Journal
CULTURE HEALTH & SEXUALITY
Volume 21, Issue 7, Pages 774-788Publisher
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/13691058.2018.1516299
Keywords
HIV/AIDS; masculinity; fisherfolk; Uganda
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Funding
- GloCal Health Fellowship from the National Institute of Health Fogarty International Center
- University of California Global Health Institute [NIH/FIC 5R25TW009343-05]
- T32 Predoctoral Fellowship Award on Substance Abuse, HIV and Related Infections from the National Institute of Drug Abuse [T32 DA023356]
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This study explored the intersection of masculinity and HIV care engagement among fishermen and other male fisherfolk on antiretroviral therapy (ART) in Wakiso District, Uganda. We conducted 30 in-depth interviews with men on ART recruited from HIV treatment sites and used a thematic analysis approach. Since HIV diagnosis and ART initiation, men had adopted masculine identities more conducive to HIV care engagement. The masculine roles of worker and provider, husband and sexual partner and the appearance of physical strength were compromised by HIV, but restored by ART's positive effects on health. Peers also emerged as facilitators to HIV care, with men supporting each other to seek testing and treatment. However, structural and occupational barriers to HIV care associated with the masculine role of worker remained a barrier to care engagement. Findings suggest that emphasising the benefits of ART in bolstering men's ability to fulfil the roles important to them may improve the effectiveness of HIV testing and treatment messaging for men. Differentiated care models that address structural-level barriers to care, and community-level gender-transformative programming to help fishermen engage in HIV care, may be beneficial.
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