Why men shun HIV testing

Dar es Salaam. The joint United Nations Programme on HIV/Aids (UNAIDS) launched the 95-95-95 treatment strategy in 2014 to set a target to diagnose 95 percent of all HIV-positive individuals, provide antiretroviral (ARV) therapy for 95 percent of those diagnosed, and achieve viral suppression for 95 percent of those treated by 2030.

According to different reports on how far the implementation of the target has gone, there is a light at the end of the tunnel; however, more efforts need to be made to address the challenges of engaging men in underprivileged communities.

In this year’s Tanzania Health Summit, which had more than 40 health forums, the topic of what it takes to reach men with HIV prevention services was among other forums discussed.

The forum aimed at sharing experiences and best practices for effectively reaching men with HIV prevention services as medical experts, practitioners, and stakeholders discussed the challenges of engaging men and shared the best practices on how some barriers can be addressed.

A random survey by The Citizen revealed that, apart from it being challenging to reach out to men in underprivileged communities, the majority of men shun away going for HIV tests compared to their female counterparts due to stigma, cultural issues, and gender norms, to mention a few.

Charles Maregesi is a fishermen at Murangi in Tarime District. For him being a fisherman and again as a Kurya makes him among other men who go through cultural norms in accessing HIV prevention services.

According to a study conducted in 2021 by the government titled Traditional Male Circumcision Practices Among the Kurya of North-eastern Tanzania and Implications for National Programmes, there was a high regard for traditional male circumcision as it is not just a way of upholding cultural practices; it is also associated with bravery since anesthetics are not used during the procedure.

Traditional male circumcision poses a risk of HIV transmission as it is done using the very same knife and in an unhygienic situation, while medical circumcision reduces the risk of HIV transmission by 60 percent, according to Dr Ngwegwe Damas, the HIV Coordinator in Serengeti District Hospital.

He said men in his community are facing cultural barriers, and it stops them from accessing the HIV prevention services, and that is the reason why the hospital came up with a campaign to educate the community on the health dangers men are likely to get by not acquiring the health services due to cultural barriers.

Maregesi said he is HIV positive, and he is not sure of where he got the disease from.

Going to hospital for ARV

Treatment is not a cure for HIV, it does not remove HIV from your body completely and is also a challenge, as his work is in a remote area, and it takes courage to go to hospital with the fear of being noticed by his community that he is HIV positive.

As part of the suggested best practices by the health experts in reaching out to more men in the mining and fishing activities for them to be able to be involved in getting HIV prevention services, outreach programmes came in as a major practice.

Community outreach volunteer Cleopatra Dhaje is part of the outreach programme to mobilise and educate the high-risk population in the mining and fishing camps in Mara Region.

“I have been doing this for more than five years now. I was trained on how to approach different people and encourage them for HIV self-testing, starting a conversation on changing their behaviours as a way of preventing HIV/Aids spread,” said Dhaje.

She said that through brochures she usually walks with and gives men to read and encourage one-on-one sessions, she has been able to get more than 50 clients who tested HIV positive and are now enrolled on ARVs.

Lucas Naisiae works at Mererani in the mining sector. He said the majority of men working in the mining sector are kind of excluded by a lot of services, and if it continues to be like that, it will end up getting more HIV patients.

“None of us as men is ready to go for HIV testing, as we know how we behave. Life is very frustrating as we try to generate income. When we get money, it is time to relax and enjoy. Majority of us enjoy sex and alcohol,” said Lucas.

Adding to that, he said, even getting condoms is sometimes a challenge, as not all the time you can easily buy a condom, and the majority of men do not prefer the use of condoms despite knowing they are putting their lives in danger.

He calls for more health programmes at the mining site to remind men that HIV is still there and can be prevented. For those who visit the site with condoms, they should continue visiting, as it gives them access to condoms for men who care for their health.

Iddy Swedi, a peer educator under the Meeting Targets and Maintaining Epidemic Control (EpiC) project, is dedicated to achieving and maintaining HIV epidemic control in the country through the provision of strategic technical assistance and direct service delivery to break through barriers to 95-95-95 goals and promote self-reliant management of national HIV programmes by improving HIV case-finding, prevention, and treatment programming.

He uses a music approach in mobilising adolescents and young men to access and demand HIV services. He visits different areas where his fellow youth gather for different activities, including sports.

He said he also visits bodaboda centres and educates the riders on the best way to prevent themselves from getting HIV/Aids and how they can get friendly services at the health centres close to where they live or work.

According to the Tanzania HIV Impact Survey (THIS) 2022-2023, the national HIV prevalence among adults aged 15-49 was 4.4 percent with variation across age and sex. Notably, men aged 35 and above exhibit higher HIV prevalence compared to their younger counterparts.

The survey highlights cumulative risk behaviours, socio-economic factors, and gaps in healthcare access and utilisation.

Supported by Bill & Melinda Gates Foundation