Barriers For Men Research Articles

Men’s perceptions of HIV self-testing in Eswatini: a qualitative study

ABSTRACT Men in Eswatini test for HIV at lower rates compared to women despite the widespread availability of HIV testing services in the country. HIV self-test kits have been proposed as an HIV testing model to reach more men by bypassing the health facility, which is known to be a barrier for men using HIV testing services. In this study, we sought to understand men’s perspectives on HIV self-testing in Eswatini. We conducted semi-structured interviews with 22 men, recruited from a rural community and from an urban men’s clinic, to assess their awareness of HIV self-testing and their perceptions of it as an alternative HIV testing option. Findings show that men were aware of HIV self-testing but had concerns that left most feeling hesitant about adopting it. Many men expressed doubts about the accuracy of self-testing and their own technical competence to use the kit without supervision. They also expressed fears about testing, and possibly learning they were HIV positive, without adequate pre – and post-HIV test counseling. To allay men’s fears and improve uptake of HIV self-testing, practitioners might consider innovative methods such as virtual counseling services and linking HIV self-testing to other community-based HIV care services.

Perceptions of Pre-exposure Prophylaxis (PrEP) for HIV prevention among men living with HIV in the context of reproductive goals in South Africa: a qualitative study

BackgroundPre-exposure Prophylaxis (PrEP) and Treatment as Prevention (TasP) are effective strategies to prevent HIV transmission within serodifferent couples. However, limited usage of PrEP, knowledge and interest has been amongst the barriers for men, alongside testing and treatment adherence. We explored the perceptions of PreP for HIV prevention with Men living with HIV (MWH) who have reproductive goals, to understand awareness and experiences related to PrEP use in the context of HIV prevention with their partners.MethodsWe undertook a qualitative study with 25 MWH aged 18 to 65 between April and September 2021 in South Africa. Potential participants were screened for eligibility and scheduled to participate in telephonic interviews. Interviews were audio recorded, transcribed, translated and thematically analysed.ResultsThemes were organized into opportunities and barriers that men with HIV articulate as important for using PrEP to meet individual, couple, and community reproductive goals. At the individual level, some men were willing to discuss PrEP with their partners to protect their partners and babies from acquiring HIV. Lack of knowledge about PrEP among men was a potential barrier to promoting PrEP among their female partners. At the couple level, PrEP use was seen as a way to strengthen relationships between partners, signifying care, trust, and protection and was seen as a tool to help serodifferent couples meet their reproductive goals safely. At the community level, PrEP was viewed as a tool to promote HIV testing and prevention efforts, especially among men, but participants emphasized the need for more education and awareness.ConclusionDespite PrEP implementation in South Africa, awareness of PrEP among men with HIV in rural areas remains low. Engaging MWH to support their partners in accessing PrEP could be an innovative strategy to promote HIV prevention. Additionally, providing men with comprehensive reproductive health information can empower them to make more informed decisions, adopt safer sexual practices, and challenge societal norms and stigmas around HIV.

Barriers to access cancer‐related services for men in high‐income countries: A narrative review looking beyond socioeconomic disadvantages

AbstractIntroductionCancer screening programs are routinely available in high‐income countries, but participation rates are low, especially among men. This narrative review aims to identify male‐specific access barriers to cancer‐related healthcare in high‐income countries that offer statutory insurance/subsidized health care.MethodsWe searched PubMed, Science Direct, and Web of Science for peer‐reviewed journal articles published within the past 10 years on cancer healthcare access, help‐seeking behavior, and men. Step‐wise screening of title, abstract, and full text resulted in 23 studies that fit the selection criteria for findings in high‐income countries. The results were analyzed descriptively using qualitative thematic synthesis.ResultsIn the reviewed studies, barriers for men in accessing cancer‐related healthcare offers could be broadly categorized under sociocultural norms, personal behaviors, and structural problems. The most common barriers were related to sociocultural influences and included notions of masculinity, distrust in the medical system, and personnel/social commitments. Major personal barriers included fear of getting cancer or screening methods, lack of awareness about cancer, and problems in communication with healthcare professionals. Accessibility and lack of insurance were reported as common structural barriers.ConclusionsThe reluctance of men in approaching medical help was rooted in sociocultural norms of traditional masculinity with direct and indirect consequences such as fear, lack of awareness, distrust of medical personnel, and problems in communicating with healthcare professionals. Gender‐specific, male‐oriented information via digital, anonymous interventions may be helpful for increasing participation of men in cancer care.

Gender differences in retirement transition goals and barriers: a case study in the university sector

ABSTRACT Australia’s retirement system is often heralded as world-class. Yet research investigating the superannuation system has reported highly gendered outcomes even in the university sector, which has generous superannuation provisions and established career management practices. This study investigates gender differences in retirement transition goals and barriers in the sector. Data from university employees who are 50 years or older show that gender differences exist. Women are more likely than men to be frustrated in their attempts to transition into retirement as desired and are more likely to desire a reduction in workdays per week. Men are more likely to prefer to continue working as currently or to reduce responsibility. Economic reasons are more likely to be the barrier for women, while organisational reasons are more likely to be the barrier for men.

Barriers to Career Advancement in the Hotel Industry in Timor-Leste: Study of Gender Stereotyping, Old Boys’ Network and Gender Differences

The hotel industry in Timor-Leste is female-dominated. However, women are under-represented in managerial and senior executive positions. This study examines the relative importance of gender stereotyping and old boys’ network variables as barriers that impact women’s and men’s career advancement in the hotel industry in Dili, Timor-Leste. A survey questionnaire was distributed at 20 hotels in Dili, Timor-Leste, and 16 hotels granted approval, represented by 385 individuals (226 women and 159 men). These data were analyzed using structural equation modeling. The results from this study indicated that gender stereotyping had a significant influence as a barrier to career advancement. Old boy’s network had no significant barrier to the career advancement for both in women versus men comparison. Furthermore, the male group scores higher than the female group in the variables of stereotyping in gender differences analysis as the higher scores represent the biases against women. This study is the first study to examine barriers for individuals’ career advancement in the hotel industry of Dili, Timor-Leste. This study suggests theoretical and practical implications on barriers for men’s and women’s career advancement and mitigates gender inequality in the organization.

Barriers to HIV care in Uganda and implications for universal test-and-treat: a qualitative study

ABSTRACT Achieving universal HIV test-and-treat will require targeted interventions for those with worse outcomes, including advanced HIV. We conducted qualitative, semi-structured interviews with healthcare workers (HCWs) and people living with HIV (PLWH) at 5 HIV clinics in Kampala, Uganda, to understand barriers to care. PLWH enrolled started/restarted on HIV treatment ≤3 months prior. PLWH were grouped as 1) “ART-experienced” or those restarted therapy after ≥12 months off, 2) ART naïve CD4 count <100 cells/uL “late presenters” or 3) ART naïve CD4 count >350 cells/uL “early presenters”. In-depth interviews were conducted in Luganda, translated, and transcribed verbatim. Between May and August 2017, 58 PLWH and 20 HCWs were interviewed. High stigma and low social support emerged as themes among all as barriers to care. Alcohol abuse was a barrier for men. Fear of domestic violence and abandonment were barriers for women, limiting disclosure of their HIV status to their male partners. Clinic factors such as rapport with staff, distance, efficiency, and privacy impacted care. Future interventions to decrease delayed ART initiation should target stigma and social support. Assisted disclosure, contact tracing, and alcohol abuse treatment should be implemented. Strengthening client support, reducing wait times, and increasing privacy assurances would improve care-seeking behaviors.

“There may be a problem, but I’m not going because…”: examining classes of men and their rationales for not seeking mental health treatment

Background Men are less likely than women to seek out mental health treatment, despite men also having mental health struggles. Aim We examined typologies of men’s reasons for not seeking treatment even though they perceived a need for treatment. Method We conducted a latent class analysis using a U.S. national sample of 836 men who specifically indicated a need for mental health services, but did not seek treatment from the National Study on Drug Use and Health. Results We identified three distinct types of men and their unique rationales for not seeking treatment: positive attitudes class, perceived high behavioral control class, and negative attitudes class. Conclusions Unique strategies to market clinical services to each of the various needs and concerns of these types of men may prove more beneficial than a generic outreach approach. We encourage mental health professionals to proactively educate men about their services and aim to reduce barriers for men seeking treatment.

Service user and healthcare provider perspectives on barriers for men using sexually transmitted infection services in public hospital of Nepal: a qualitative study

ABSTRACT Background In a time of rapid modernization in Nepal, most Nepalese men are engaging in more risky sexual health behaviours. As most of these Nepali men have little factual information or guidance about sexual health or access to health care, it is imperative to explore how and if there remain particular barriers to sexual health service use for sexually transmitted infection (STI) prevention, screening and treatment. Our study explored the perspectives of healthcare providers and Nepalese men as service users who access public hospital in Nepal, regarding the barriers to STI service use. Methods 18 semi-structured interviews were conducted through purposive sampling for healthcare service providers while Nepali male service users between age 25–49 years were interviewed following a convenience sampling. Qualitative thematic analysis, separately for providers and service users was conducted in order to identify varying perspectives regarding barriers to STI service use. Results The main barriers by healthcare providers include low health literacy, poor user-provider interaction, overcrowding in service delivery, and in maintaining confidentiality. Service users mentioned about poor sexual health knowledge and confidentiality remain a concern, while both groups mentioned about fear of infection with STI as a facilitator factor in availing sexual health service screening and treatment. Conclusion Our data identify complexities of delivering sexual health services to Nepali men and barriers to service use. The data suggest that there is a need for greater education regarding STIs and related services, and also consideration of the various cultural factors that influence service use in Nepal.

Is there any association between prostate-specific antigen screening frequency and uptake of active surveillance in men with low or very low risk prostate cancer?

BackgroundPatient-related factors such as concern about cancer are believed to influence both men’s decisions to undergo prostate specific antigen (PSA) testing and to have definitive treatment if diagnosed with low risk prostate cancer (PCa). The potential link between screening frequency and choice of active surveillance (AS) for low risk disease has not been studied previously. Our aim was to investigate whether there is any association between PCa screening frequency or previous negative prostate biopsy and uptake of AS among men with low risk PCa.MethodsThis register-based study included all men ≤75 years from Stockholm who were diagnosed with low risk PCa from 2008 to 2014 (n = 4336). Pre-diagnostic PSA testing and biopsy histories were obtained from the Stockholm PSA and Biopsy Register, a population-based register for the Stockholm country. The association between previous screening/biopsy history and AS uptake (based on primary treatment recorded in the National Prostate Cancer Register) was examined using multivariable logistic regression.ResultsForty seven percent of men with low risk PCa underwent AS. Uptake was associated with older age, very low risk disease, more recent diagnosis and absence of family history. None of the screening/biopsy measures (testing frequency, mean interval, PSA velocity, highest pre-diagnostic PSA or prior negative biopsy) were associated with uptake of AS among men with low risk PCa. Generalisability to settings with different policies and practices may be limited.ConclusionWe found no evidence that screening frequency and negative biopsy influence uptake of AS among Swedish men with low risk PCa. Further research is required to determine factors that still present barriers for men taking up AS.

Gender, Depressive Symptoms, Chronic Medical Conditions, and Time to First Psychiatric Diagnosis among American Older Adults.

Background:To test whether gender moderates the effects of baseline depressive symptoms and chronic medical conditions (CMCs) on risk of receiving subsequent psychiatric diagnosis among older adults.Methods:Data came from ten waves of the Health and Retirement Study, a nationally representative longitudinal study. We followed 9794 individuals older than 52 years without any diagnosed psychiatric disorder at baseline for up to 18 years. Baseline depressive symptoms and CMC were the predictors, time to receiving an emotional diagnosis was the outcome, baseline demographics and socioeconomics were controls, and gender was the moderator. We used Cox proportional hazards models for data analysis.Results:In the pooled sample, female gender increased the effect of baseline depressive symptoms (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.26–2.00) and reduced the effect of baseline CMC (HR, 0.78; 95% CI, 0.63–0.97) on time to receiving a psychiatric diagnosis. Among men, baseline depressive symptoms (HR, 2.36; 95% CI, 1.87–2.97) increased and baseline CMC (HR, 0.81; 95% CI, 0.69–0.95) decreased time to receiving a psychiatric diagnosis. Among women, depressive symptoms (HR, 1.49; 95% CI, 1.21–1.83) but not CMC (HR, 1.06; 95% CI, 0.91–1.23) were associated with time to receiving a psychiatric diagnosis over time.Conclusions:Men and women differ in how depressive symptoms and CMC influence their risk of receiving a psychiatric diagnosis over time. Depressive symptoms are more salient promotor for men than women while CMC is only a barrier for men.

No Room to "Lean In": A Qualitative Study on Gendered Barriers to Promotion and Leadership.

The gender gap in professorship and leadership roles persists in academic medicine, whereas reasons for these disparities remain unclear. Open-ended text responses to a 2013 faculty engagement survey were analyzed by using the grounded theory and consensual qualitative analysis techniques. The authors grouped 491 faculty's text responses into descriptive codes and three themes: (1) No Obstacles, (2) Barriers to Success, and (3) Concerns Regarding Processes. Demographics of codes were compared by using chi-square analysis. Male faculty identified barriers that included negative views of leadership or leaders. Female faculty, especially those in clinical roles, expressed barriers related to role overload, including that the demands of their current positions prevented advancement or addition of further roles, no matter how desirable further roles may be. Women also shared that considerable self-promotion was required to receive acknowledgement of their work and support by leadership. A proposed framework depicts male and female faculty's concerns on a continuum. No Obstacle and Process Concerns were relatively gender neutral, whereas large gender disparities occurred within the Barriers to Success theme. Women's barriers largely revolved around internal obstacles (I can't do any more), and men's barriers largely revolved around external factors (leaders are impeding my progress). Resources are needed to mitigate work overload specifically for female faculty, and to ensure that all faculty are both engaged in advanced career opportunities and encouraged to pursue leadership positions.

Gender Bias Within the Superintendency

&#x0D; &#x0D; &#x0D; Current research reveals a large per- centage of teaching positions and administrative ser- vices credentials are held by women, although histori- cally, men dominate the superintendent role. Specifically, in the area of women in the superintendency, a discrepancy exists between men and women in recruitment practices, types of barriers and challenges, and the length of time one stays in the superintendent position. This study examines the superintendent role and the perceived leadership qualities necessary, barriers, challenges, and opportunities, as well as the career pathway taken by those in the superintendent role. With a mixed-method design, the study reflects upon responses from six superintendents, three wom- en and three men, using semi-structured interview questions and data collected with Bolman and Deal’s (1990) Leadership Orientations (Self) Instrument and a demographics survey. A theoretical framework of management and leadership styles was utilized to analyze the data for themes relating to the three research questions. The findings generally indicated women superintendents perceive they are expected to act and behave differently to succeed in the role, while men are more at ease with making decisions and leading others. Gender biases were found to be prevalent for women, as the role of parenthood was the biggest barrier when considering their career pathway. This was not found to be a barrier for men.&#x0D; &#x0D; &#x0D;

Perceptions about the cultural practices of male partners during postpartum care in rural Tanzania: a qualitative study

ABSTRACT Background: Men play an important role in maternal health. The postpartum period is a critical stage, yet there is a scarcity of research that explores men’s involvement during this stage. Objective: The aim of the study was to explore male partners’ perceptions of the cultural practices during postpartum care in rural Tanzania. Methods: Fourteen focus group discussions were conducted with 93 men, with an age range of 19–65 years, in August 2013. The study was conducted in the Kongwa District, located in the Dodoma region in central Tanzania. Qualitative data were digitally recorded, transcribed verbatim and analyzed using content analysis. Results: Four categories emerged, namely: ‘Men as providers and, occasionally, care takers’, ‘Men as decision makers’, ‘Diverse perceptions of sexual abstinence’ and ‘Barriers for men in using/accompanying partners to use reproductive and child healthcare services’. The cross-category theme ‘Men during postpartum: remaining powerful but excluded’ refers to how men are in a powerful position above women in different aspects of life. Elderly women played an important role in caring for postpartum mothers and their newborns, but men were the ones making the final decision about where to seek care. Traditional practices isolated men from their partners for a certain period, and enforced sexual abstinence for the women during the postpartum period. However, cultural norms permitted men to engage in extramarital relations. Reproductive and child healthcare services were perceived by men as not welcoming the male partners, and local gender norms discouraged men from accompanying their partners to seek services. Conclusions: In this study, we found that men perceived their role during the postpartum period as financial providers, decision makers and, occasionally, care givers. Men also held diverse perceptions with regard to sexual abstinence and felt excluded from participating in maternal healthcare services.

A mathematical approach for assessing the transport of large neutral amino acids across the blood-brain barrier in man

Changes in the large neutral amino acid (LNAA) transport across the blood-brain barrier (BBB) is thought to contribute to brain dysfunction in a number of clinical conditions, including phenylketonuria, acute liver failure, and sepsis. Here, we present a novel approach for estimating BBB permeability and the LNAA concentrations in brain extracellular fluid, by demonstrating that they can be mathematically derived on the basis of kinetic constants of the BBB available from the literature, if cerebral blood flow and the arterial and jugular venous LNAA concentrations are known. While it is well known that the permeability surface area product of the BBB to a LNAA from blood to brain (PS1) can be calculated from the arterial LNAA concentrations and kinetic constants of the BBB, we demonstrate that the permeability surface area product from brain to blood (PS2) can be calculated by deriving the substrate activity of the saturable transporter from the kinetic constants and arterial and jugular venous LNAA concentrations, and that the concentration of the LNAA in brain extracellular fluid can then be determined. This approach is methodically simple, and may be useful for assessing the transcerebral exchange kinetics of LNAAs in future human-experimental and clinical studies.

Barriers and Strategies to Participation in Tissue Research Among African-American Men.

Before the burgeoning field of biospecimen collection can advance prevention and treatment methods, researchers must access diverse molecular data samples. However, minorities, especially African-American men, remain reticent to join these studies. This study, using theory-based approaches, investigated African-American men's barriers to participating in biorepository research. Fourteen focus groups were conducted among 70 African-American men (ages 40 to 80). The groups were stratified by prostate cancer history and educational attainment background. Participants identified perceived factors that promoted or hindered study participation when questioned about their knowledge and attitudes about biospecimen research. Ninety-four percent of participants indicated never participating in a study that collected biological samples. Barriers to their participation included lack of knowledge and understanding regarding biospecimen research practices and uses. In addition, they extensively cited a prevalent mistrust of the medical community and discomfort with study recruitment practices. African-American males were more willing to participate in biorepository studies with physician endorsement or if they understood that participation could benefit future generations. Men also wanted more recruitment and advertising done in familiar places.

A qualitative study of Chinese Canadian fathers' smoking behaviors: intersecting cultures and masculinities.

BackgroundChina is home to the largest number of smokers in the world; more than half of the male population smoke. Given the high rates of Chinese immigration to Canada and the USA, researchers have explored the effect of immigration on Chinese smokers. Reduced tobacco use among Chinese immigrants has been reported in the United States; however, little is known about the social factors underlying men’s smoking practices in settings where tobacco control measures have denormalized smoking, and in the context of fatherhood. The purpose of this Canada-based study was to explore the smoking-related experiences of immigrant Chinese fathers.MethodsIn this qualitative study, semi-structured telephone interviews were conducted with 22 Chinese Canadian fathers who smoked or had recently quit smoking, and had at least one child under the age of five years old.ResultsThe Chinese fathers had dramatically changed their smoking patterns due to concern for their children’s health and social norms and restrictions related to smoking in Canada. The facilitators and barriers for men’s smoking were intertwined with idealized masculine provider and protector roles, and diverse Canadian Chinese cultural norms related to tobacco use.ConclusionsThe findings have implications for the development of future smoking cessation interventions targeting Chinese Canadian immigrant smokers as well as smokers in China.

Married Men Perceptions and Barriers to Participation in the Prevention of Mother-to-Child HIV Transmission Care in Osogbo, Nigeria.

Men's role in HIV prevention is pivotal to changing the course of the epidemic. Men's barriers toward participation in Prevention of Mother-to-Child Transmission (PMTCT) have not been adequately documented. This study is therefore designed to determine men's level of awareness and barriers to their participation in PMTCT programmes in Osogbo, Nigeria. This study was a descriptive qualitative one that utilized Focus Group Discussion (FGD). One-hundred and sixty married men were selected by convenience sampling and interviewed. Data collected were analysed using content analysis technique. Demographic data were analysed using SPSS 15.0 software to generate frequency tables. Participants mean age was 31.9 ± 5.9 years. Many of the participants had heard about PMTCT and the majority agreed that it is good to accompany their wife to Antenatal Care (ANC) but only few had ever done so. Societal norms and cultural barriers were the leading identified barriers for male involvement in PMTCT programmes. The majority of the participant perceived it was a good idea to accompany their wife to antenatal care but putting this into practice was a problem due to societal norms and cultural barriers. Community sensitization programmes such as health education aimed at breaking cultural barriers should be instituted by government and nongovernmental agencies.

Do College Students’ Gender-typed Attitudes About Occupations Predict Their Real-World Decisions?

We investigated US college students’ gender-typed attitudes about occupations for themselves as a predictor of their real-world decisions regarding an academic major and intended future career. We also investigated US college students’ attitudes about the appropriateness of gender-typed occupations for other men and women. The sample (N = 264) was mostly Caucasian and was drawn from a large state university in the Mid-Atlantic region of the US. An established self-report measure (see Liben and Bigler 2002) was used to assess attitudes about occupations for the self and other people. Gender-typed majors and intended careers were categorized using a coding scheme that was developed for the study. College students preferred gender-stereotypical occupations for themselves. Women’s, but not men’s, preferences for gender-typed occupations predicted their decisions about their academic major and the career they intended to pursue. Both men and women reported that men should only hold masculine occupations, but that women should hold both masculine and feminine occupations. We discuss the implications of our results for understanding the gender gap in occupations in the US, such as the underrepresentation of women in STEM careers and barriers for men in stereotypically female occupations.

Gender differences in diabetes self-management among African American adults.

The rising incidence of diabetes complications among African Americans is a major health concern. Few studies have addressed gender differences in diabetes self-management in this population. The purpose of this study was to determine whether gender differences in facilitators and barriers to self-management exist among African American adults with type 2 diabetes. Thirty-eight participants were recruited from community agencies and each participated in one of seven audio-recorded focus group sessions. Regular health care visits, positive outlook, prioritization of health, and independence facilitated self-management behaviors in men, whereas acceptance of diabetes was a facilitator for women. Lack of time at work, lack of family support, and lack of knowledge were barriers for men, whereas lack of finances, embarrassment, negative outlook, perceived lack of disease control, and adverse effects of medications were barriers for women. Further research is necessary to design and test gender-specific tailored interventions to improve diabetes self-management in this population.

Synthesis and preclinical evaluation of [11C]D617, a metabolite of (R)-[11C]verapamil

(R)-[(11)C]verapamil is widely used as a positron emission tomography (PET) tracer to evaluate P-glycoprotein (P-gp) functionality at the blood-brain barrier in man. A disadvantage of (R)-[(11)C]verapamil is the fact that its main metabolite, [(11)C]D617, also enters the brain. For quantitative analysis of (R)-[(11)C]verapamil data, it has been assumed that the cerebral kinetics of (R)-[(11)C]verapamil and [(11)C]D617 are the same. The aim of the present study was to investigate whether the cerebral kinetics of (R)-[(11)C]verapamil and [(11)C]D617 are indeed similar and, if so, whether [(11)C]D617 itself could serve as an alternative PET tracer for P-gp. [(11)C]D617 was synthesized and its ex vivo biodistribution was investigated in male rats at four time points following intravenous administration of [(11)C]D617 (50 MBq) without (n=4) or with (n=4) pretreatment with the P-gp inhibitor tariquidar (15 mg·kg(-1), intraperitoneally). Brain distribution was further assessed using consecutive PET scans (n=8) before and after pretreatment with tariquidar (15mg·kg(-1), intravenously), as well as metabolite analysis (n=4). The precursor for the radiosynthesis of [(11)C]D617, 5-amino-2-(3,4-dimethoxy-phenyl)-2-isopropyl-pentanitrile (desmethyl D617), was synthesized in 41% overall yield. [(11)C]D617 was synthesized in 58%-77% decay-corrected yield with a radiochemical purity of ≥99%. The homogeneously distributed cerebral volume of distribution (V(T)) of [(11)C]D617 was 1.1, and this increased 2.4-fold after tariquidar pretreatment. V(T) of [(11)C]D617 was comparable to that of (R)-[(11)C]verapamil, but its increase after tariquidar pretreatment was substantially lower. Hence, (R)-[(11)C]verapamil and [(11)C]D617 do not show similar brain kinetics after inhibition of P-gp with tariquidar.