Masculinity and uptake of HIV services: validity of the Conformity to Masculine Norms Inventory-22 in Malawi and Zambia

Men continue to have lower rates of HIV testing and ART initiation and often access these services at later stages compared to women [1-3]. Qualitative research suggests the influence of masculine norms in delaying HIV service uptake due to risk undervaluation, disregarding of symptoms, or the perception that HIV infection and treatment undermines social and economic positioning [4-6]. Masculinity measures have aimed to quantitatively capture the relationship between masculinity and health-seeking [7], but have seldom been used in sub-Saharan Africa and in the context of HIV [8]. We aimed to assess the factor structures of established masculinity measures for use in rural Malawi and Zambia.