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“You Take Medications, You Live Normally”: The Role of Antiretroviral Therapy in Mitigating Men’s Perceived Threats of HIV in Côte d’Ivoire

  • Zoé Mistrale HendricksonEmail author
  • Danielle A. Naugle
  • Natalie Tibbels
  • Abdul Dosso
  • Lynn M. Van Lith
  • Elizabeth C. Mallalieu
  • Diarra Kamara
  • Patricia Dailly-Ajavon
  • Adama Cisse
  • Kim Seifert Ahanda
  • Sereen Thaddeus
  • Stella Babalola
  • Christopher J. Hoffmann
Original Paper

Abstract

Men diagnosed with HIV face gender-related barriers to initiating and adhering to antiretroviral therapy (ART). This qualitative study (73 in-depth interviews; 28 focus group discussions), conducted with men in three urban sites in Côte d’Ivoire in 2016, examined perceptions of ART, including benefits and challenges, to explore how ART mitigates HIV’s threats to men’s sexuality, economic success, family roles, social status, and health. Participants perceived that adhering to ART would reduce risk of transmitting HIV to others, minimize job loss and lost productivity, and help maintain men’s roles as decision makers and providers. ART adherence was thought to help reduce the threat of HIV-related stigma, despite concerns about unintentional disclosure. While ART was perceived to improve health directly, it restricted men’s schedules. Side effects were also a major challenge. Social and behavior change approaches building on these insights may improve male engagement across the HIV care continuum.

Keywords

Masculinity HIV Antiretroviral therapy Côte d’Ivoire West Africa 

Resumen

Hombres seropositivos enfrentan barreras de género para iniciar y adherirse al tratamiento antirretroviral (TAR). Este estudio (73 entrevistas en profundidad; 28 grupos focales), realizado en 2016 en Costa de Marfil con hombres en tres centros urbanos, examinó percepciones sobre TAR, beneficios y retos, para explorar cómo éste mitiga amenazas a la sexualidad, éxito económico, roles familiares, estatus social y salud del hombre. Participantes entendieron que TAR reduciría riesgo de transmitir VIH, minimizaría pérdida de empleos, productividad, y ayudaría a preservar su rol como tomadores de decisiones y proveedor. Adherencia al TAR se entendió como medio para reducir estigma del VIH, no obstante preocupaciones sobre divulgación involuntaria. TAR se entendió como forma de mejorar la salud pero restringiendo actividades del hombre. Efectos secundarios resaltaron como gran reto. Utilizando estos hallazgos, enfoques de cambio social y de comportamiento pueden mejorar participación del hombre en el continuo de atención del VIH.

Notes

Acknowledgements

The authors would like to acknowledge the men and health workers who so graciously shared their stories and invaluable information with us for this research study. We would also like to thank the data collection team who expertly gathered the narratives of men presented here and provided input during the data analysis process. The research presented here was supported by funding from PEPFAR through the United States Agency for International Development [Cooperative Agreement #AID-OAA-A-12-00058] to the Johns Hopkins Center for Communication Programs. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the United States Government, USAID, PEPFAR, or any other affiliate organizations or institutions.

Compliance with Ethical Standards

Conflict of interest

Two of the authors, Seifert Ahanda and Thaddeus, were employed by the funding agency at the time of data collection.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Zoé Mistrale Hendrickson
    • 1
    • 2
    • 6
    Email author
  • Danielle A. Naugle
    • 1
  • Natalie Tibbels
    • 1
  • Abdul Dosso
    • 3
  • Lynn M. Van Lith
    • 1
  • Elizabeth C. Mallalieu
    • 1
  • Diarra Kamara
    • 3
  • Patricia Dailly-Ajavon
    • 3
  • Adama Cisse
    • 3
  • Kim Seifert Ahanda
    • 4
  • Sereen Thaddeus
    • 4
  • Stella Babalola
    • 1
    • 2
  • Christopher J. Hoffmann
    • 5
  1. 1.Johns Hopkins Center for Communication ProgramsBaltimoreUSA
  2. 2.Health Behavior & Society DepartmentJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Johns Hopkins Center for Communication ProgramsAbidjanCôte d’Ivoire
  4. 4.United States Agency for International DevelopmentWashingtonUSA
  5. 5.School of MedicineJohns Hopkins UniversityBaltimoreUSA
  6. 6.BaltimoreUSA

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