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Decomposing gender gaps in HIV service outcomes

Datos Bibliográficos

ID21880962
AutoresGary Gaumer (0000-0003-3304-1258, Brandeis University), Collins Gaba (0009-0004-1911-1832, Brandeis University), Elad Daniels (0000-0001-5452-8984, Brandeis University), Deborah Valerie Stenoien (0009-0000-7126-6613, Brandeis University), Monica Jordan (0000-0003-4080-0267, Brandeis University), V S S Kumar (Brandeis University), VS Senthil Kumar (Institute for Global Health and Development, Brandeis University Heller School for Social Policy and Management, Waltham, Massachusetts, USA), William H Crown (0000-0002-8822-2737, Institute for Global Health and Development, Brandeis University Heller School for Social Policy and Management, Waltham, Massachusetts, USA), William Crown (Brandeis University), Moaven Razavi (0000-0002-6082-6897, Brandeis University), A Nandakumar (0000-0002-0976-9313, Brandeis University)
Año2026
Volumen11
Número1
Páginase020900
Fecha de publicación2026-01-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaBMJ Global Health (JOURNAL)
Identificadores de la revistaISSN: 2059-7908 • E-ISSN: 2059-7908
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2025-020900
PMID41545214
OpenAlexW7124450220
IdiomaEN
Referencias citadas19

This study uses Population-based HIV Impact Assessments survey data to examine factors associated with gender disparities in HIV outcomes. The analysis examined the share of adult males and females living with HIV who are aware of their status, are on treatment and have achieved viral load suppression across 13 African countries. The study then used the Blinder-Oaxaca statistical method to decompose these gaps into three core elements: (1) the part caused by observed differences in characteristics between the two groups, (2) the part caused by unobservable differences between the groups, often attributed to structural barriers and (3) the unexplained portion of the gap. The study then compares how these gaps and decompositions have changed over time. The model confirms that males have poorer outcomes than females across all three indicators. Factors contributing to these gender disparities include individual-level characteristics such as age, education and wealth, as well as structural barriers such as stigma, restrictive gender norms and lower health service utilisation among men. Although males generally possess more protective individual-level characteristics, these structural barriers offset their advantages, resulting in poorer outcomes across all indicators. The gap in service outcomes between men and women has decreased over time, with structural or cultural barriers showing the greatest improvement. Additional investment in and evaluation of male-friendly services is essential to understand what interventions have contributed to decreasing this gap. This knowledge should be used to inform future investments to support individual-level treatment outcomes and prevent new infections

Gender gap · Psychological intervention · Survey data collection · Unobservable · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · HIV/AIDS Research and Interventions

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