Women With HIV Far More Likely To Be Treated Than Men

Dr. Andrew Auld MD, MSc Medical Epidemiologis Division of Global HIV & TB CDC

Dr. Andrew Auld

MedicalResearch.com Interview with:
Dr. Andrew Auld 
Medical Epidemiologist
Division of Global HIV & TB

MedicalResearch: What is the background for this study?

Dr. Auld: Equitable access to antiretroviral therapy for men and women living with HIV is a principle endorsed by most countries and funding bodies, including the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). This analysis, including more than 765,000 adult patients starting antiretroviral therapy in 12 countries (10 African countries, Haiti, and Vietnam), is the most up-to-date and comprehensive assessment of differences in HIV treatment access among men and women with HIV in developing countries.

MedicalResearch: What are the main findings?

Dr. Auld: Investigators showed that in all 10 African countries and Haiti, women with HIV were far more likely to be on treatment than men. In these 11 countries, women were 23%–83% more likely to access antiretroviral therapy than men with HIV. In addition, in six African countries and Haiti, gender imbalance in HIV treatment access appears to be getting worse over time.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Auld: Reversing these trends is critically important, especially in resource-constrained settings with high HIV burden. In most resource-limited settings, increasing antiretroviral therapy coverage among men with HIV should be a key focus to reduce gender imbalance in HIV treatment access. Increasing treatment uptake among men with HIV would reduce morbidity and mortality in this group and also significantly reduce HIV incidence among their sex partners, including adolescent girls and young women, who are at high risk of infection in many developing countries.

To increase male uptake of antiretroviral therapy, systems to reach more men with HIV testing and linkage-to-care services and adoption of new World Health Organization guidelines, recommending test-and-treat for both men and women (i.e., regular testing of adults, and offering antiretroviral therapy to all infected persons, regardless of CD4 count), are needed.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Auld: Key reasons that women with HIV are currently more likely than men to access HIV treatment in most resource-limited settings, include:

(1) women have access to routine HIV testing and counseling in antenatal care,

(2) in most countries all pregnant women with HIV are eligible to receive life-long HIV treatment, and

(3) men may not be reached with testing and may delay seeking treatment due to HIV-related stigma.

Research to identify the most effective and efficient ways to reach more men with HIV testing and linkage-to-care services in resource-limited settings is needed.


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

MWR Weekly

November 27, 2015 / 64(46);1281-1286

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Dr. Andrew Auld MD, MSc (2015). Women With HIV Far More Likely To Be Treated Than Men