Department of Health Systems and Policy, School of Public Health and Family Medicine, College of Medicine, Blantyre, Malawi.
Department of Public Health, School of Public Health and Family Medicine, College of Medicine, Blantyre, Malawi.
Am J Mens Health. 2021 Mar-Apr;15(2):15579883211011381. doi: 10.1177/15579883211011381.
HIV testing is the entry point to the cascade of services within HIV care. Although Malawi has made positive strides in HIV testing, men are lagging at 65.5% while women are at 81.6%. This study explored the preferences of men on the avenues for HIV testing in Blantyre, Malawi. This was a descriptive qualitative study in the phenomenological tradition in seven public health facilities in Blantyre, Malawi, among men and health-care workers (HCWs). We conducted 20 in-depth interviews and held 14 focus group discussions among 113 men of varying HIV statuses. All our participants were purposively selected, and data were digitally recorded coded and managed through NVivo. Thematic analysis was guided by the differentiated service delivery model. Men reported a preference for formal and informal workplaces such as markets and other casual employment sites; social places like football pitches, bars, churches, and "bawo" spaces; and outreach services in the form of weekend door-to-door, mobile clinics, men-to-men group. The health facility was the least preferred avenue. The key to testing men for HIV is finding them where they are. Areas that can be leveraged in reaching men are outside the routine health system. Scaling up HIV testing among men will require targeting avenues and operations outside of the routine health system and leverage them to reach more men with services. This suggests that HIV testing and counseling (HTC) uptake among men may be increased if the services were provided at informal places.
HIV 检测是 HIV 护理服务链的起点。尽管马拉维在 HIV 检测方面取得了积极进展，但男性的检测率仅为 65.5%，而女性为 81.6%。本研究探讨了马拉维布兰太尔男性对 HIV 检测途径的偏好。这是在马拉维布兰太尔的 7 个公共卫生机构中进行的一项描述性定性研究，研究对象为男性和卫生保健工作者 (HCWs)。我们对 113 名不同 HIV 状况的男性进行了 20 次深入访谈和 14 次焦点小组讨论。我们所有的参与者都是经过有目的选择的，数据通过 NVivo 进行数字记录、编码和管理。主题分析以差异化服务交付模式为指导。男性报告称，他们更喜欢正式和非正式的工作场所，如市场和其他临时就业场所；社交场所，如足球场、酒吧、教堂和“bawo”空间；以及周末上门、流动诊所、男性团体等形式的外展服务。卫生机构是最不受欢迎的途径。对男性进行 HIV 检测的关键是在他们所在的地方找到他们。可以利用的领域是常规卫生系统之外。要在男性中扩大 HIV 检测，需要针对常规卫生系统之外的途径和业务，并利用这些途径为更多男性提供服务。这表明，如果在非正式场所提供服务，男性接受 HIV 检测和咨询 (HTC) 的比例可能会增加。
