Rankin-Williams Amy C, Geoffroy Elizabeth M, Schell Ellen S, Mguntha Andrew M
Department of Health Policy and Management, Gillings School of Global Pubic Health, University of North Carolina, Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599, USA.
Global AIDS Interfaith Alliance, 2171 Francisco Blvd East, San Rafael, CA 94901, USA.
Int Health. 2017 Nov 1;9(6):367-373. doi: 10.1093/inthealth/ihx042.
In southern Malawi, 12.8% of adults are HIV positive. Men are less likely to have been tested than women. We investigated men's HIV knowledge and the attitudes, influencers, facilitators and barriers affecting HIV testing.
We conducted an explanatory mixed-methods study with analysis of secondary quantitative data from 425 rural men collected in January 2014 (time 1) and April 2015 (time 2) and qualitative interviews with 50 men in September 2015. All respondents lived in villages receiving HIV education and testing.
Quantitative data revealed that comprehensive HIV knowledge increased and was associated with having been tested by time 2. Educational level was positively associated with having been tested. Men's reasons for not getting tested were fear of learning their HIV status, fear of rejection by partners and wives and fear of discrimination. Wives influenced men's opinions about healthcare. The qualitative results demonstrated that men feared being seen at test sites and feared discrimination. Wives had the greatest reported influence on male testing. Men perceived services as female-oriented and stigmatizing. They preferred door-to-door testing.
Providers can improve uptake by increasing men's HIV knowledge, leveraging the influence of spouses and offering door-to-door testing with male health workers.
在马拉维南部，12.8%的成年人艾滋病毒检测呈阳性。男性接受检测的可能性低于女性。我们调查了男性的艾滋病毒知识以及影响艾滋病毒检测的态度、影响因素、促进因素和障碍。
我们进行了一项解释性混合方法研究，分析了2014年1月（时间1）和2015年4月（时间2）收集的425名农村男性的二次定量数据，并于2015年9月对50名男性进行了定性访谈。所有受访者都生活在接受艾滋病毒教育和检测的村庄。
定量数据显示，到时间2时，全面的艾滋病毒知识有所增加，并且与接受检测有关。教育水平与接受检测呈正相关。男性不接受检测的原因是害怕得知自己的艾滋病毒感染状况、害怕被伴侣和妻子拒绝以及害怕受到歧视。妻子影响了男性对医疗保健的看法。定性结果表明，男性害怕在检测地点被人看到，害怕受到歧视。据报告，妻子对男性检测的影响最大。男性认为服务以女性为导向且带有污名化。他们更喜欢上门检测。
医疗服务提供者可以通过增加男性的艾滋病毒知识、利用配偶的影响力以及提供由男性卫生工作者进行的上门检测来提高检测率。
