title: Experiences of alcohol consumption and taking antiretroviral medication among men living with HIV in Tshwane, South Africa.
abstract: Hazardous alcohol consumption may compromise optimal antiretroviral therapy (ART) adherence among patients. Adoption of hegemonic notions of masculinity may encourage health-risk behaviours, such as alcohol consumption, and discourage health-enhancing behaviours, such as ART adherence among men. This study aimed to explore linkages between masculinity, alcohol consumption, and taking ART medication among male ART recipients in South Africa. Male facilitators conducted five focus group discussions with 27 black male ART recipients aged between 28 and 65 years at five ART clinics. Eligibility criteria were: 18 years or older, at least three months on ART, and alcohol consumption in the past three months. Data were analysed inductively using thematic content analysis. The men demonstrated a masculinity that fostered commitment to taking ART. However, normative notions of masculinity in the men's social circles often compromised their timeous taking of medication. Fears of alcohol-ART interactions often led to intentional non-adherence to ART when drinking. Finally, healthcare provider-patient power dynamics seemed to prevent the men from discussing their challenges regarding alcohol use and ART adherence with their healthcare providers. Interventions that focus on addressing harmful hegemonic notions of masculinity among men are needed in community settings such as drinking establishments where men tend to socialise. Patient-centred approaches which enhance men's sense of involvement in their treatment are needed in healthcare settings.
authors.affiliation: a Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council , Pretoria , South Africa.
authors.forename: Sebenzile
authors.initials: S
authors.lastname: Nkosi
authors.affiliation: a Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council , Pretoria , South Africa.
authors.forename: Eileen P
authors.initials: EP
authors.lastname: Rich
authors.affiliation: a Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council , Pretoria , South Africa.
authors.forename: Connie T
authors.initials: CT
authors.lastname: Kekwaletswe
authors.affiliation: a Alcohol, Tobacco & Other Drug Research Unit, South African Medical Research Council , Pretoria , South Africa.|b School of Public Health , University of the Witwatersrand , Johannesburg , South Africa .|c School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa.
authors.forename: Neo K
authors.initials: NK
authors.lastname: Morojele
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000523:psychology*; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D017144:Focus Groups; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D057228:Masculinity; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011369:Professional-Patient Relations; D012725:Sexual Behavior / Q000523:psychology*; D013019:South Africa; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents
keywords: HIV; South Africa; alcohol consumption; antiretroviral therapy; hegemonic masculinity