ArticlePloS one2021
Shifting gender norms to improve HIV service uptake: Qualitative findings from a large-scale community mobilization intervention in rural South Africa.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Gender-responsive and -transformative interventions in HIV, TB and malaria programmes: a review of evidence.BMC public health · 2026Pooled it
- Barriers and facilitators of HIV partner status notification in low- and lower-middle-income countries: A mixed-methods systematic review.BMC infectious diseases · 2024Pooled it
- A community mobilisation intervention to improve engagement in HIV testing, linkage to care, and retention in care in South Africa: a cluster-randomised controlled trial.The lancet. HIV · 2022Trial
- Assessing progress in gender-transformative sexual and reproductive health interventions: how does practice-based knowledge compare with published evidence in sub-Saharan Africa?Global health action · 2026Article
- Article
- "I believe in my ancestors, and I participate and believe:" negotiating identity, tradition, and HIV-related health among SGM communities in the Eastern Cape.SSM. Qualitative research in health · 2026Article
- Identifying Key Intervention Attributes Driving Acceptability of Spouse/Partner-Centered HIV Interventions in Vietnam Using Conjoint Analysis.Patient preference and adherence · 2026Article
- Influence of education status, age, and gender on HIV prevention awareness and preferences among youth in a rural Ugandan district: a cross-sectional study.BMC public health · 2025Article
- Factors influencing community demand for assisted partner services for HIV in western Kenya: a multilevel qualitative analysis.BMJ open · 2025Article
- Factors Influencing the Acceptability and Uptake of HIV Self-Testing Among Priority Populations in Sub-Saharan Africa: A Scoping Review.Public health reviews · 2025Review
- Power and poverty: A participatory study on the complexities of HIV and intimate partner violence in an informal urban settlement in Nairobi, Kenya.Social science & medicine (1982) · 2023Article
- Mixed-methods cross-sectional study of the prevention of vertical HIV transmission program users unaware of male partner's HIV status, in six South African districts with a high antenatal HIV burden.BMC public health · 2023Article
- Gender norms and access to sexual and reproductive health services among women in the Marrakech-Safi region of Morocco: a qualitative study.BMC pregnancy and childbirth · 2023Article
- Community Mobilization is Associated with HIV Testing Behaviors and Their Psychosocial Antecedents Among Zambian Adults: Results from a Population-Based Study.AIDS and behavior · 2023Article
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Authors and funding
14 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundInterventions to improve HIV service uptake are increasingly addressing inequitable and restrictive gender norms. Yet comparatively little is known about which gender norms are most salient for HIV testing and treatment and how changing these specific norms translates into HIV service uptake. To explore these questions, we implemented a qualitative study during a community mobilization trial targeting social barriers to HIV service uptake in South Africa.
methodsWe conducted 55 in-depth interviews in 2018, during the final months of a three-year intervention in rural Mpumalanga province. Participants included 25 intervention community members (48% women) and 30 intervention staff/community-opinion-leaders (70% women). Data were analyzed using an inductive-deductive approach.
resultsWe identified three avenues for gender norms change which, when coupled with other strategies, were described to support HIV service uptake: (1) Challenging norms around male toughness/avoidance of help-seeking, combined with information on the health and preventive benefits of early antiretroviral therapy (ART), eased men's fears of a positive diagnosis and facilitated HIV service uptake. (2) Challenging norms about men's expected control over women, combined with communication and conflict resolution skill-building, encouraged couple support around HIV service uptake. (3) Challenging norms around women being solely responsible for the family's health, combined with information about sero-discordance and why both members of the couple should be tested, encouraged men to test for HIV rather than relying on their partner's results. Facility-level barriers such as long wait times continued to prevent some men from accessing care.
conclusionsDespite continued facility-level barriers, we found that promoting critical reflection around several specific gender norms, coupled with information (e.g., benefits of ART) and skill-building (e.g., communication), were perceived to support men's and women's engagement in HIV services. There is a need to identify and tailor programming around specific gender norms that hinder HIV service uptake.
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