@article{fdi:010076321,
  title = {{M}en, masculinity, and engagement with treatment as prevention in {K}wa{Z}ulu-{N}atal, {S}outh {A}frica},
  author = {{C}hikovore, {J}. and {G}illepsie, {N}. and {M}c{G}rath, {N}. and {O}rne-{G}liemann, {J}. and {Z}uma, {T}. and {L}armarange, {J}oseph and {S}agaon {T}eyssier, {L}uis and {ANRS} 12249 {T}as{P} {S}tudy {G}roup and et al.},
  editor = {},
  language = {{ENG}},
  abstract = {{M}en's poorer engagement with healthcare generally and {HIV} care specifically, compared to women, is well-described. {W}ithin the {HIV} public health domain, interest is growing in universal test and treat ({UTT}) strategies. {UTT} strategies refer to the expansion of antiretroviral therapy ({ART}) in order to reduce onward transmission and incidence of {HIV} in a population, through a treatment as prevention ({T}as{P}). {T}his paper focuses on how masculinity influences engagement with {HIV} care in the context of an on-going {T}as{P} trial. {D}ata were collected in {J}anuary-{N}ovember 2013 using 20 in-depth interviews, 10 of them repeated thrice, and 4 focus group discussions, each repeated four times. {A}nalysis combined inductive and deductive approaches for coding and the review and consolidation of emerging themes. {T}he accounts detailed men's unwillingness to engage with {HIV} testing and care, seemingly tied to their pursuit of valued masculinity constructs such as having strength and control, being sexually competent, and earning income. {A}rticulated through fears regarding getting an {HIV}-positive diagnosis, observations that men preferred traditional medicine and that primary health centres were not welcoming to men, descriptions that men used lay measures to ascertain {HIV} status, and insinuations by men that they were removed from {HIV} risk, the indisposition to {HIV} care contrasted markedly with an apparent readiness to test among women. {G}endered tensions thus emerged which were amplified in the context where valued masculinity representations were constantly threatened. {A}mid the tensions, men struggled with disclosing their {HIV} status, and used various strategies to avoid or postpone disclosing, or disclose indirectly, while women's ability to access care readily, use condoms, or communicate about {HIV} appeared similarly curtailed. {UTT} and {T}as{P} promotion should heed and incorporate into policy and health service delivery models the intrapersonal tensions, and the conflict, and poor and indirect communication at the micro-relational levels of couples and families.},
  keywords = {{AFRIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{AIDS} {C}are.{P}sychological and {S}ociomedical {A}spects of {AIDS}/{HIV}},
  volume = {28},
  numero = {{S}uppl. 3},
  pages = {74--82},
  ISSN = {0954-0121},
  year = {2016},
  URL = {https://www.documentation.ird.fr/hor/fdi:010076321},
}