As Xolani Zwane, a 38-year-old father of three in South Africa, entered a clinic supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), he was unaware that he would soon take a significant step to protect himself and his family from HIV.
Prior to this visit, Xolani did not know that through voluntary medical male circumcision (VMMC) he could reduce his risk of acquiring HIV by at least 60 percent. Once the clinic’s manager explained the medical benefits of VMMC, Xolani decided it was the right choice. As he noted two days later, “There was no reason not to do it, and [now] I feel great.” Because of his positive experience, Xolani plans on having his four-year-old son circumcised as soon as he is old enough.
On this Father’s Day, PEPFAR celebrates the fathers like Xolani and the millions of men around the world playing vital roles in ensuring their own health, the welfare of their families and societies, and our collective efforts to control the HIV/AIDS pandemic. These are the men who get tested for HIV, go for VMMC, and consistently take their antiretroviral medications if they are diagnosed with HIV. They also support their partners and children to stay HIV free or, if needed, access life-saving treatment (ART).
PEPFAR is deeply committed to reaching men with HIV prevention and treatment services, and we know this is not always easy. Data from many countries show that men, especially those 20–35 years of age, tend to access HIV testing at far lower rates than do women. As a result, men living with HIV often enter care with more advanced disease, are less likely to receive ART, miss opportunities to prevent ongoing transmission, and have much higher AIDS-related mortality than their female counterparts.
In addition, from recent program data and PEPFAR-supported Public Health Impact Assessments in three countries, we know that more than half of men under age 35 do not know their HIV status and are not on treatment, fueling the epidemic among 15- to 24-year-old women.
PEPFAR is driving innovation so that more men can receive life-saving HIV prevention and treatment services. For example, we are delivering these services to where men already are through mobile and community clinics and keeping sites open late and on weekends so men do not have to miss work to know their status or get treatment. And we are using more granular data to target VMMC to the specific age bands of men who have the highest risk of HIV infection, increasing our impact with every dollar we invest.
We are also leveraging the power of the private sector through key partnerships to increase our impact. This includes our DREAMS public-private partnership, which is helping girls develop into Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe women — but also aims to make sure that men are part of the equation, as they are half of the solution.
We have joined forces with The Elizabeth Taylor AIDS Foundation to pioneer new ways of delivering high-quality HIV services for working-age men in one of the highest-affected districts in Malawi and partnered with AstraZeneca to expand access to HIV services for men ages 25 to 50 through smart integration, concurrently screening them for HIV and hypertension in two of the highest-HIV-affected counties in Kenya.
Today and every day, we applaud the fathers and other men who are accessing HIV services, embracing gender equity, stopping the cycle of sexual and gender-based violence, and supporting their daughters — and all adolescent girls and young women — to stay in school, find employment, and live HIV-free lives. By reaching men and fathers like Xolani with HIV services and empowering them as healthy role models for their families and communities — together, we are accelerating progress toward controlling the HIV/AIDS pandemic.
About the Author: Ambassador Deborah L. Birx, M.D. serves as U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health Diplomacy at the U.S. Department of State.