Men living with HIV or who did not know their HIV status cited privacy concerns, such as a provider disclosing their HIV status or that they would be stigmatized by their provider, as a barrier to seeking care, according to recent research published in PLOS ONE.
“It’s not that going to the health facility doesn’t occur to men,” Natalie J. Tibbels, MSPH, from the Johns Hopkins Center for Communication Programs at Johns Hopkins Bloomberg School of Public Health in Baltimore, stated in a press release. “But when it comes to HIV, there is a sense that while you might get good treatment, there might be ramifications resulting from going to the clinic. Men in the study were willing to forfeit the benefits of testing and treatment because the costs of being known as HIV positive or stigmatized were too high.”
Patient in the waiting room. Source: Getty
The researchers conducted interviews and focus group discussions with 227 adult men between 25 years and 49 years old in Côte d’Ivoire, asking the men about their values and aspirations, their experience with HIV treatment as well as what their perceptions of HIV treatment and social norms surrounding treatment were.
The men living with HIV and with unknown status surveyed questioned providers’ motives for providing care and were concerned about confidentiality among providers, and said they “anticipated demeaning behavior” from providers and doubted their ability to interpret test results. In addition, men who hadn’t yet sought care worried that being seen in the clinic, which could make members of their community believe they were infected with HIV despite actual HIV status.
Other concerns about seeking HIV treatment included long wait times at a center, perception as clinics being “feminine” spaces, delay in treatment due to antiretroviral therapy being unavailable, and cost of treatment. However, men who sought treatment at centers said these fears at the provider or facility level were rarely realized.
“If men have hesitations around getting HIV services at a formal health facility, then we need to think outside the box,” said Tibbels. “We need to take their concerns to heart in order to be successful in getting more men into treatment. If that means making it possible for men to be tested and treated outside of the health facility, it's something we should do.”
Tibbels and colleagues noted providers could re-emphasize the importance of confidentiality of providers, and outreach programs that incorporate gender norms and gender roles to decrease negative perceptions of seeking HIV treatment among men. “Understanding the perspective of men is critical to tailoring health communication and clinical services to meet their needs,” Tibbels said.