Men and ARVs: how does being a man affect access to antiretroviral therapy in South Africa? an investigation among Xhosa-Speaking men in Khayelitsha

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Centre for Social Science Research

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University of Cape Town

This paper aims to improve understanding of the nature and causes of barriers to accessing ARV treatment that affect men and result in their low rates of clinic attendance. The findings are intended to provide a direction for policy in the implementation of the South African government’s Comprehensive Plan for HIV/AIDS. Through a combination of semi-structured interviews and focus groups, experiences and opinions were collected from men living with HIV/AIDS and health workers working at an ARV treatment clinic in Khayelitsha, South Africa. Using an interpretivist approach, and informed by theories of social constructionism, an understanding was formed taking into consideration the complex nature of their realities. Thematic content analysis was selected as the best way of handling a large volume of material spanning a broad range of issues. Only by attempting to understand the nature of Xhosa culture and what it means to be a Xhosa man, was it possible to comprehend the material. Barriers to access manifested themselves at several levels of experience. Stigma, gender issues, preference of traditional medicine, cultural ideals of manhood, and several practical issues, all influenced a man’s ability to acknowledge his HIV status or to seek help. Suggestions to address these problems were made throughout the paper, founded on a combination of interviewees’ opinions and researcher’s analysis. These suggestions are important to acknowledge before a national ARV programme becomes fully implementational.