The current ‘one-size-fits all approach’ is not working to adequately fight the TB epidemic, the Desmond Tutu Health Foundation said. Instead, interventions need to do more to include the voices of men, and challenge masculine tropes that create barriers to holistic treatment.

Speaking during a webinar organised by the International Aids Society (IAS) on Tuesday, Andrew Medina-Marino of the Desmond Tutu Health Foundation said men need to be empowered to challenge unhealthy masculinity norms that impact their health.

“The Global TB community must engage and consider men’s voices when designing interventions to improve their TB health outcomes,” said Medina-Marino. “They must also empower men to challenge unhealthy masculinity norms that impact their health as the one size-fits-all approach is not working, and ignoring men voices will sustain and worsen the epidemic for all.”

Medina-Merino was speaking during a webinar themed ‘Addressing the TB screening, prevention and treatment needs of people living with HIV in the era of COVID-19.’ The Desmond Tutu Health Foundation is a non-profit company established in association with the Desmond Tutu HIV Centre.

TB leading cause of death, especially in men

A study in KwaZulu-Natal found that TB is the leading cause for the different life expectancy between men and women. TB contributed to 81% to the 11.2-year life expectancy difference between men and women living with HIV, and 43% to the 13.1-year difference among those without HIV.

“The South African REMox TB study found that men were more likely to have adverse treatment outcomes compared to women due to cavitation from previous TB infections and a host of other studies found that men are more likely to be lost to care or die in treatment,” said Medina-Merino.

“In 2017, 63% of all microbiologically confirmed cases of TB in South Africa were among men. Furthermore, in many age groups the incidence of TB among men compared to women is nearly two to three times higher,” he said.

Men on TB treatment feel ‘isolated’

Desmond Tutu Health Foundation conducted another study in Buffalo City Metro Health District in the Eastern Cape province to understand the experiences of men undergoing treatment. They found that men described a sense of isolation during TB treatment.

“Men described their desire and willingness to support other men during TB treatment with both mental and tangible resources. Many men spoke about spaces where they felt comfortable talking about men’s issues and suggested that these spaces may be conducive for a conversation about TB, a common theme was that these spaces were primarily dominated by males. And men reported feeling isolated from their families and communities during TB treatment and advocated for community awareness to reduce their isolation,” said Medina-Merino.

According to Medina-Merino, no TB treatment support interventions have included the preferred modes of delivery men described in the study.

“Men have emphasised the need of peer-peer support in order to navigate TB-related stigma and unhealthy masculinity norms. [They] advocated for awareness events to educate their communities about challenges men face when ill with TB and that interventions should be delivered in familiar locations where men congregate. But to date, no TB support interventions have included the preferred components or modes of delivery described by men in our study,” added Marino.—Health-e News