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
By Shawn Malone, Project Director, The Mpilo Project, PSI, South Africa
June is Men’s Health Month, and while the focus is on men’s attitudes about their health, we’ve also been reflecting on the health sector’s attitudes about men.
We hear many stereotypes about men and health. “Men are apathetic about their health.” “Men are poor health-seekers.” “Men are stubborn and difficult patients.” But how many of those are actually true?
The 11th South Africa AIDS Conference just concluded, and in one of the plenary sessions we had the opportunity to respond to the question: “Strategies for reaching men—are we seeing a return on investment?”
The short answer: Yes!
Since 2017, the percentage of men with HIV in South Africa who know their status has increased from 78% to 94%, nearly on par with women. We can attribute that in part to approaches like HIV self-testing that have made it quick, easy and private for men to learn their status.
We’ve also seen good progress on viral suppression, which has increased from 82% to 93%, again comparable to the rate among women – proof that men on treatment are fully capable of being adherent.
Yet only 70% of men who know they have HIV are currently on treatment – hardly any increase at all from 68% in 2017.
Given the progress we’ve seen in men testing for HIV and achieving viral suppression, the persistent gap in men on treatment suggests that something is wrong not with men but with the HIV treatment services and support we are offering them.
The good news is that we know much more than we did a few years ago about what works. By leveraging user insights, robust evidence, and empathy-based approaches, we’re able to better understand men’s mindsets and barriers and to co-create solutions that respond to men’s needs and preferences – an approach we call Consumer-Powered Healthcare.
A few examples:
- The MINA campaign aims to reach men with “the new HIV story” of being able to live a long, healthy, happy life with HIV, and to help them feel more welcome in the clinic. MINA-supported districts and facilities have seen strong growth in testing and linkage, as well as modest improvement in retention.
- The Coach Mpilo model employs men who are thriving with HIV as coaches of men at risk of non-initiation or disengagement. Coaches provide a safe, relatable source of support and serve as living proof that HIV is not the end of the road. The model is achieving 97% linkage and 94% retention.
- The B-OK bead bottles are a simple visual tool for helping people to understand the benefits of HIV treatment and viral suppression and, more importantly, building the motivation to start. and stay on treatment. In a joint Indlela/Mpilo Project evaluation of the tool, awareness of U=U increased from 7% to 99%.
Men are not indifferent about their health, and they are not inherently poor health-seekers. If they seem to be avoiding us, let’s consider that it may be because we are not giving them what they need.
We’ve seen that men do engage when we…
- meet them where they are (rather than where we want them to be)
- speak to their needs and priorities (rather than ours)
- give them the right sources of support (rather than one-size-fits-all)
- help them build understanding and motivation (rather than simply instructing)
When we invest, we see returns. Let’s keep investing in scaling what works.
Happy Men’s Health Month!
