Men weigh in on stubborn HIV infections

Nnasaretha Kgamanyane | Wednesday November 8, 2023 13:34

Nonofo Leteane from National AIDS and Health Promotion Agency (NAHPA) believes there are some stereotypes around the way men are socialised.

Speaking at the recent UNAIDS Pitso, he pointed out that society imposes certain expectations on men that lead to them engaging in risky behaviours, which include transmitting HIV infections.

For instance, society, Leteane said, expects men to be “very strong” and therefore if one is a real man he is not supposed to fall sick.

“That is why we men have very poor health-seeking behaviour because if you visit a health facility, to some extent, the society does not regard you as a real man.

“We have those challenges because of a lot of misconceptions around men’s health.

“Men have a lot of barriers to accessing health services, such as the fear of testing positive and having to disclose their status,” he said.

Leteane said men are being left behind in the 95-95-95 UNAIDS target. The targets calls for 95 percent of all people living with HIV to be aware of their status, 95 percent of those aware of their status to be on Antiretrovirals (ARVs), and 95 percent of those on ARVs to have achieved viral load suppression.

“The challenges facing men are the reason why even the first 95 has left so many men behind in terms of testing for HIV or knowing our positive HIV status,” he said.

“There is fear that others would never view you as masculine or as a strong man if you are found to be HIV positive.”

Leteane also explained that there issues of stigma and discrimination, lack of access to HIV services, lack of trusted health care and lack of male-centred health facilities that contribute to men not seeking health services that could help them fight against HIV.

According to the NAHPA officer, males aged between 15 to 64 years in the country have not reached the first 95. Viral suppression among males aged 15 to 44 years also lacks behind.

While data from the recently published Botswana AIDS Impact Survey (BAIS) V shows that men generally have lower incidence, or annual infection rates than women, Leteane cautions that this is probably due to lower testing levels. As a result, their HIV prevalence levels or the proportion living with the virus, is high as shown by the BAIS.

“These are the same men that have abusive relationships with the younger girls because if you look at the trends in this country, there is a lot of transactional sex and a lot of intergenerational sex that is happening around.

“A lot of young girls are being defiled and there is a lot of incest.

“Therefore it means a lot of young girls are exposed to the risks of infection,” he said.

Looking at the best practice to address these challenges, Leteane said he pointed out that there had been localisation of the Framework of Action for Men Engagement in HIV Testing, Treatment and Prevention Southern Africa to the Botswana context. He further explained that through the framework NAHPA and other stakeholders have managed to implement capacity building involving existing stakeholders such as men sector communities, dikgosi, as well as faith-based organisations and traditional health practitioners. He added that government is also funding men’s engagement programmes, while Tebelopele has also contributed through men’s health clinics.

Also speaking at the Pitso, Men and Boys for Gender Equality co-founder, Desmond Lunga, said there were a lot of elements that have to be improved in terms of raising a boy child, to encourage them to take responsibility.

While girls play with dolls and are taught responsibility from a young age, young boys are playing with guns and also discouraged from expressing their feelings such as crying.

“At an early age we see ourselves teaching a girl child how to take care of the household.

“There is no one talking to a boy child about issues of sexuality, or of expressing themselves, which takes us to the challenges we are facing today where we see a lot of mental health challenges amongst men.

“They fail to express themselves and as a result we see high numbers of men engaging in drug and alcohol abuse,” he explained.

Furthermore, Lunga pointed out that a number of men go straight to bars after work adding that there was a need to follow them and engage them in conversations around their health, in those places where they are comfortable.

He added that there is need to mobilise men in different spaces to reach out to their fellow men.

“There is a need to have bar tenders, barbers and others as peer educators to reach fellow men,” he said.

“In addition, men in remote rural areas like farms also need to be reached.

“For meaningful transformation and behavioural change, we needed to programme for the long term and see that young boys will be raised to be responsible men.

“There is a need for systems that support that young boy to grow into a responsible man.”

Last year, Botswana received world-wide acclaim and applause when it became just the second country in the world to reach the United Nations’ 95-95-95 target for HIV/AIDS.

However, authorities are concerned that older men’s behaviour could undo these achievements, as many refuse to test, engage in risky sexual contact and fail to adhere to ARVs when diagnosed.