SUFFERING IN SILENCE

Why men living with HIV die earlier than women

The 13-year-long study found out ARVs alone are not helping men live longer

In Summary
  • The 13 year study found out that men living with the virus suffer in silence would die even when introduced to antiretroviral drugs compared to their female counterparts who received much attention.
  • The study found out that male patients who began anti-retroviral therapy at an adolescent stage did not have an increased mortality rate since they built a strong immunity over time.
Charles Ayisi (records officer at Kakamega County Teaching and Referral Hospital), Prof Luqman Mushila, Dr Roselyne Asiko and Dean John Arudo from the School of Nursing at Masinde Mulliro University address the media after the release of research findings on February 5, 2021.
Charles Ayisi (records officer at Kakamega County Teaching and Referral Hospital), Prof Luqman Mushila, Dr Roselyne Asiko and Dean John Arudo from the School of Nursing at Masinde Mulliro University address the media after the release of research findings on February 5, 2021.
Image: HILTON OTENYO

Higher deaths in men living with HIV/Aids have been linked to poverty, stigma and lack of psychosocial support.

Research findings by experts from Masinde Muliro and Stanford universities and the Kakamega County Referral Hospital reveal that men received the least attention from organisations involved in HIV/Aids campaigns compared to women living with the virus.

The 13-year-long study found out that men living with the virus suffer in silence and would die earlier even when introduced to antiretroviral drugs compared to their female counterparts who received much attention.

In most cases, the study says, donor funding in Kenya focuses on Prevention of Mother to Child Transmission (PMTCT) that offer a range of services for women  to maintain their health and stop their infants from infections.

Even the NGOs that support HIV/Aids programmes only deal with women and kids but men are more often left out of the programmes.

The lead researchers in the study are Prof Luqman Mushila, Dr Roselyne Abwalaba, Dr John Arudo and Michele Barry. Others are Charles Ayisi and Josephat Sakwa.

The study, dubbed ‘Ten Year Survival with analysis on gender difference, risk factors and causes of death during 13 years of public antiretroviral therapy in rural Kenya’ was conducted on patients enrolled in antiretroviral therapy at Kakamega County Teaching and Referral Hospital.

A total 6,133 people living with HIV participated in the research, carried out between July 2004 to March 2017 and later published in the Medicine Journal in 2020.

At least 3,699 (60 per cent) of the participants were adult females while 1,903 (31 per cent) were adult males, 285 (5 per cent) were paediatric females while 246 (1 percent) were paediatric males. The findings were released on January 5 at the county general hospital.

The study found out that male patients who began anti-retroviral therapy at an adolescent stage did not have an increased mortality rate since they built a strong immunity over time.

“Male gender began to be an independent risk factor for death only for patients beginning antiretroviral therapy after the age of 25 years as compared to men who are exposed to ARV drugs when at a relatively younger age,” said Dr Abwalaba from the School of Nursing, Midwifery and Paramedical Sciences at Masinde Muliro.

According to Abwalaba, those who missed attending clinics for more than a month were at a high risk of dying early.

She added: "It’s not in Kenya alone where men with HIV die early, even in the Sub Saharan Africa where 56 per cent of people living with HIV are women, an estimated 300,000 men died of acquired immuno-deficiency syndrome (Aids)-related illnesses in 2018 compared to 270,000 women."

It was found that men who were in employment preferred taking a double dose in the evening when going to bed due to the side effects associated with ARVs such as loss appetite, diarrhoea, fatigue and lipodystrophy (losing or gaining fat in certain body areas).

According to Prof Lugman of Mmust, the only way to address the increasing number of deaths of men infected with the virus was to start tailor made programmes that address their needs.

"To stop men living with HIV from going to an early grave, government and NGOs should start programs that are sensitive to the needs of the men as opposed to neglecting them," Prof Luqman said.

The study further established that tuberculosis, diarrhoea, wasting syndrome, malaria and pneumonia were leading causes of death among the adults living with HIV in Kenya. 

 "A total 846 patients died while on antiretroviral drugs during the study period where 422 (49.9 per cent) adult females, 328 (38.8 per cent) adult males, 48 (5.7 per cent) paediatric females and 48 (5.7 per cent) paediatric males,” said Prof Luqman.

Tuberculosis was the leading cause of deaths causing 129 of 846 deaths recorded followed by Malaria that killed 47 people and diarrheal illness caused the death 15 people among others. 

Other diseases are encephalitis (brain infection), meningitis (infection of the membranes that surround the brains and the spinal cord) Kaposi Sarcoma (skin cancer) and urinary tract infection among the women.

“Malaria is recognised as a significant cause of death for pregnant women living with HIV in sub-Saharan Africa, causing more than 5 percent of deaths,” said Dr Abwalaba.

Prof Luqman said that among the children, diarrheal illness, tuberculosis, wasting syndrome and pneumonia were the leading causes of death.