Gender norms and HIV testing/treatment uptake: evidence from a large population-based sample in South Africa
J. Pulerwitz, A. Gottert, K. Kahn, N. Haberland, A. Julien, A. Selin, R. Twine, D. Peacock, X. Gómez-Olivé, S. A. Lippman, and A. Pettifor
2019. AIDS and Behavior. Online ahead of print, 29 July
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.