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Int Health. 2013 Mar;5(1):72-7. doi: 10.1093/inthealth/ihs007. Epub 2012 Dec 4.

Addressing gender inequity in HIV care in rural Lesotho: the 'Male Initiative'.

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Partners In Health, Lesotho, Private Bag A239, Maseru, Lesotho.



Lesotho is a nation in Southern Africa with an HIV prevalence of 25%. Males are less likely to access HIV services and there is a need for strategies to improve male participation in HIV care. This paper describes the development and implementation of the Male Initiative to increase male participation in HIV services.


A combination of qualitative and quantitative methods were used to describe the components, process, organization, participation and potential impact of the Male Initiative.


The Male Initiative was developed in partnership with local village chiefs, traditional healers and spiritual leaders. It used the traditional male meeting structure known as the Pitso-ea-banna to deliver messages about HIV care. 1311 men participated in five Male Initiative meetings over a 30 month period from June 2006-31 December, 2008. Male enrollment increased from 32% in 2006 to 36.8% in 2008, a trend which approached statistical significance (p = 0.07) and suggests potential programmatic impact that merits further study.


Gender inequalities in enrollment in HIV care can be addressed through programs developed in partnership with local leaders and delivered in culturally accepted settings.


HIV; Lesotho; Male

[Indexed for MEDLINE]

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