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University of Notre Dame

Publication Date

Fall 2013

Program Name

Uganda: Development Studies

Abstract

Throughout a six-week practicum period at TASO Mulago in Kampala, Uganda and St. Francis Naggalama Hospital in Naggalama, Uganda, the researcher aimed to find methods to increase male engagement in all facets of comprehensive HIV/AIDS care. Women and children generally receive most global attention on the issue of HIV/AIDS in Uganda but men are beginning to demand more attention. Antiretroviral treatment has been critical in allowing countless people to live functionally with HIV but many research projects have hypothesized that delayed access to HIV/AIDS treatment and prevention methods has resulted in men exhibiting higher mortality rates upon initiation of this treatment. The disparity in men’s reception to this treatment puts the effectiveness of this and many other aspects of comprehensive HIV/AIDS treatment into question. Through statistical analysis, observation, formal and informal interviews, and focus group discussions the researcher aimed to test the hypotheses that men are much more likely to die when they initiate antiretroviral treatment than women and that this higher mortality rate results from later initiation of treatment characterized by CD4 cell count and WHO disease stage number. Through statistical analysis the researcher established the mortality rate as 16.485 deaths per 1000 men and 11.13 deaths per women at TASO Mulago and 69.444 deaths per 1000 men and 23.809 deaths per 1000 women at St. Francis Naggalama Hospital, proving the hypothesis that men have a higher mortality rate upon initiation of ART. Significant differences in CD4 cell counts and WHO disease stage numbers proves the hypothesis that this higher mortality rate is a result of later initiation of ART. Through qualitative data the researcher found that women are required to test for HIV at early signs of pregnancy and through antenatal care but men have no similar avenue to test for HIV and as a result they only test for HIV as a result of grave illness brought about by a weakened immune system characteristic of high HIV prevalence. Men are also highly stigmatized by social forces that further exaggerate gender differences in access to HIV/AIDS care and support. The researcher proposes enhanced male circumcision programs to serve as avenues for men to engage in all facets of 5 comprehensive HIV/AIDS care. Through these programs men would gain education and encouragement to join in the fight against this epidemic.

Disciplines

Family, Life Course, and Society | Health Policy | Health Services Administration | Immune System Diseases | Inequality and Stratification | Medicine and Health | Public Health | Public Health Education and Promotion

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