Community-based strategies to strengthen men’s engagement in the HIV care cascade in sub-Saharan Africa

The successful scale-up of antiretroviral therapy (ART) in sub-Saharan Africa (SSA) will require policy makers to address the gender gap in HIV testing and treatment access. Men in SSA are less likely than women to undergo HIV testing and more likely to start ART at advanced disease stages and interrupt or drop out of ART. These disparities have resulted in a life expectancy gap of up to 10 years between HIV-positive men and women. Low male testing and treatment rates also increase HIV transmission to female partners. For example, pregnant women in SSA have high HIV testing coverage through antenatal care (ANC) yet have twice the HIV incidence of nonpregnant women. This can be partially attributable to low testing rates in their male partners. In Kenya during 2013, 88% of pregnant women were tested for HIV compared to 4.5% of their male partners.