{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:15:51Z","timestamp":1787933751961,"version":"build-2784847793"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In southern Africa, men are less likely than women to access HIV services, including HIV testing, antiretroviral therapy (ART), and HIV prevention services. As a result, men living with HIV are less likely to be virally suppressed and more likely to transmit HIV than their female peers. Using the socio-ecological model as a framework, we explored factors that influence men\u2019s motivation and capability to access available HIV services, including how social norms and social networks influence men\u2019s engagement with services, in Lusaka, Zambia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted seven focus group discussions (FGDs) with men and women in an urban community in Lusaka. Five FGDs were conducted with men; two with young men aged 20\u201324; two with men aged 25\u201335 and one with men aged 20\u201335. We conducted two FGDs with women, stratified by age 18\u201324 and 25\u201335. The total number of participants was 70. Data were coded and analysed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pervasive negative community narratives around HIV, negative social and gender norms, the influence of men\u2019s social networks, including stigma related to a positive HIV test result and fear of social isolation, were among the key factors influencing men\u2019s access to HIV services. For HIV testing, the organization and delivery of services in health facilities, including location of HIV testing, waiting times, and likelihood of being seen accessing services, dissuaded men from testing for HIV. In general, health facilities were seen as women\u2019s spaces and unresponsive to men\u2019s needs. However, provider-initiated initiatives, including couples testing in antenatal care and an offer of HIV testing prior to medical male circumcision, and community-based HIV testing facilitated service use. Though condoms were the primary HIV prevention tool mentioned by study participants, norms of their use in marriage and sexual relations limited use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite HIV having evolved to a chronic condition and various HIV prevention tools available, fear, social isolation, stigma, and harmful gender norms continue to negatively impact men\u2019s motivation and capability to engage with available HIV services. Measures to facilitate men\u2019s use of these services should consider how to increase social support alongside the delivery of services in spaces that meet men\u2019s needs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-025-23703-2","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T13:18:15Z","timestamp":1759756695000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u201cA heart of the man is lighter than that of the woman\u2026\u201d exploring men\u2019s motivation and capability to access HIV services in Lusaka, Zambia: findings from the Yaba Guy Che study"],"prefix":"10.1186","volume":"25","author":[{"given":"Chisanga","family":"Mwansa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mwelwa M.","family":"Phiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Belemu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loyd","family":"Kalekanya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Banda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucheka","family":"Sigande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Ayles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musonda","family":"Simwinga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadette","family":"Hensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"23703_CR1","unstructured":"The Joint United Nations Programme on HIV\/AIDS (UNAIDS). 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AIDS Behav. 2021;25(9):2863\u201374.","journal-title":"AIDS Behav"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-23703-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-025-23703-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-23703-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T11:51:59Z","timestamp":1781610719000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12889-025-23703-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,6]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["23703"],"URL":"https:\/\/doi.org\/10.1186\/s12889-025-23703-2","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,6]]},"assertion":[{"value":"1 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Yaba Guy Che study was approved by the University of Zambia Biomedical Research Ethics Committee (2374\u2009\u2212\u20092021) and the London School of Hygiene and Tropical Medicine (26713). All participants in this study provided written informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3353"}}