Male Partners Involvement in Prevention of Mother-to-Child Transmission of HIV Services in Southern Central Ethiopia: In Case of Lemo District, Hadiya Zone

HIV Testing Uptake Among Ethiopian Rural Men: Evidence from 2016 Ethiopian Demography and Health Survey Data

Background

Human immunodeficiency virus (HIV) testing coverage among men remains low in Ethiopia; the problem of limited HIV testing coverage is worst in rural areas. Therefore, this study aims to identify factors associated with HIV testing uptake among rural men in Ethiopia.

Methods

Data from 10,187 rural men was extracted from the 2016 Ethiopian Demography and Health Survey. All analyses were performed using the complex sample analysis procedure to account for the multistage sampling. Bivariable and multivariable regression analyses were performed to identify factors associated with HIV testing uptake. Statistical significance was defined as a 95% Confidence Interval (CI) with a p-value of less than 0.05.

Results

Overall, only 40.3% of rural men have ever been tested for HIV. Being aged 31-44 years (Adjusted Odds Ratio (AOR) =1.12, 95% CI [1.01-1.42]), living in developed regions (AOR=1.43, 95% CI [1.09-1.88]), engaging in non-agricultural activities (AOR = 1.27, 95% CI [1.05-1.52]), being Muslim (AOR = 2.07; 95% CI [1.67-2.67]), having comprehensive knowledge about HIV (AOR =1.31, 95% CI [1.12-1.54]), being from a medium (AOR = 0.56, 95% CI [0.47-0.93]) and rich (AOR = 0.80, 95% CI [0.56-0.80]) households, attending primary (AOR = 0.21, 95% CI [0.16-0.28]) and secondary (AOR = 0.35, 95% CI [0.25-0.35]) school, having their first sexual experience at the age of 17 or younger (AOR = 0.26, 95% CI [0.19-0.93]), having discriminatory attitudes towards HIV patients (AOR = 0.67, 95% CI: 0.47-0.93) and having no health insurance coverage (AOR = 0.54, 95% CI [0.42-0.69]) were significantly associated with HIV testing uptake.

Conclusion

HIV testing uptake among rural men was low. Strengthening awareness programmes on HIV and HIV testing, integrating HIV testing with all other healthcare, strengthening partner accompany and HIV testing during pregnancy and delivery, and providing home-based HIV testing may increase HIV testing uptake.

Spatial variability of mother-to-child human immunodeficiency virus transmission in a province in the Brazilian Rainforest: An ecological study

The mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) remains a serious public health problem in the Brazilian Rainforest. This study aimed to spatially analyze this type of infection between 2007 and 2018 in Pará, which is the second-largest Brazilian state in the Brazilian Rainforest and also has the highest MTCT of HIV in Brazil. We analyzed the incidence rates of HIV (including the acquired immunodeficiency syndrome (AIDS) by MTCT as the main route of infection in children younger than 13 years old and whose mothers live in Pará. We employed spatial autocorrelation, spatial scanning, and geographic-weighted spatial regression techniques. In the period of this study, 389 new HIV/AIDS were noted, with territorial expansion of the incidence rates in the municipalities in northern and southern Pará having the highest rates. São Francisco do Pará had high spatial risk and high-spatiotemporal risk clusters comprising municipalities in western and south-western Pará between 2013 and 2016. The spatial variability of HIV/AIDS incidence rates was found to be common in the number of men and women with formal jobs; unemployed ≥18 years old people; elementary school pupils; and families enrolled in the "Single Registry for Social Programs". The social equity approach in Pará guarantee pregnant women access to preventive, diagnostic and treatment health services and their children should be supported to eliminate the MTCT of HIV in Pará.

Magnitude and determinants of male partner involvement in PMTCT service utilization of pregnant women attending public health facilities of Ethiopia, 2021: a systematic review and meta-analysis

BACKGROUND

Infant antiretroviral prophylaxis has an important role in reduction of Human immune virus transmission from mother to child during the postpartum period. Male partner involvement was considered as a priority aforementioned area needs to be enhanced in Prevention of Mother-To Child Transmission (PMTCT). PMTCT service utilization can minimize the risk of the transmission of HIV from mother to child and related mortalities. Adequate utilization and adherence to this service has been challenging for some of the women if their partners are not aware or do partners do not support the women. The aim of this study is to assess the magnitude and determinants of male involvement in PMTCT service in Ethiopia.

METHODS AND MATERIALS

We had conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). We had used PubMed, Google Scholar, and cross reference for searching articles. We had used the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument for critical appraisal of studies. Met-analysis and meta-regression were computed to present the pooled prevalence and determinants of male partner involvement with a 95% confidence interval using Revman.

RESULTS

Among a total of 338 studies, 11 studies were included in this analysis. The estimated pooled magnitude of male partner involvement was 40% (95% CI: 29.11-50.69). Knowledge of husband on PMTCT (2.30, 95% CI 1.75, 3.02), perceived responsibility for the women (4.22, 95% CI 2.31, 7.71), being government employee (2.89, 95% CI 2.02, 4.12), cultural barriers (3.44, 95% CI 2.54, 4.65) and educational status of husband (2.4, 95% CI 1.79, 3.50) were the determinants of pooled estimates of male partner involvement in PMTCT activities.

CONCLUSION

The pooled prevalence of male partner involvement was lower than the study conducted in sub Saharan Africa. Knowledge of husband on PMTCT, perceived responsibility for women, occupational status, cultural barriers and educational status of husband were determinants of male partner involvement. Therefore, the existing strategies to improve male involvement should be strengthened.

A qualitative exploration of roles and expectations of male partners from PMTCT services in rural Malawi

BACKGROUND

Prevention of mother-to-child transmission of HIV (PMTCT) is effective in curbing rates of HIV infection in children because its interventions reduce the rates of transmission during pregnancy, in labour, and in breastfeeding. Male involvement (MI) greatly influences uptake and adherence to PMTCT services. Lack of clarity on the roles and expectations of men in PMTCT is one of the main barriers to MI. The main aim of the study was to explore the roles and expectations of male partners from PMTCT services in Malawi.

METHODS

This was a descriptive qualitative study that involved men whose partners were either pregnant or breastfeeding a child, health care workers working in PMTCT services for over six months, and traditional leaders. We conducted 9 in-depth interviews and 12 key informant interviews from January to March 2018. All interviews were audio-recorded, transcribed, and translated. Thematic analysis was employed to analyze data.

RESULTS

The subjective and community norms and attitudes of men towards PMTCT provide the context in which male partners define the specific roles they render and the services they expect from PMTCT services. The roles of men in PMTCT service were contextualized in what is socially acceptable and normalized in the setting and include supportive roles expressed as accompanying the wife to attend; antenatal care services, Dry blood sample collection (DBS) when its due, keeping appointments when is due to take the ARVs, providing financial support; HIV prevention behavior change and decision-making roles. The desired services within PMTCT include health assessment such as checking their weight; blood pressure; blood sugar and promotion activities such as education sessions that are provided in a male-friendly manner that is in tandem with existing socio-cultural norms and attitudes of men towards such services.

CONCLUSION

The roles of male partners in PMTCT services are underpinned by subjective norms and what is socially acceptable within a specific context. The services that men require from PMTCT services are influenced by their attitudes and beliefs towards PMTCT interventions. Services should be male-tailored provided in an atmosphere that allows and accepts male partners to exercise their roles in PMTCT services.

Male partner involvement in HIV testing and counseling among partners of pregnant women in the Delanta District, Ethiopia

Background

Only screening a pregnant mother is not satisfactory to prevent mother-to-child transmission of HIV (PMTCT). A male partner’s involvement in HIV testing and counseling is also critical for PMTCT, however, it is one of the biggest challenges in Ethiopia. This study aimed to assess a male partner’s involvement in HIV testing and counseling and associated factors among partners of pregnant women in the Delanta District, Northern Ethiopia.

Methods

A community-based cross-sectional study design was conducted in the Delanta District from March 15 to May 10, 2018. During the study period, 609 male partners were involved. A binary and multiple logistic regression model was used to examine the association between variables.

Results

Out of all, 325 (53.7% at 95% CI: 49.6 to 57.5) of male partners were involved in HIV testing and counseling in the District. Male partners who were living together, ever heard about HIV from health professionals, pregnant women’s antenatal care (ANC) visit, partner visited the PMTCT clinic with wife, and partner and wife discussion before HIV testing and counseling were factors associated with male partner involvement.

Conclusion

The proportion of male partner involvement was found to be low as compared to the national standards. Local health authorities and health care workers need to develop and conduct interventions that help partners with their wife to live together, improve their awareness about HIV and testing, ANC visit by pregnant women, and encourage having home discussion before HIV testing through counseling, by so doing finally raise the level of male partner involvement in HIV testing and counseling.

Correlates of HIV-Positive Fathers' Involvement in Prevention of Mother-to-child Transmission Programs in Northern Nigeria

BACKGROUND

The involvement of men in prevention of mother-to-child HIV transmission (PMTCT) programs could accelerate the elimination of vertical transmission. Yet, little research has focused on HIV-positive male partners. This study determined the predictors of male partners' PMTCT knowledge and involvement in a tertiary hospital in northern Nigeria.

METHODS

A clinic-based sample of 401 HIV-positive male partners of women who delivered within 12 months prior were interviewed using structured questionnaires. PMTCT knowledge and involvement scores were computed. Adjusted odd ratios (AOR) for predictors were derived from multivariate logistic regression models.

RESULTS

The proportion of respondents with adequate PMTCT knowledge was 40.9%. Less than half (43.6%) of the respondents participated in PMTCT, with median involvement score of 2.00 (interquartile range, IQR = 0, 5.0). One quarter of respondents (25.7%, n =103) reported >1 sex partners, 10.5% consistently used condoms, and 20.7% had disclosed to all partners. Fathers' involvement in PMTCT was predicted by paternal education (AOR = 0.30; 95% Confidence Interval (CI): 0.12-0.77, no formal vs. post-secondary), HIV-positive child (AOR = 3.85; 95%CI: 1.41-10.54, yes vs. no), treatment duration (AOR = 4.17; 95%CI: 1.67-10.41, ≤1 vs. ≥10 years), disclosure to partner(s) (AOR = 1.21; 95%CI: 1.15-3.52, 'disclosed to all' vs. 'not disclosed'), condom use (AOR = 5.81; 95%CI: 3.07-11.0, always vs. never), and PMTCT knowledge (AOR = 0.62; 95%CI: 0.31-0.92, inadequate versus adequate).

CONCLUSION

The involvement of fathers in HIV PMTCT programs was low and predicted by paternal education, HIV-positive child, duration of antiretroviral treatment, disclosure to partner, consistent condom use, and level of PMTCT knowledge. Our findings will inform the development of policies to increase male partner involvement in PMTCT in Nigeria.

Male involvement in prevention of mother to child transmission of human immunodeficiency virus and associated factors in Enebsiesarmider District, north West Ethiopia, 2018: a cross-sectional study

Background

Globally, male involvement has been identified as a priority target area to be strengthened in the prevention of mother to child transmission (PMTCT) of HIV. However, there are limited studies on husband involvement in the prevention of mother to child transmission of HIV in Ethiopia. Therefore, this study aimed to assess male involvement in the prevention of mother to child transmission of HIV and associated factors among males whose wives gave birth in the last six months before the survey in Enebsiesarmider district, Northwest Ethiopia.

Methods

A Community-based cross-sectional study was employed to assess male involvement in the prevention of mother to child transmission of human immunodeficiency virus and associated factors in Enebsiesarmider District, Northwest Ethiopia. The study was conducted from February 10–30, 2018. A total of 525 participants were involved in the study. A stratified cluster sampling method was used to recruit study participants. Data were collected using a structured interviewer-administered questionnaire. Data were entered using the epi Data software and exported to SPPS for analysis. Descriptive statistics including mean, a proportion were used to describe study variables. Multivariable logistic regression was employed to describe variables with the outcome variable.

Result

Overall male involvement in PMTCT was found to be 26.1% [95%CI, 22.1–29.5]. Respondents who have attended secondary education and above were more likely get involved in PMTCT than who have no formal education [AOR 2.45, 95%CI, 1.47–4.11], Respondents who have good knowledge on PMTCT [AOR 2.57, 95%CI, 1.58–4.18], good knowledge on ANC [AOR 2.10, 95%CI, 1.28–3.44], low cultural barriers [AOR 2.20, 95%CI, 1.34–3.63] low health system barriers [AOR 2.40, 95%CI, 1.37–4.20] were variables that significantly increase male involvement in PMTCT practices.

Conclusion

Male involvement in PMTCT was found to be low in the study area. Therefore, the district health office in collaboration with local health care providers shall design strategies for enhancing male involvement through creating a husband’s knowledge regarding the merit of prevention of mother to child transmission through the provision of adequate information for all male partners at ANC clinic is recommended.

Determinants of Male Partner Involvement Towards Prevention of Mother to Child Transmission Service Utilization Among Pregnant Women Who Attended Focused Antenatal Care in Southern Ethiopia

BACKGROUND

Male partner involvement is an important and crucial determinant of prevention of mother to child transmission (PMTCT) of HIV. It creates an opportunity to reverse the transmission of HIV during pregnancy, labor, and breastfeeding. Thus, involving male partners during HIV screening of pregnant mothers at ANC is the key to fight against MTCT of HIV.

OBJECTIVE

This study was designed to assess the magnitude and factors associated with male partner's involvement on PMTCT service utilization among pregnant women who attended focused antenatal care (FANC) in Southern Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted among 420 randomly selected pregnant women who enrolled in PMTCT service at ANC clinics. Pre-tested and structured self-administered questionnaires were used to collect the data. Multiple logistic regression analysis was used to determine the presence of statistically significant associations between the outcome variable and the independent variables with a p-value less than 0.05.

RESULTS

A total of 409 pregnant women who had ANC follow-up have participated in this study. The majority 160 (39.1%) of the participants were in the age group of 25-29 years. The magnitude of male involvement in PMTCT service was 129 (29.8%). Number of ANC visits (3rd visit (AOR=2.36, CI=1.09, 5.10), 4th visit (AOR=3.49, CI=1.65, 7.38), birthplace interest (AOR=3.01, CI=1.16, 7.84), awareness about partner monthly income (AOR=2.17, CI=1.15, 4.11), source of family saving scheme (partner (AOR=2.99, CI=1.39, 6.43), self (AOR=8.59, CI=3.92, 18.82), both (AOR=5.13, CI=2.21, 11.92), maternal perception about the importance of consulting partner before HIV testing (AOR=9.30, CI=2.65, 32.64), and kinds of partner support (psychological (AOR=0.08, CI=0.02, 0.29), financial (AOR=0.33, CI=0.17, 0.68) were found to be significantly associated with male involvement in PMTCT.

CONCLUSION

This study found out that male partner involvement in PMTCT is low. Therefore, improving male partner involvement in PMTCT is recommended for improving maternal FANC service utilization and adherence with notification of their partner and provision of psychological and financial support.

Rate of Couple HIV Testing in a Prenatal Care Clinic and Factors Associated with Refusal of Testing Among Male Partners

Objective

To determine the rate of HIV testing in couples during pregnancy and the reasons and risk factors related to male partners refusing to be tested.

Materials and methods

This was a cross-sectional study conducted in pregnant women undergoing prenatal care after receiving information about HIV testing on their first visit. After 20 weeks of gestation, they were approached to participate in the study, which consisted of an interview and examination of their medical records. Data collection included the women’s socioeconomic status, obstetric condition and serological test results together with their partner information. If relevant, the partner’s reasons for refusing to undergo HIV testing.

Results

A total of 400 pregnant women were recruited between February and August 2018, 150 (37.5%) of whose male partners underwent HIV testing. There were five couples in which one or both members were found to be positive for HIV: 1 seroconcordant couple, 1 serodiscordant couple in which the pregnant woman was positive, and 3 serodiscordant couples in which the male partners were positive. The most common reason for male partners refusing to take the test was their already having been tested once before. The women having had other sexual partners prior to their current partners was a significant risk factor for the partners refusing to be tested.

Conclusion

There was a low rate of couple HIV testing and a substantial portion of discordant infection among positive couples. Routine couples counseling and testing should be encouraged to reduce the vertical transmission and the number of new cases of HIV infection.