Men's perceptions of HIV care engagement at the facility- and provider-levels: Experiences in Cote d'Ivoire

Men in sub-Saharan Africa have lower rates of HIV testing and are less likely to initiate treatment compared to women. Service delivery dimensions are a key factor in facilitating engagement along the HIV treatment continuum for men and women, yet male specific overall perceptions of the service del...

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Bibliographic Details
Published in:PloS one 2019-03, Vol.14 (3), p.e0211385-e0211385
Main Authors: Tibbels, Natalie Jean, Hendrickson, Zoé Mistrale, Naugle, Danielle Amani, Dosso, Abdul, Van Lith, Lynn, Mallalieu, Elizabeth C, Kouadio, Anne Marie, Kra, Walter, Kamara, Diarra, Dailly-Ajavon, Patricia, Cisse, Adama, Seifert-Ahanda, Kim, Thaddeus, Sereen, Babalola, Stella, Hoffmann, Christopher J
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
Adult
Africa South of the Sahara
AIDS
AIDS treatment
Antiretroviral drugs
Antiretroviral therapy
Attitude to Health
Beliefs, opinions and attitudes
Biology and Life Sciences
Care and treatment
Cognitive biases
Communication
Cote d'Ivoire - epidemiology
Counseling services
Côte d'Ivoire
Disclosure of information
Drug therapy
Focus Groups
Health aspects
HIV
HIV infections
HIV Infections - diagnosis
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV tests
Human immunodeficiency virus
Humans
Male
Management
Mass Screening
Medical care
Medical decision making
Medical diagnosis
Medical personnel
Medical tests
Medicine and Health Sciences
Men
Men - psychology
Middle Aged
Patient Acceptance of Health Care - psychology
People and Places
Perception
Public health
Qualitative analysis
Research and Analysis Methods
Retirement benefits
Self disclosure
Social interactions
Social Stigma
Social support
Sociology
Women
Workers
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Description
Summary:Men in sub-Saharan Africa have lower rates of HIV testing and are less likely to initiate treatment compared to women. Service delivery dimensions are a key factor in facilitating engagement along the HIV treatment continuum for men and women, yet male specific overall perceptions of the service delivery environment have received little attention in West Africa. This study draws on qualitative data collected in Côte d'Ivoire to explore provider-level and structural factors affecting men's engagement in HIV testing and treatment through interviews and focus group discussions conducted with health workers and men living with HIV (some on ART) or whose HIV status was unknown. Factors influencing decisions to test or initiate treatment were considered in terms of perceived benefits and costs. Men described costs at the interpersonal (client-provider) level, such as unwanted disclosure or stigma, which were weighed against the potential for social support and clinical guidance. Likewise, fear of unwanted disclosure operated at the facility level, as the layout of facilities sometimes grouped clients living with HIV together. Notably, the benefits men described from engaging in HIV testing and care all operated at the interpersonal level and none at the facility level. In light of the fact that provider- and facility-level factors influenced the perceptions and experiences of men along the treatment continuum, we offer recommendations to reduce barriers to testing and engagement in care related to service delivery.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0211385