Men from sub-Saharan Africa are less inclined to test for HIV because of clinic hours and the stigma associated with HIV males.

Research presented at last month’s Conference on Retroviruses and Opportunistic Infections (CROI) also showed that home testing was not as effective with men.

A study found that men in Zambia were less likely to test for HIV when testing was offered through household campaigns, because they were away from home or at work.

Men frequently complain that clinic opening hours make it difficult for them to attend without missing paid work.

There is also the public perception that HIV clinics are mainly geared to women and children, so attending what are commonly seen in the community as women’s services can signal that a man is HIV positive.

To test the effects of clinic hours, in Khayelitsha township, South Africa, two clinics were set up designed to attract men, one during working hours, the other after hours.

HIV testing and counselling took place in high volumes at each clinic (291 tests per month at the day clinic and 25 tests per month at the after-hours clinic), and around half of HIV testing and counselling took place as a consequence of a visit for STI diagnosis and treatment.

Attendees at the after-hours clinic were much more likely to present as HIV positive (64% vs 14%). Due to its convenient opening hours, the after-hours clinic attracted a large number of men already on ART who transferred from other services.

Forty-three per cent of men receiving ART through the clinic had transferred from another clinic, compared to 8% of the male day clinic cohort.

image: A flier advertising the Khayelitsha men’s testing clinics.