Addressing gender inequity in HIV care in rural Lesotho: the ‘Male Initiative’

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. CONCLUSION: Gender inequalities in enrollment in HIV care can be addressed through programs developed in partnership with local leaders and delivered in culturally accepted settings.