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AIDS Educ Prev. 2017 Jun;29(3):274-287. doi: 10.1521/aeap.2017.29.3.274.

Men's Perceptions of Treatment as Prevention in South Africa: Implications for Engagement in HIV Care and Treatment.

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Department of Epidemiology and Biostatistics, University of California, San Francisco.
Population Council, Washington, D.C.
Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Sonke Gender Justice, Cape Town, South Africa.
MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill.
School of Health, University of New England, New South Wales, Australia.
Center for AIDS Prevention Studies, Department of Medicine, University of California, San Francisco.
Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill.


While South Africa provides universal access to treatment, HIV testing and antiretroviral therapy (ART) uptake remains low, particularly among men. Little is known about community awareness of the effects of treatment on preventing transmission, and how this information might impact HIV service utilization. This qualitative study explored understandings of treatment as prevention (TasP) among rural South African men. Narratives emphasized the know value of ART for individual health, but none were aware of its preventive effects. Many expressed that preventing transmission to partners would incentivize testing, earlier treatment, and adherence in the absence of symptoms, and could reduce the weight of a diagnosis. Doubts about TasP impacts on testing and care included enduring risks of stigma and transmission. TasP information should be integrated into clinic-based counseling for those utilizing services, and community-based education for broader reach. Pairing TasP information with alternative testing options may increase engagement among men reluctant to be seen at clinics.

[Indexed for MEDLINE]

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