Invisible men: The social complexities of involving males in biomedical HIV prevention in Eswatini

Following the discovery of potent novel biomedical HIV technologies in the form of Voluntary Medical Male Circumcision and Test and Start, Eswatini implemented these important technologies to curb the spread of HIV infections in the country with the highest HIV prevalence in the world. In dire need of these efficacious technologies, the country with technical and financial support from donors successfully implemented both novel biomedical technologies. With technical and financial might, due to known historical statistics of low uptake of HIV services, Swazi men were targeted as a crucial population to make these technologies effective and reduce new HIV infections. This technological and financial prowess turned out to be inconsequential as uptake was low. Drawing on evidence from ethnographic fieldwork, this thesis explored Swazi males’ perceptions on VMMC and Test and Start. I aimed to gain an emic perspective on why there was low utilization of these readily available potent biomedical technologies by Swazi males. Implementation of these interventions was challenged by complex social, economic and political realities. Policy makers had overlooked the social realities and complexities of the interventions, failing to consider how targeted populations would receive them or if they would use them to the extent required to have the desired population-level preventive effect.