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Gender Norms and HIV Testing/Treatment Uptake: Evidence from a Large Population-Based Sample in South Africa.

  • Author(s): Pulerwitz, J;
  • Gottert, A;
  • Kahn, K;
  • Haberland, N;
  • Julien, A;
  • Selin, A;
  • Twine, R;
  • Peacock, D;
  • Gómez-Olivé, X;
  • Lippman, SA;
  • Pettifor, A
  • et al.
Abstract

How does the endorsement of different dimensions of gender norms by men and/or women influence their use of HIV testing and antiretroviral treatment? This question was examined using data from a 2014 population-based survey of 1053 women and 1004 men, ages 18-49, in rural South Africa. We used a global measure for views toward gender norms (the GEM Scale), plus four subsets of scale items (all reliabilities ≥ 0.7). In multivariate analyses using the global measure, endorsement of inequitable gender norms was associated with more testing (AOR 2.47, p < 0.01) and less treatment use (AOR 0.15, p < 0.01) among women but not men. When examining specific subsets of inequitable norms (e.g., endorsing men as the primary decision-maker), decreased odds of treatment use was found for men as well (AOR 0.18, p < 0.01). Careful attention to the role specific gender norms play in HIV service uptake can yield useful programmatic recommendations.

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