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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


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.


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.

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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.

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Correspondence to Zoé Mistrale Hendrickson.

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

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Hendrickson, Z.M., Naugle, D.A., Tibbels, N. et al. “You Take Medications, You Live Normally”: The Role of Antiretroviral Therapy in Mitigating Men’s Perceived Threats of HIV in Côte d’Ivoire. AIDS Behav 23, 2600–2609 (2019).

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