Our research found that the way HIV testing and treatment is offered makes a big difference for men’s use of care. Unlike women, men are not targeted by HIV policies to ensure they are tested and treated. As a result, heterosexual men have become a marginalised group when it comes to HIV services. They are systematically disadvantaged in their access to care.
We found that in southern Malawi there are limited options available for men to test and start treatment. They must seek out HIV services for themselves and are not actively recruited as is the case with pregnant women.
Men who do choose to get tested can go to a public or private clinic. Both scenarios present problems.
Public clinics are typically tailored to women. They are inevitably crowded with women waiting to see a nurse, increasing waiting times for services and making public clinics “woman’s spaces” that men believe are not intended for them. In smaller public facilities, HIV services may only be available during hours when pregnant women are served. This again limits men’s access to care. When HIV services are so focused on women, can we expect men to access them?
Private clinics provide a more male-friendly alternative, but paying for care is a luxury most cannot afford.
The alternative is to forego testing altogether. For many, this will mean an untimely death.