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Men More Likely To Die of AIDS-Related Illnesses - Report

In Uganda, some men reported they would rather avoid knowing their HIV status and receiving life-saving treatment because they associated being HIV-positive with emasculating stigma. One study in South Africa showed that 70 percent of men who had died from AIDS-related illnesses had never sought care for HIV.
Men are more likely to die of AIDS-related illnesses than women, according to a new report released by the Joint United Nations Programme on HIV/AIDS (UNAIDS) on World Aids Day. 

The report titled the Blind Spot indicates that men are dying because often, they are less likely to take an HIV test, less likely to access antiretroviral therapy, more likely to start treatment late, to interrupt treatment and to be lost to treatment follow-up.

It indicates that globally less than half of men living with HIV are on treatment, compared to 60 percent of women.

“Addressing the inequalities that put women and girls at risk of HIV is at the forefront of the AIDS response,” Michel Sidibé, Executive Director of UNAIDS said. “But there is a blind spot for men—men are not using services to prevent HIV or to test for HIV and are not accessing treatment on the scale that women are.”

In sub-Saharan Africa, men and boys living with HIV are 20 percent less likely than women and girls living with HIV to know their HIV status, and 27 percent less likely to be accessing treatment. In KwaZulu-Natal, the province with the highest HIV prevalence in South Africa, only one in four men aged 20–24 years living with HIV in 2015 knew that they had the virus.

In western and central Africa, a region that is struggling to respond effectively to HIV, only 25 percent of men living with HIV are accessing treatment. When people are not on treatment they are more likely to transmit HIV.

“When men access HIV prevention and treatment services, there is a triple dividend,” Sidibé said. “They protect themselves, they protect their sexual partners and they protect their families.”

The report highlights data from sub-Saharan Africa that show that condom use during sex with a non-regular partner is low among older men, who are also more likely to be living with HIV. 50 percent of men aged 40–44 years and 90 percent of men aged 55–59 years reported not using a condom.

These data are consistent with studies showing a cycle of HIV transmission from older men to younger women, and from adult women to adult men of a similar age in places with high HIV prevalence.

The Blind Spot also shows that HIV prevalence is consistently higher among men within key populations. Outside of eastern and southern Africa, 60 percent of all new HIV infections among adults are among men. The report outlines the particular difficulties men in key populations face in accessing HIV services, including discrimination, harassment and denial of health services.

“We cannot let complacency set in,” said Mr Sidibé. “If complacency sets in, HIV will take hold and our hopes of ending AIDS by 2030 will be shattered.”

While HIV testing has been able to reach women, particularly women using antenatal services, the same entry points have not been found for men, limiting uptake of HIV testing among men.

“The concept of harmful masculinity and male stereotypes create conditions that make having safer sex, taking an HIV test, accessing and adhering to treatment—or even having conversations about sexuality—a challenge for men,” Sidibé said adding that “men need to take responsibility. This bravado is costing lives.”

The report shows the need to invest in boys and girls at an early age, ensuring that they have access to age-appropriate comprehensive sexuality education that addresses gender equality and is based on human rights, creating healthy relationships and promoting health-seeking behaviour for both girls and boys.

The report shows that men visit health-care facilities less frequently than women, have fewer health checks and are diagnosed with life-threatening conditions at later stages than women.

In Uganda, some men reported they would rather avoid knowing their HIV status and receiving life-saving treatment because they associated being HIV-positive with emasculating stigma. One study in South Africa showed that 70 percent of men who had died from AIDS-related illnesses had never sought care for HIV.

The report urges HIV programmes to boost men's use of health services and to make services more easily available to men. This includes making tailored health services available, including extending operating hours, using pharmacies to deliver health services to men, reaching men in their places of work and leisure, including pubs and sports clubs, and using new communications technologies, such as mobile phone apps.

It also urges a supportive legal and policy environment that addresses the common barriers to accessing HIV services, especially for key populations, and can accommodate the diverse needs and realities of men and boys.

The Blind Spot shows that by enabling men to stay free from HIV, get tested regularly and start and stay on treatment of HIV-positive, the benefits will not only improve male health outcomes but will contribute to declines in new HIV infections among women and girls and to altering harmful gender norms.

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