When masculinity interferes with women's treatment of HIV infection: a qualitative study about adherence to antiretroviral therapy in Zimbabwe
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BACKGROUND: Social constructions of masculinity have been shown to serve as an obstacle to men's access and adherence to antiretroviral therapies (ART). In the light of women's relative lack of power in many aspects of interpersonal relationships with men in many African settings, our objective is to explore how male denial of HIV/AIDS impacts on their female partners' ability to access and adhere to ART. METHODS: We conducted a qualitative case study involving thematic analysis of 37 individual interviews and five focus groups with a total of 53 male and female antiretroviral drug users and 25 healthcare providers in rural eastern Zimbabwe. RESULTS: Rooted in hegemonic notions of masculinity, men saw HIV/AIDS as a threat to their manhood and dignity and exhibited a profound fear of the disease. In the process of denying and avoiding their association with AIDS, many men undermine their wives' efforts to access and adhere to ART. Many women felt unable to disclose their HIV status to their husbands, forcing them to take their medication in secret, and act without a supportive treatment partner, which is widely accepted to be vitally important for adherence success. Some husbands, when discovering that their wives are on ART, deny them permission to take the drugs, or indeed steal the drugs for their own treatment. Men's avoidance of HIV also leaves many HIV-positive women feeling vulnerable to re-infection as their husbands, in an attempt to demonstrate their manhood, are believed to continue engaging in HIV-risky behaviours. CONCLUSIONS: Hegemonic notions of masculinity can interfere with women's adherence to ART. It is important that those concerned with promoting effective treatment services recognise the gender and household dynamics that may prevent some women from successfully adhering to ART, and explore ways to work with both women and men to identify couples-based strategies to increase adherence to ART.
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Receiving treatment and being dependent on others can threaten a man's masculinity.
“Receiving treatment and being dependent on others can threaten a man’s masculinity [32].”
From Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women’s perspectives (2017) · cites this paper as [32]
The first theory suggests that HIV testing and treatment threatens traditional norms of masculinity.
“The first theory suggests that HIV testing and treatment threatens traditional norms of masculinity [19, 32].”
From Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women’s perspectives (2017) · cites this paper as [32]
Previous literature has discussed how men may seek to control their partner and their partner's actions (such as taking medication) as a means to assert power and therefore reinforce an image of masculinity.
“Previous literature has discussed how men may seek to control their partner and their partner’s actions (such as taking medication) as a means to assert power and therefore reinforce an image of masculinity [32].”
From Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women’s perspectives (2017) · cites this paper as [32]
Previous research has documented husband's interfere with their partner's adherence to ART.
“Previous research has documented husband's interfere with their partner's adherence to ART [32].”
From Echoes of old HIV paradigms: reassessing the problem of engaging men in HIV testing and treatment through women’s perspectives (2017) · cites this paper as [32]
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- Authors
- Skovdal, M., Campbell, C., Nyamukapa, C., & Gregson, S.
- Affiliations
- London School of Economics and Political Science (GB)
- Biomedical Research and Training Institute (ZW)
- Corresponding author
- Skovdal, Morten
- Venue
- Journal of the International AIDS Society
- Publisher
- Wiley
- Published
- 2011-01
- Volume
- 14
- Issue
- 1
- Pages
- 29-29
- ISSN
- 1758-2652 (ISSN-L)
- PMC
- PMC3127801
- OpenAlex
- W2110910736
- Cited by
- 84
- References
- 38
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 4 · 2022: 1 · 2021: 8 · 2020: 4 · 2019: 2 · 2018: 9 · 2017: 5 · 2016: 9 · 2015: 7 · 2014: 9 · 2013: 11 · 2012: 7
- FWCI
- 6.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of the International AIDS Society (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, other-oa)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion)
- London School of Economics and Political Science Theses Online (London School of Economics and Political Science) (submittedVersion)
- Greater South Information System
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › HIV/AIDS Impact and Responses
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- masculinity, antiretroviral therapy adherence, HIV/AIDS, HIV status disclosure, men's health, Zimbabwe
- MeSH terms
- Adult, Female, Humans, Male, Patient Compliance, Sexual Partners, Zimbabwe, HIV Infections, Spouses, Anti-HIV Agents, Qualitative Research, Young Adult, Masculinity
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