Perceptions and Attitudes Towards HIV Test and Treat: A Comparative Study of Males and Females in Eswatini
1
Department of Health Studies, University of South Africa, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Eswatini continues to record the world’s highest HIV prevalence (27.9%), with women aged 15–49 bearing a significantly greater burden (36.1%) than men (19.4%). Despite the rollout of the WHO/UNAIDS Test and Start initiative, men remain notably underrepresented in HIV testing and treatment services. Addressing these gender imbalances is critical, as greater male engagement is necessary to reach the 95-95-95 targets and strengthen national HIV outcomes. This study therefore, investigates gender differences in perceptions, attitudes, and knowledge of the Test and Start program among people living with HIV in Manzini, Eswatini.
METHODS:
A quantitative descriptive survey design was used to collect data from 604 participants (50% male, 50% female) living with HIV, sampled through stratified random techniques from two major health facilitiesa hospital (62%) and a clinic (38%). A structured Likert‑scale questionnaire captured respondents’ perceptions, attitudes, beliefs, and knowledge. Data were analysed using descriptive and inferential statistics with SPSS Version 26.
RESULTS:
Women reported stronger understanding and more favourable attitudes toward ART and the Test and Start program (93% vs. 86% among men). Men showed lower risk perception (71% vs. 77%), higher stigma (72% vs. 54%), reduced awareness, and greater cultural and logistical barriers, contributing to delayed testing and ART initiation. Positive attitudes were strongly associated with treatment adherence and preventive behaviours. Respondents aged 31–40 showed lower program perceptions than the 21–30 group.
CONCLUSIONS:
Significant gender disparities influence engagement with the Test and Start program. While women exhibit greater confidence in ART benefits, men face barriers shaped by cultural norms, limited knowledge, and stigma. Gender‑sensitive, community‑centered approaches engaging men through peer support, traditional leaders, and targeted outreach are critical to improving testing, treatment uptake, and achieving equitable HIV outcomes in Eswatini.
Eswatini continues to record the world’s highest HIV prevalence (27.9%), with women aged 15–49 bearing a significantly greater burden (36.1%) than men (19.4%). Despite the rollout of the WHO/UNAIDS Test and Start initiative, men remain notably underrepresented in HIV testing and treatment services. Addressing these gender imbalances is critical, as greater male engagement is necessary to reach the 95-95-95 targets and strengthen national HIV outcomes. This study therefore, investigates gender differences in perceptions, attitudes, and knowledge of the Test and Start program among people living with HIV in Manzini, Eswatini.
METHODS:
A quantitative descriptive survey design was used to collect data from 604 participants (50% male, 50% female) living with HIV, sampled through stratified random techniques from two major health facilitiesa hospital (62%) and a clinic (38%). A structured Likert‑scale questionnaire captured respondents’ perceptions, attitudes, beliefs, and knowledge. Data were analysed using descriptive and inferential statistics with SPSS Version 26.
RESULTS:
Women reported stronger understanding and more favourable attitudes toward ART and the Test and Start program (93% vs. 86% among men). Men showed lower risk perception (71% vs. 77%), higher stigma (72% vs. 54%), reduced awareness, and greater cultural and logistical barriers, contributing to delayed testing and ART initiation. Positive attitudes were strongly associated with treatment adherence and preventive behaviours. Respondents aged 31–40 showed lower program perceptions than the 21–30 group.
CONCLUSIONS:
Significant gender disparities influence engagement with the Test and Start program. While women exhibit greater confidence in ART benefits, men face barriers shaped by cultural norms, limited knowledge, and stigma. Gender‑sensitive, community‑centered approaches engaging men through peer support, traditional leaders, and targeted outreach are critical to improving testing, treatment uptake, and achieving equitable HIV outcomes in Eswatini.
| eISSN: | 2654-1459 |
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