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).

Multimedia

Audio
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 Five Patients Given Experimental Ebola Drug Said To Be Improving

Experimental drugs have been tried on six people: three Westerners and now, three African pyhysicians More

Video In Ukraine, Fear and Distrust Remain Where Fighting has Stopped

As Ukrainian military reclaims control of eastern cities residents rebuild their lives, but many say everyone is being treated with suspicion More

Video In Rural Kenya, Pressure Builds Against Female Circumcision

Girls learn to object; FGM practitioners face penalties from jail sentences to stiff fines More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Five Patients Given Experimental Ebola Drug Said to Be Improvingi
X
Carol Pearson
August 19, 2014 11:43 PM
The World Health Organization has approved the use of experimental treatments for Ebola patients in West Africa. The Ebola outbreak there is unprecedented, the disease deadly. The number of people who have died from Ebola has surpassed 1,200. VOA's Carol Pearson reports on the ethical considerations of allowing experimental drugs to be used.
Video

Video Five Patients Given Experimental Ebola Drug Said to Be Improving

The World Health Organization has approved the use of experimental treatments for Ebola patients in West Africa. The Ebola outbreak there is unprecedented, the disease deadly. The number of people who have died from Ebola has surpassed 1,200. VOA's Carol Pearson reports on the ethical considerations of allowing experimental drugs to be used.
Video

Video In Ukraine, Fear and Distrust Remain Where Fighting has Stopped

As the Ukrainian military reclaims control of eastern cities from pro-Russian separatists, residents are getting a chance to rebuild their lives. VOA's Gabe Joselow reports from the town of Kramatorsk in Donetsk province, where a sense of fear is still in the air, and distrust of the government in Kyiv still runs deep.
Video

Video China Targets Overseas Assets of Corrupt Officials

As China presses forward with its anti-graft effort, authorities are targeting corrupt officials who have sent family members and assets overseas. The efforts have stirred up a debate at home on exactly how many officials take that route and how likely it is they will be caught. Rebecca Valli has this report.
Video

Video Leading The Fight Against Islamic State, Kurds Question Iraqi Future

Western countries including the United States have begun arming the Kurdish Peshmerga forces in northern Iraq to aid their battle against extremist Sunni militants from the Islamic State. But there are concerns that a heavily-armed Kurdistan Regional Government, or KRG, might seek to declare independence and cause the break-up of the Iraqi state. As Henry Ridgwell reports from London, the KRG says it will only seek greater autonomy from Baghdad.
Video

Video In Rural Kenya, Pressure Builds Against Female Circumcision

In some Kenyan communities, female genital mutilation remains a rite of passage. But activists are pushing back, with education for girls and with threats of punishment those who perform the circumcision. Mohammed Yusuf looks at the practice in the rural eastern community of Tharaka-Nithi.
Video

Video For Obama, Racial Violence is Personal Issue

The racial violence in the St. Louis suburb of Ferguson is presenting U.S. President Barack Obama with an issue to which he has a deep personal connection. To many Americans, Obama's election as America's first black president marked a turning point in race relations in the United States, and Obama has made ending the violence a policy priority. On Monday he issued a new call for calm and understanding. Luis Ramirez reports from the White House.
Video

Video Clinton-Obama Relationship Could Impact 2016 Election

President Barack Obama and former Secretary of State Hillary Clinton have a long and complicated relationship. That relationship took another turn recently when Clinton criticized the president’s foreign policy. VOA National Correspondent Jim Malone reports there is renewed attention on the Clinton-Obama relationship as Hillary Clinton considers running for
Video

Video Iran Looks to Maintain Influence in Baghdad With New Shia PM

Washington and Tehran share the goal of stopping Syrian-based militants in Iraq. But experts say it's Iran, not the United States, that will most influence how the new government in Baghdad approaches internal reforms and the war in Syria. VOA State Department Correspondent Scott Stearns has the story.

AppleAndroid