Background: Men in South Africa, particularly in peri-urban areas, remain underrepresented in Human Immunodeficiency Virus (HIV) testing services (HTS), contributing to delayed diagnoses and ongoing transmission. Despite national efforts, gender-specific barriers to HTS persist. This study explored the perspectives of men and healthcare providers on barriers to and facilitators of male uptake of HTS at primary health care (PHC) facilities. Methods: A qualitative research design was used. The study was conducted in Orange Farm, one of the largest peri-urban township areas in South Africa. Semi-structured interviews were conducted with 12 male patients, six lay counsellors, and five professional nurses between July and August 2022. Data were analysed thematically using the socio-ecological model as a guiding framework. Results: Barriers to HTS uptake manifested across five distinct levels. At the individual level, limited awareness of HIV and available testing options hindered engagement. Interpersonally, silence within families and a lack of emotional support discouraged testing. Organisationally, discomfort with cross-gender interactions and negative attitudes among healthcare staff created further obstacles. At the community level, the absence of male-targeted educational initiatives contributed to low participation. Finally, at the policy level, inconsistent implementation of HTS guidelines undermined service delivery and accessibility. Key facilitators aligned with each level included enhanced awareness at the individual level; open, supportive family dialogue at the interpersonal level; male-friendly service environments at the organisational level; community-driven education initiatives at the community level; and improved adherence to HTS guidelines at the policy level. Conclusions: These findings underscore the necessity of a multi-level, gender-sensitive approach to bolster male engagement in HTS at PHC facilities. Strengthening HIV service delivery for men requires the cultivation of supportive environments across all of the individual, interpersonal, organisational, community, and policy levels.
A Thu, study studied this question.