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Kengne-Nde C, Tejiokem MC, Orne-Gliemann J, Melingui B, Koki Ndombo P, Essounga NA, Bissek AC, Cauchemez S, Tchendjou PT. Couple oriented counselling improves male partner involvement in sexual and reproductive health of a couple: Evidence from the ANRS PRENAHTEST randomized trial. PLoS One 2021; 16:e0255330. [PMID: 34329355 PMCID: PMC8323939 DOI: 10.1371/journal.pone.0255330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 06/29/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Male partner involvement (MPI) has been recognized as a priority area to be strengthened in Prevention of Mother to Child Transmission (PMTCT) of HIV. We explored the impact of Couple Oriented Counselling (COC) in MPI in sexual and reproductive health and associated factors. METHOD From February 2009 to October 2011, pregnant women were enrolled at their first antenatal care visit (ANC-1) and followed up until 6 months after delivery in the Mother and Child Center of the Chantal Biya Foundation within the randomized prenahtest multicentric trial. The MPI index was defined using sexual and reproductive health behaviour variables by using multiple correspondence analysis followed by mixed classification. Men were considered as highly involved if they had shared their HIV test results with their partner, had discussed on HIV or condom used, had contributed financially to ANC, had accompanied their wife to ANC or had practiced safe sex. Factors associated to MPI were investigated by the logistic model with GEE estimation approach. RESULTS A total of 484 pregnant women were enrolled. The median age of the women was 27 years (IQR: 23-31) and 55.23% had a gestational age greater than 16 weeks at ANC-1. Among them, HIV prevalence was 11.9% (95% CI: 9.0-15.4). The median duration of the women's relationship with their partner was 84 months (IQR: 48-120). MPI index at 6 months after delivery was significantly greater in the COC group than the classical counselling group (14.8% vs 8,82%; p = 0,043; Fig 1). The partners of the women who participated in the COC were more likely to be involved during follow up than others (aOR = 1.45; 95% CI = 1.00-2.10). Partners with no incoming activity (aOR = 2.90; 95% CI = 1.96-4.29), who did not used violence within the couple (aOR = 1.70; 95% CI = 1.07-2.68), and whose partner came early for ANC-1 (aOR = 1.37; 95% CI = 1.00-1.89) were more likely to be involved than others. CONCLUSION MPI remains low in stable couples and COC improves partner involvement. Our findings also support the need of strengthening outreach towards "stable" couples and addressing barriers. This could go a long way to improve PMTCT outcomes in Cameroon. TRIAL REGISTRATION PRENAHTEST, NCT01494961. Registered 15 December 2011-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01494961.
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Affiliation(s)
- Cyprien Kengne-Nde
- Centre Pasteur Cameroon, Epidemiology and Public Health Service, Yaounde, Cameroon
- Bordeaux School of Public Health, Bordeaux University, Bordeaux, France
- Mathematical Modeling of Infectious Diseases Unit, Pasteur Institute, Paris, France
- * E-mail: (CK-N); (PTT)
| | - Mathurin Cyrille Tejiokem
- Centre Pasteur Cameroon, Epidemiology and Public Health Service, Yaounde, Cameroon
- International Network of Pasteur Institutes, Paris, France
| | - Joanna Orne-Gliemann
- INSERM U897, Bordeaux School of Public Health, Bordeaux University, Bordeaux, France
| | - Bernard Melingui
- Centre Pasteur Cameroon, Hematology Laboratory, Yaounde, Cameroun
| | - Paul Koki Ndombo
- Centre of Mother and Child, Chantal Biya Foundation, Yaounde, Cameroon
| | - Ngo A. Essounga
- Ministry of Scientific Research and Innovation, Yaounde, Cameroon
| | - Anne Cécile Bissek
- Division of Operational Research, Ministry of Public Health, Yaounde, Cameroon
| | - Simon Cauchemez
- Mathematical Modeling of Infectious Diseases Unit, Pasteur Institute, Paris, France
- International Network of Pasteur Institutes, Paris, France
| | - Patrice T. Tchendjou
- Centre Pasteur Cameroon, Epidemiology and Public Health Service, Yaounde, Cameroon
- International Network of Pasteur Institutes, Paris, France
- * E-mail: (CK-N); (PTT)
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Bhushan NL, Golin CE, McGrath N, Maman S, Tsidya M, Chimndozi L, Wesevich A, Hoffman IF, Hosseinipour MC, Miller WC, Rosenberg NE. The impact of HIV couple testing and counseling on social support among pregnant women and their partners in Lilongwe, Malawi: an observational study. AIDS Care 2019; 31:199-206. [PMID: 30182730 PMCID: PMC6322660 DOI: 10.1080/09540121.2018.1510102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 08/01/2018] [Indexed: 12/20/2022]
Abstract
Couples HIV testing and counseling (couple counseling) promotes safer sexual behaviors, increases communication between couples, and decreases HIV transmission. However, the impact of couple counseling on social support, critical for persons living with HIV, has not been examined. Ninety couples with a recently tested HIV-positive pregnant woman (female-positive couples) and 47 couples with a recently tested HIV-negative pregnant woman (female-negative couples) were enrolled in an observational study at an antenatal clinic in Malawi. Each couple member was assessed immediately before and one month after couple counseling for partner, family, and peer social support using the Multidimensional Scale of Perceived Social Support. Before couple counseling, social support was lower among women than men in both female-positive couples (β = -10.00, p < .01) and female-negative couples (β = -8.43, p < .01). After couple counseling, social support increased for women in female-positive couples (β = 4.01, p < .01) and female-negative couples (β = 4.69, p < .01) but not for men in either type of couple. Couple counseling could be an effective strategy to increase social support for women, including those with recent HIV diagnoses.
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Affiliation(s)
- Nivedita L Bhushan
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
- b School of Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Carol E Golin
- b School of Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
- c School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Nuala McGrath
- d Faculty of Medicine and Faculty of Social, Human, and Mathematical Sciences , University of Southampton , Southampton , UK
| | - Suzanne Maman
- b School of Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Mercy Tsidya
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
| | - Limbikani Chimndozi
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
| | - Austin Wesevich
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
| | - Irving F Hoffman
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
- c School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Mina C Hosseinipour
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
- c School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - William C Miller
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
- b School of Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
- c School of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
- e Division of Epidemiology , The Ohio State University , Columbus , OH , USA
| | - Nora E Rosenberg
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
- b School of Public Health , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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Tiendrebeogo T, Plazy M, Darak S, Miric M, Perez-Then E, Butsashvili M, Tchendjou P, Dabis F, Orne-Gliemann J. Couples HIV counselling and couple relationships in India, Georgia and the Dominican Republic. BMC Public Health 2017; 17:901. [PMID: 29178852 PMCID: PMC5702196 DOI: 10.1186/s12889-017-4901-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/12/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Couples HIV counseling and testing is essential for combination HIV prevention, but its uptake remains very low. We aimed to evaluate factors associated with couples HIV counseling uptake in India, Georgia and the Dominican Republic, as part of the ANRS 12127 Prenahtest intervention trial. METHODS Pregnant women ≥15 years, attending their first antenatal care (ANC) session between March and September 2009, self-reporting a stable partner, and having received couple-oriented post-test HIV counseling (trial intervention) were included. Individuals and couple characteristics associated with the acceptability of couples HIV counseling were assessed using multivariable logistic regression for each study site. RESULTS Among 711 women included (232, 240 and 239 in the Dominican Republic, Georgia and India, respectively), the uptake of couples HIV counseling was 9.1% in the Dominican Republic, 13.8% in Georgia and 36.8% in India. The uptake of couples HIV counseling was associated with women having been accompanied by their partner to ANC, and never having used a condom with their partner in the Dominican Republic; with women having been accompanied by their partner to ANC in India; with women having a higher educational level than their partner and having ever discussed HIV with their partner in Georgia. CONCLUSION Couple HIV counseling uptake was overall low. Strategies adapted to local socio-cultural contexts, aiming at improving women's education level, or tackling gender norms to facilitate the presence of men in reproductive health services, should be considered. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01494961 . Registered December 15, 2011. (Retrospectively registered).
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Affiliation(s)
- Thierry Tiendrebeogo
- INSERM UMR 1219 - Bordeaux Population Health Research Center, Bordeaux, France. .,Universite Bordeaux, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), 146 rue Leo Saignat, 33 076, Bordeaux cedex, France.
| | - Melanie Plazy
- INSERM UMR 1219 - Bordeaux Population Health Research Center, Bordeaux, France.,Universite Bordeaux, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), 146 rue Leo Saignat, 33 076, Bordeaux cedex, France
| | | | - Marija Miric
- Global Health and Biotechnology Research Center, O&M Medical School, Santo Domingo, Dominican Republic
| | - Eddy Perez-Then
- Global Health and Biotechnology Research Center, O&M Medical School, Santo Domingo, Dominican Republic
| | | | - Patrice Tchendjou
- Laboratoire d'Epidémiologie et de Santé Publique, Centre Pasteur du Cameroun, Yaoundé, Cameroon.,Réseau International des Instituts Pasteurs, Paris, France
| | - François Dabis
- INSERM UMR 1219 - Bordeaux Population Health Research Center, Bordeaux, France.,Universite Bordeaux, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), 146 rue Leo Saignat, 33 076, Bordeaux cedex, France
| | - Joanna Orne-Gliemann
- INSERM UMR 1219 - Bordeaux Population Health Research Center, Bordeaux, France.,Universite Bordeaux, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), 146 rue Leo Saignat, 33 076, Bordeaux cedex, France
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Wesevich A, Mtande T, Saidi F, Cromwell E, Tweya H, Hosseinipour MC, Hoffman I, Miller WC, Rosenberg NE. Role of male partner involvement in ART retention and adherence in Malawi's Option B+ program. AIDS Care 2017; 29:1417-1425. [PMID: 28355926 DOI: 10.1080/09540121.2017.1308464] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Malawi's Option B+ program provides all HIV-infected pregnant women free lifelong antiretroviral therapy (ART), but challenges remain regarding retention and ART adherence, potentially due to male partner barriers. We explored relationships between male partner involvement and Option B+ retention and adherence. In 2014, a randomized controlled trial in Malawi compared male recruitment strategies for couple HIV testing and counseling (cHTC) at an antenatal clinic. This secondary analysis was conducted among the entire cohort (N = 200) of women, irrespective of randomization status. We assessed whether cHTC attendance, early disclosure of HIV-positive status, and partner ART reminders were associated with retention and adherence at one month after starting treatment. Retention was defined as attending HIV clinic follow-up within one day of running out of pills. Adherence was defined as taking ≥95% of ARTs by pill count. We used binomial regression to calculate adjusted risk ratios (aRR) and 95% confidence intervals (CI). Median female age was 26 years. Most women (79%) were retained; of these, 68% were adherent. Receiving cHTC was associated with improved retention (aRR 1.33, 95% CI 1.12, 1.59). Receiving male partner ART reminders was weakly associated with retention (aRR 1.16, 95% CI 0.96, 1.39). Disclosure within one day was not associated with retention (aRR 1.08, 95% CI: 0.91, 1.28). Among those who were retained, these three behaviors were not associated with improved 95% adherence. CHTC could play an important role in improving Option B+ retention. Increasing cHTC participation and enhancing adherence-related messages within cHTC are important.
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Affiliation(s)
- Austin Wesevich
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
| | - Tiwonge Mtande
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
| | - Friday Saidi
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi
| | - Elizabeth Cromwell
- b Department of Epidemiology , University of North Carolina at Chapel Hill , Chapel Hill , USA
| | - Hannock Tweya
- c Lighthouse Trust , Lilongwe , Malawi.,d The International Union Against Tuberculosis and Lung Disease , Paris , France
| | - Mina C Hosseinipour
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi.,e Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , USA
| | - Irving Hoffman
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi.,e Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , USA
| | - William C Miller
- b Department of Epidemiology , University of North Carolina at Chapel Hill , Chapel Hill , USA.,e Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , USA
| | - Nora E Rosenberg
- a UNC Project , University of North Carolina at Chapel Hill , Lilongwe , Malawi.,b Department of Epidemiology , University of North Carolina at Chapel Hill , Chapel Hill , USA.,e Department of Medicine , University of North Carolina at Chapel Hill , Chapel Hill , USA
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Emmanuel W, Edward N, Moses P, William R, Geoffrey O, Monicah B, Rosemary M. Condom Use Determinants and Practices Among People Living with HIV in Kisii County, Kenya. Open AIDS J 2015; 9:104-11. [PMID: 26668671 PMCID: PMC4676051 DOI: 10.2174/1874613601509010104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 08/21/2015] [Accepted: 08/26/2015] [Indexed: 11/22/2022] Open
Abstract
The male condom remains the single, most efficient and available technology to reduce sexual transmission of HIV as well as sexually transmitted infections. This study sought to establish condom use determinants and practices among people living with HIV (PLHIVs) in Kisii County, Kenya. We interviewed 340 PLHIVs and 6 health workers. Although most PLHIVs had correct knowledge and approved condoms as effective for HIV prevention, consistent use and condom use at last sex were notably low especially among PLHIVs aged 18 - 24, those who depended on remittances from kin as main source of income, as well as during sex with secondary and casual partners. This study notes that knowledge on various benefits of using condoms is associated with enhanced condom use practices. Non-disclosure of HIV status to secondary and casual partners remains a key barrier to condom use among PLHIVs Our observations highlight the need to further promote condom use among specific PLHIVs socio-demographic groups who continue to exhibit low condom use rates.
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Affiliation(s)
| | - Neyole Edward
- Department of Disaster Preparedness and Engineering Management, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Poipoi Moses
- Department of Educational Psychology, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | | | - Otomu Geoffrey
- County Health Directorate, Kisii County Government, Kisii Kenya
| | - Bitok Monicah
- Ministry of Health, The National Government, Nairobi, Kenya
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