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Men use HIV services less than women. Traditional gender roles are cited as primary barriers to men’s use of HIV testing and treatment. Little is known, however, about men’s experience of health services and their barriers to HIV testing uptake. Using STI services in southern Malawi as a case study, I use in-depth interviews and participant observation to compare men’s and women’s perceptions and experience of health services. By examining gendered healthcare systems, patient-provider interactions, and broader norms of healthcare seeking behavior, the influences on HIV testing decisions among high-risk men and women who should, theoretically, receive HIV testing emerge.