Hazardous alcohol consumption may compromise optimal antiretroviral therapy (ART)
adherence among patients. Adoption of hegemonic notions of masculinity may encourage
health-risk behaviours, such as alcohol consumption, and discourage health-enhancing
behaviours, such as ART adherence among men. This study aimed to explore linkages
between masculinity, alcohol consumption, and taking ART medication among male ART
recipients in South Africa. Male facilitators conducted five focus group discussions
with 27 black male ART recipients aged between 28 and 65 years at five ART clinics.
Eligibility criteria were: 18 years or older, at least three months on ART, and alcohol
consumption in the past three months. Data were analysed inductively using thematic
content analysis. The men demonstrated a masculinity that fostered commitment to taking
ART. However, normative notions of masculinity in the men's social circles often compromised
their timeous taking of medication. Fears of alcohol-ART interactions often led to
intentional non-adherence to ART when drinking. Finally, healthcare provider-patient
power dynamics seemed to prevent the men from discussing their challenges regarding
alcohol use and ART adherence with their healthcare providers. Interventions that
focus on addressing harmful hegemonic notions of masculinity among men are needed
in community settings such as drinking establishments where men tend to socialise.
Patient-centred approaches which enhance men's sense of involvement in their treatment
are needed in healthcare settings.