182bc
ORCID for Victoria Hosegood: ORCID iD orcid.org/0000-0002-2244-2518

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Date deposited: 18 Apr 2011 13:14
Last modified: 14 Mar 2024 02:56

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Author: Molly Fitzgerald
Author: Martine Collumbien

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