Gender differences in experiences of ART services in South Africa: a mixed methods study
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Date
2012
Journal Title
Journal ISSN
Volume Title
Publisher
Blackwell Publishing Ltd
Abstract
Objectives: A mixed methods study exploring gender differences in patient profiles and experiences of
ART services, along the access dimensions of availability, affordability and acceptability, in two rural
and two urban areas of South Africa.
methods Structured exit interviews (n = 1266) combined with in-depth interviews (n = 20) of women
and men enrolled in ART care.
results Men attending ART services were more likely to be employed (29% vs. 20%, P = 0.001) and
were twice as likely to be married ⁄ co-habiting as women (42% vs. 22% P = 0.001). Men had known
their HIV status for a shorter time (mean 32 vs. 36 months, P = 0.021) and were also less likely to
disclose their status to non-family members (17% vs. 26%, P = 0.001). From both forms of data
collection, a key finding was the role of female partners in providing social support and facilitating use of
services by men. The converse was true for women who relied more on extended families and friends
than on partners for support. Young, unmarried and unemployed men faced the greatest social isolation
and difficulty. There were no major gender differences in the health system (supply side) dimensions
of access.
conclusions Gender differences in experiences of HIV services relate more to social than health
system factors. However, the health system could be more responsive by designing services in ways that
enable earlier and easier use by men.
Description
Keywords
Gender, South Africa, Antiretroviral therapy
Citation
Schneider, H., et al. (2012). Gender differences in experiences of ART services in South Africa: a mixed methods study.Tropical Medicine & International Health,17(7):820-6