Men are far more likely to die from an HIV-related illness than women, although women are becoming infected with HIV at a much faster rate.
According to the 2018 Kenya HIV Estimates Report, approximately 523,600 men and 864,600 women are currently living with HIV in the country.
About half (51 percent) of people dying of Aids-related illnesses were men at 13,800 compared with 10,100 in women, with about 28,200 people dying in total.
But why are men more likely to die from HIV compared with women?
Poor health-seeking behaviour, cultural socialisation, and intake of too much alcohol are some of the reasons contributing to the higher death rate in men.
A scientist argues that because fewer men than women get tested for HIV, many will not be aware of their status.
As a result, Dr Matilu Mwau, an infectious-diseases specialist at the Kenya Medical Research Institute (Kemri), says fewer men are on antiretroviral therapy.
“In such cases, treatment is sometimes less effective,” he says, adding that health services are often not designed to attract men.
But he further adds that poor health-seeking behaviour could also contribute to the high number of deaths because many who are receiving treatment are at a later stage of HIV infection than women when the virus has had a significant amount of time during which it could deplete their immune systems.
“Whereas women have a better social network, men do not. Our socialisation that men are supposed to tolerate pain contributes to this problem,” Dr Mwau adds.
Men are also more likely to drink, further worsening their chances of survival. This, according to Dr Mwau, is because when the ARV is introduced into the body of someone who abuses alcohol, the drug doesn’t work as it should.
“Just like alcohol, ARVs are digested in the liver. Often, people who consume a lot of alcohol have enhanced enzymes in the liver to help break down the alcohol.
The ARV dosage is designed so that some is digested in the liver before being absorbed into the blood. However, if a person’s liver has scaled-up enzymes, the drugs will fully be digested in it, making them ineffective,” he explains.
Studies have also shown that men are significantly less likely than women to have been tested for HIV and therefore do not know their HIV status.
When men do not know their HIV status, they are less likely to change their sexual practices or to use condoms and are therefore also much more likely to transmit HIV to their partners.
To address the situation, Nairobi County Health Services has started offering mobile HIV testing and other health services to boda-boda (motorcyles taxi) riders.
Unaids and the South African NGO Sonke Gender Justice have produced a documentary on how to get men to use HIV services.
In the film, which will be released later this year, a Kenyan local health promotion officer makes it clear: “If we want male involvement in health services, inclusive of the HIV programming, then it is most appropriate for us to reach the men at their workplaces, be it in their offices, be it in their companies, in institutions where they are engaged over the daytime.”