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Gender inequalities have long been recognised as one of the most significant factors influencing the dynamics of the HIV epidemic in sub-Saharan Africa (SSA). However, it remains unclear how men and women are discussed in HIV-prevention initiatives and if certain representations of men and women impact prevention guidance. This research aimed to understand how men and women are portrayed in HIV-prevention guidelines produced by UNAIDS for the SSA region, and how these influence the different types of interventions targeted at women and men. Thirty-four UNAIDS prevention documents were included in the study. The policy documents were analysed to ascertain the frequency of different interventions suggested, the extent to which they were targeted at men and women, and a textual analysis of the way that men and women were represented. Due to a lack of information regarding other gender identities, the research was aimed at cis-gender men and women only. The analysis revealed that most policy documents focused on women, that there were differences in the types of interventions targeted at men and women, with few social interventions targeted at men, and that the language used to describe men and women repeats traditional gender stereotypes and cements simplistic dualisms. The lack of social interventions targeted at men suggests that behaviour change among men is not highly prioritised in current prevention initiatives. Instead, current UNAIDS policy focuses on women as the key site for intervention and empowerment. UNAIDS should therefore provide more details and examples about how best to engage men and boys in prevention efforts, as well as to include more nuanced conceptions of gender in policy guidance.

Evaluating HIV policy: a gender analysis of the representation of women and men in UNAIDS HIV-prevention guidelines