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Lower Levels of Antiretroviral Therapy Enrollment Among Men with HIV Compared with Women - 12 Countries, 2002-2013

Andrew F Auld, Ray W Shiraishi, Francisco Mbofana

    MMWR. Morbidity and Mortality Weekly Report
    |November 26, 2015
    PubMed

    Insights

    Gender inequity in antiretroviral therapy (ART) access persists, with women accessing treatment more than men in many countries. Increased male engagement in HIV testing and treatment is crucial for equitable outcomes and reducing HIV transmission.

    Area of Science:

    • Public Health
    • Epidemiology
    • Global Health

    Background:

    • Equitable access to antiretroviral therapy (ART) for people with human immunodeficiency virus (HIV) is a global health priority.
    • Gender disparities in accessing life-saving HIV treatment remain a significant challenge in many regions.

    Purpose of the Study:

    • To evaluate gender equity in ART access among adults (≥15 years) in 12 countries between 2002 and 2013.
    • To compare the ratio of women to men accessing ART with the estimated ratio of HIV-infected women to men in the general population.

    Main Methods:

    • Analysis of 765,087 adult ART patient medical records across 12 countries in five geographic regions.
    • Comparison of annual ART enrollment ratios (women to men) with Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates of HIV prevalence ratios.

    Main Results:

    • In 10 African countries and Haiti, the ratio of women to men among new ART enrollees significantly exceeded UNAIDS estimates by 23%-83%.
    • The ratio of women to men in ART enrollment increased more sharply over time than HIV prevalence ratios in six African countries and Haiti.
    • ART access shows a persistent gender gap favoring women in many high HIV burden settings.

    Conclusions:

    • Increased ART coverage among men is essential to reduce HIV-related morbidity and mortality.
    • Enhanced HIV testing, linkage-to-care services for men, and 'test-and-treat' strategies are needed to address gender inequity in ART access.
    • Reducing gender disparities in ART access is critical for effective HIV control and prevention efforts.

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