Black African men

Black African men are diagnosed with HIV in lower numbers than women; this is mainly because of women’s contact with antenatal care, where HIV testing is routine. Moreover, in families, women may come into contact with health services more frequently than men. There has been limited research into the specific reasons why African men do not access HIV prevention, testing and treatment services (and other health services) as needed.

An in-depth study of black African men living with HIV in the UK found that many of the men were socially isolated (only half were in relationships and many of the fathers were no longer living with their children). A recurring theme in the interviews was loss of potential: not having the money or jobs they had anticipated, being unable to provide for a wife and children. Many of the men found it hard to reconcile the current life with their own ideas of ‘manliness’ and described themselves as being ‘weak’.^1,2

In the BASS Line survey, African men were more likely than women to report multiple sexual partners, extra-relational sex, sex with someone of a different HIV status, unprotected intercourse and condom failure. Men in their twenties were most likely to have more than one regular partner. Compared to women, men were more likely to be unconcerned about being involved in HIV transmission, more likely to have a problem getting hold of condoms, less likely to know where to test and significantly less knowledgeable about HIV in general.

These results have led the BASS Line researchers to argue that men, not women, should be prioritised by health promoters working with African communities.³