News / Africa

Men Face Higher Death Risk, But Why?

Crosses fill a graveyard in Cape Town's Khayelitsha township February 27, 2010. Many of those buried in the South African cemetery died from AIDS or related complications such as tuberculosis (TB).
Crosses fill a graveyard in Cape Town's Khayelitsha township February 27, 2010. Many of those buried in the South African cemetery died from AIDS or related complications such as tuberculosis (TB).
Joe DeCapua
HIV-infected men in South Africa are nearly one-third more like to die than women, even though both receive similar treatment. But researchers say they don’t know why.

University of Cape Town’s Morna Cornell led a team of researchers who looked at more than 46,000 adults taking antitrovirals drugs between 2002 and 2009.



“Why we started looking at this was because increasing numbers of studies are coming out, which are reporting that men have a higher risk of death on antiretrovirals than women. And obviously this is an issue of great concern and something we wanted to understand a bit more,” she said.

Studies show that, in fact, men are one-third more likely to die than women during treatment. But Cornell said too often researchers may simply assume they know why, when in fact they do not.

“These papers are published. They find higher mortality, but that they conclude that this is largely due to individual-level factors. They argue that it's because men come in later for treatment. It’s because men are less likely to be adherent to their treatment. They are suggesting maybe men are more likely to be lost to follow-up from a program and then to die. Maybe they’ve got different virologic responses or they’re not taking the treatment properly, et cetera,” she said.

Cornell said she wanted to study in a “very systematic way” all the possible explanations as to why men have a much greater risk of death.

“The first thing that we did is that we looked at the differences when people enroll. We then said, ok, well, that explains some of it, but it doesn’t explain all of it. We’ve still got this 30 percent difference. Well, could it be because, as many people have suggested, men are more likely to be lost to a program and therefore that they are more likely to be dead. Because there’s a very high risk of death after being lost to a program. And we found that, yes, men were more likely to be lost to our system, but they were not more likely to be dead after being lost to follow-up. So that didn’t explain it. Maybe men are less likely to stick to their treatment? And we found that, in fact, there was absolutely no difference. No gender difference that we could find,” she said.

Researchers looked at other factors, such as whether there was a difference in suppression of HIV while on treatment. No answer was found there either.

“What is it? What could it be? Why? And I actually suddenly thought, well, why else do people die? Why do people die who don’t have HIV? And it was one of those I suppose eureka moments, where you suddenly realize you’ve been thinking inside a little box all this time. And you’ve been looking for all of the reasons within the antiretroviral program. But actually, possibly, the reasons lay outside it,” she said.

What she found was a much broader mystery with some stark facts.

“It’s not just in Africa and not just in South Africa. That in fact worldwide, men have twice the risk of death compared with women. And yet for some reason [it] does not seem to draw the kind of attention I think it deserves,” she said.

Cornell described it as a crisis. She said researchers cannot assume the mortality differences are merely the result of a failure of medical services or that men are to blame because of their behavior. She says when it comes to men gender differences are often ignored.

“I think that we have failed men,” she said, “I think that we haven’t found ways of offering men services which they think are important. Of offering them in a way which is accessible to them – male-friendly services – at times where they can make it. We really haven’t even looked at what are the obstacles. Why are men not coming in earlier?”

Cornell, a PhD candidate at the University of Cape Town’s School of Public Health, said she doubts it’s because men are just trying to tough it out. Cornell added that men are victims of gender inequality when it comes to health care and health status. She says it’s time to find how that can be changed.

You May Like

Video One Year After Thai Coup, No End in Sight for Military Rule

Since carrying out the May 22, 2014 coup, the general has retired from the military but is still firmly in charge More

Goodbye, New York

This is what the fastest-growing big cities in America have in common More

Job-Seeking Bangladeshis Risk Lives to Find Work

The number of Bangladeshi migrants on smugglers’ boats bound for Southeast Asian countries has soared in the past two years More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Turkey's Main Opposition Party Hopes for Election Breakthroughi
X
May 22, 2015 10:23 AM
Turkey’s main opposition Republican People’s Party has sought an image change ahead of the June 7 general election. The move comes after suffering successive defeats at the hands of the Islamist-rooted AK Party, which has portrayed it as hostile to religion. Dorian Jones reports from the western city of Izmir.
Video

Video Turkey's Main Opposition Party Hopes for Election Breakthrough

Turkey’s main opposition Republican People’s Party has sought an image change ahead of the June 7 general election. The move comes after suffering successive defeats at the hands of the Islamist-rooted AK Party, which has portrayed it as hostile to religion. Dorian Jones reports from the western city of Izmir.
Video

Video Europe Follows US Lead in Tackling ‘Conflict Minerals’

Metals mined from conflict zones in places like the Democratic Republic of Congo are often sold by warlords to buy weapons. This week European lawmakers voted to force manufacturers to prove that their supply chains are not inadvertently fueling conflicts and human rights abuses. Henry Ridgwell reports from London.
Video

Video Class Tackles Questions of Race, Discrimination

Unrest in some U.S. cities is more than just a trending news item at Ladue Middle School in St. Louis, Missouri. As VOA’s Kane Farabaugh reports, it’s a focus of a multicultural studies class engaging students in wide-ranging discussions about racial tensions and police aggression.
Video

Video Mind-Controlled Prosthetics Are Getting Closer

Scientists and engineers are making substantial advances towards the ultimate goal in prosthetics – creation of limbs that can be controlled by the wearer’s mind. Thanks to sophisticated sensors capable of picking up the brain’s signals, an amputee in Iceland is literally bringing us one step closer to that goal. VOA’s George Putic reports.
Video

Video Afghan Economy Sinks As Foreign Troops Depart

As international troops prepare to leave Afghanistan, and many foreign aid groups follow, Afghans are grappling with how the exodus will affect the country's fragile economy. Ayesha Tanzeem reports from the Afghan capital, Kabul.
Video

Video Poverty, Ignorance Force Underage Girls Into Marriage

The recent marriage of a 17-year old Chechen girl to a local police chief who was 30 years older and already had a wife caused an outcry in Russia and beyond. The bride was reportedly forced to marry and her parents were intimidated into giving their consent. The union spotlighted yet again the plight of many underage girls in developing countries. Zlatica Hoke reports poverty, ignorance and fear are behind the practice, especially in Asia and Africa.
Video

Video South Korea Marks Gwangju Uprising Anniversary

South Korea this week marked the 35th anniversary of a protest that turned deadly. The Gwangju Uprising is credited with starting the country’s democratic revolution after it was violently quelled by South Korea’s former military rulers. But as Jason Strother reports, some observers worry that democracy has recently been eroded.
Video

Video California’s Water System Not Created To Handle Current Drought

The drought in California is moving into its fourth year. While the state's governor is mandating a reduction in urban water use, most of the water used in California is for agriculture. But both city dwellers and farmers are feeling the impact of the drought. Some experts say the state’s water system was not created to handle long periods of drought. Elizabeth Lee reports from Ventura County, an agricultural region just northwest of Los Angeles.
Video

Video How to Clone a Mammoth: The Science of De-Extinction

An international team of scientists has sequenced the complete genome of the woolly mammoth. Led by the Swedish Museum of Natural History in Stockholm, the work opens the door to recreate the huge herbivore, which last roamed the Earth 4,000 years ago. VOA’s Rosanne Skirble considers the science of de-extinction and its place on the planet
Video

Video Blind Boy Defines His Life with Music

Cole Moran was born blind. He also has cognitive delays and other birth defects. He has to learn everything by ear. Nevertheless, the 12-year-old has had an insatiable love for music since he was born. VOA’s June Soh introduces us to the young phenomenal harmonica player.

VOA Blogs