Table 2 Coding framework: Pathways through which masculinity impacts on women's opportunities for adherence

- Men feel superior

- Strong and resilient

- Independent and tough

- Pride

- Can't show fear

- Men are heads of house

- Men have girlfriends

- Women not allowed extra marital relationships

1. Men are perceived as physically strong and capable of withstanding disease.

2. Men are perceived as emotionally independent and tough.

3. Men should not show fear.

4. Men are perceived as breadwinners and the ones to carry out heavy duties, while women work at home, providing care for children and supporting husbands.

Social constructions of masculinity

- Fear of being recognised as HIV positive

- Having AIDS exposes their promiscuity

- Embarrassment

- Fear disclosing status to their wives

- Fear being alone

- HIV compromises their manhood

- Denying it can happen to them

- Death over dishonour

- Blaming others

- Not taking AIDS seriously

- Avoiding talking about AIDS

5. Men are afraid of being recognised as HIV positive as it exposes their promiscuity and he may lose his dignity.

6. Men have guilt about sleeping around and feel so embarrassed that they often fear disclosing their status to their wives.

7. Married men fear being abandoned by their wives and young men fear being rejected by girls and living a life alone.

8. Many men deny that they are ill from AIDS and would rather blame others or die with "dignity".

Men's fear and denial of HIV

- Women fear disclosing HIV status to husbands

- Men stop wives from taking drugs

- Men's denial compromises women's treatment

- Men steal women's tablets

- Men's denial can re-infect women

- Couples counselling needed

- Using sex to demonstrate manhood

9. Men's lack of participation in HIV services, coupled with their sexuality, leaves women susceptible for re-infection.

10. Because of men's negative reactions to HIV, many women fear disclosing their status to their husbands, losing out on an important treatment partner.

11. Out of shame, men may deny their wives taking ART.

12. If husbands know that their wives are on ART and suspect they are sick too, they may steal their wives' ARVs.

Masculinity interfering with married women's ART adherence