title: Addressing gender inequity in HIV care in rural Lesotho: the 'Male Initiative'.
abstract: BACKGROUND
  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.
  
  
  METHODS
  A combination of qualitative and quantitative methods were used to describe the components, process, organization, participation and potential impact of the Male Initiative.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Gender inequalities in enrollment in HIV care can be addressed through programs developed in partnership with local leaders and delivered in culturally accepted settings.
authors.affiliation: Partners In Health, Lesotho, Private Bag A239, Maseru, Lesotho.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lesia
authors.forename: Ann C
authors.initials: AC
authors.lastname: Miller
authors.forename: Jonas
authors.initials: J
authors.lastname: Rigodon
authors.forename: J Keith
authors.initials: JK
authors.lastname: Joseph
authors.forename: Jennifer
authors.initials: J
authors.lastname: Furin
mesh_terms: D001294:Attitude to Health; D003469:Culture; D015658:HIV Infections / Q000628:therapy*; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007927:Lesotho; D008297:Male; D054526:Men's Health / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015397:Program Evaluation / Q000379:methods* / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data
keywords: HIV; Lesotho; Male