“I must love her more”: Black South African male partners’ perceptions of breast cancer and their role in their partner’s access to health care in Diepsloot, Johannesburg

Abstract

Background: In South Africa (SA), women with breast cancer (BC) present to the health care system at advanced stages of the disease, resulting in poor prognosis. Limited awareness of the disease, large distances to health care centers, and lack of affordable transportation have all been implicated as factors delaying presentation. In addition, women in SA have limited social and financial independence, which may make it difficult for them to resolve their own health care needs. Despite this, little is known about what South African male partners know about breast cancer and what role they play in their partner’s access to health care. Methods: This interpretive qualitative case study, guided by the theoretical framework of hegemonic masculinity(ies), used semi-structured interviews to investigate perceptions and knowledge of BC and gender norms in regards to health care access in a group of black South African males (n=20) in long-term heterosexual relationships living in a resource-poor setting. Interview data was analyzed using thematic analysis and compared to observational data collected through opportunities with local BC organizations. Results: Participants demonstrated very little knowledge of breast cancer and cancer in general. Some specific misconceptions about cancer are reported, including confusion between cancer and HIV. Participants were positive about receiving health care for cancer but are burdened by barriers to reaching care and a lack of access to information about the disease. The men describe themselves as playing an active, mostly positive role in their partner’s access to health care. They demonstrate perspectives about gender relations that defy hegemonic forms of masculinity. Conclusions: Major public health efforts are required to increase awareness of BC in order to encourage earlier presentation to the healthcare system. These efforts should recognize the importance of the male partner in women’s health issues.