Abstract
BackgroundCurrent data from Uganda indicate that, compared to women, men are under-represented in HIV treatment, seek treatment later and have a higher mortality while on antiretroviral therapy (ART). By focusing on a masculine work ethic as one of the most predominant expressions of masculinity, this study explores why for some men HIV treatment enhances their masculinity while for others it undermines masculine work identity, leading them to discontinue the treatment.MethodsParticipant observation and 26 in-depth interviews with men were conducted in a gold mining village in Eastern Uganda between August 2009 and August 2010. Interviewees included men who were taking HIV treatment, who had discontinued treatment, who suspected HIV infection but had not sought testing, or who had other symptoms unrelated to HIV infection.ResultsMany participants reported spending large proportions of their income, alleviating symptoms prior to confirming their HIV infection. This seriously undermined their sense of masculinity gained from providing for their families. Disclosing HIV diagnosis and treatment to employers and work colleagues could reduce job offers and/or collaborative work, as colleagues feared working with “ill” people. Drug side-effects affected work, leading some men to discontinue the treatment. Despite being on ART, some men believed their health remained fragile, leading them to opt out of hard work, contradicting their reputation as hard workers. However, some men on treatment talked about “resurrecting” due to ART and linked their current abilities to work again to good adherence. For some men, it was work colleagues who suggested testing and treatment-seeking following symptoms.ConclusionsThe central role of a work ethic in expressing masculinity can both encourage and discourage men's treatment-seeking for AIDS. HIV testing and treatment may be sought in order to improve health and get back to work, thereby in the process regaining one's masculine reputation as a hard worker and provider for one's family. However, disclosure can affect opportunities for work and drug side-effects disrupt one's ability to labour, undermining the sense of masculinity gained from work. HIV support organizations need to recognize how economic and gender concerns impact on treatment decisions and help men deal with work-related fears.
Highlights
Current data from Uganda indicate that, compared to women, men are under-represented in HIV treatment, seek treatment later and have a higher mortality while on antiretroviral therapy (ART)
They subscribed to various constructs of masculinity including those related to marriage and sexual achievement, respectability, being outgoing, male oriented friendships, work ethic and ‘‘sacrifice’’ for family, moneymaking and property ownership
Not all men in the village displayed all of these attributes all of the time and in equal measure, these ideals more or less provided the framework within which men interpreted the meaning of undertaking HIV testing and/or treatment
Summary
Current data from Uganda indicate that, compared to women, men are under-represented in HIV treatment, seek treatment later and have a higher mortality while on antiretroviral therapy (ART). Economic disadvantage and poverty; cultural practices such as widow inheritance; sexual double standards that favour men’s sexual infidelity; and a power imbalance in decision-making processes in the domestic and societal spheres are major drivers of HIV risk among women in SSA [2,3]. In this context, there are legitimate policy concerns about the impacts of HIV-related disease on women. This paper attempts to address this gap by focusing on how masculinity expressed in terms of work ethic influences men’s response to the need to test and seek HIV treatment among the Iteso men of MamKiror village, Busia District, Eastern Uganda. We adopt the participants’ understanding and refer to both ART and Septrin drugs (cotrimoxazole) as HIV treatment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
